As people are living longer, neurodegenerative disorders such as Alzheimer's disease (AD) are becoming more prevalent but the pursuit for treatments has yet to deliver satisfactory results. By the time AD is diagnosed, the typical hallmarks of tangles and plaques are present and cognitive decline has occurred, pointing future research towards the early stages of the disease. Indeed, recent research has unearthed cell-autonomous atrophy of astrocytes in the early stages of AD, characterised by decreased cell size and loss of processes. This aberrant astrocyte morphology was present in both sporadic and familial AD models and manifests independently of senile plaques. These findings challenge the neuron-centric view of AD, granting glial cells an undeniable role in neurodegeneration. The exact mechanisms underlying aberrant astrocyte morphology are entirely unexplained. This thesis demonstrates that the Cas-family proteins, previously identified by GWAS as genetic risk-factors for late-onset AD, NEDD9 and CASS4 act as regulators of astrocyte morphology.
Primary human cortical astrocytes were transiently transfected in vitro with vectors mediating the overexpression or siRNA-induced knockdown of either NEDD9 or CASS4. Concurrent expression of GFP, which localised throughout the entire cell, permitted the visualisation of complete cellular morphologies, including fine processes. Morphological analysis by visual binning into morphological subtypes or 3D reconstruction followed by morphometric quantifications (e.g. surface area, volume) revealed that overexpression or knockdown of either NEDD9 or CASS4 induced significant changes in astrocyte morphology compared to controls. Moreover, manipulation of Cas-protein levels induced altered expression and sub-cellular distribution of key astrocyte functional markers, including glial fibrillary acid protein (GFAP) and the calcium-binding protein, S100B; mimicking the pathological phenotype reported in human iPSC astrocyte models of AD.
Hence, it appears that both NEDD9 and CASS4 are capable of inducing morphological and functional changes in human astrocytes and may therefore contribute to astrocyte pathology in AD.


Large and rare copy number variants (CNVs) at several loci have been shown to increase risk for schizophrenia. Aiming to discover novel susceptibility CNV loci, we analyzed 6882 cases and 11 255 controls genotyped on Illumina arrays, most of which have not been used for this purpose before. We identified genes enriched for rare exonic CNVs among cases, and then attempted to replicate the findings in additional 14 568 cases and 15 274 controls. In a combined analysis of all samples, 12 distinct loci were enriched among cases with nominal levels of significance ( P < 0.05); however, none would survive correction for multiple testing. These loci include recurrent deletions at 16p12.1, a locus previously associated with neurodevelopmental disorders ( P 5 0.0084 in thediscoverysampleand P 5 0.023inthe replication sample). Otherplausiblecandidatesincludenon-recurrent deletions at the glutamate transporter gene SLC1A1, a CNV locus recently suggested to be involved in schizophrenia through linkage analysis, and duplications at 1p36.33 and CGNL1 . A burden analysis of large ( > 500 kb), rare CNVs showed a1.2% excess incases after excluding known schizophrenia-associated loci, suggesting that additional susceptibility loci exist. However, even larger samples are required for their discovery.


This article explores how Korean exchange students organized their studies during exchange programs in Swedish higher education. For most students, the programs became a disordered period in relation to their education. The value of exchange studies seems mainly to be extra-curricular. Drawing upon actor network theory, the article argues that the students' way of organizing their studies is based not only on individual choice but also on relations to other actors in a network.


In this paper, a concatenated "super" string model based minimum classification error (MCE) model adaptation approach is described. We show that the error rate minimization in the proposed approach can be formulated into maximizing a special ratio of two positive functions. The proposed string model is used to derive the growth transform based error rate minimization for MCE linear regression (MCELR). It provides an effective solution to apply MCE approach to acoustic model adaptation with sparse data. The proposed MCELR approach is studied and compared with the maximum likelihood linear regression (MLLR) based model adaptation. Experiments on large vocabulary speech recognition tasks are performed. Experimental results indicate that the proposed MCELR model adaptation can lead to significant speech recognition performance improvement and its performance advantage over the MLLR based approach is observed even when the amount of adaptation data is sparse.


Researchers in comparative research are increasingly relying on individual level data to test theories involving unobservable constructs like attitudes and preferences. Estimation is carried out using large-scale cross-national survey data providing responses from individuals living in widely varying contexts. This strategy rests on the assumption of equivalence, that is, no systematic distortion in response behavior of individuals from different countries exists. However, this assumption is frequently violated with rather grave consequences for comparability and interpretation. I present a multilevel mixture ordinal item response model with item bias effects that is able to establish equivalence. It corrects for systematic measurement error induced by unobserved country heterogeneity, and it allows for the simultaneous estimation of structural parameters of interest.


The purpose of the course presented here is to introduce freshmen to embedded systems using LEGO Mindstorms, under an ANSI-C programming environment. The students build their own LEGO robots, make programs for them using ANSI-C, and operate them. By creating these LEGO robots, the students become more motivated, learning the basic concepts of embedded systems and how these concepts can be applied to real world problems.


Abstract Previous criteria for liver transplantation in patients with hepatocellular carcinoma (HCC) has predominantly emphasized the size and number of existent tumors; however, criteria have not included tumor biology, which may comprise a critical factor for predicting patient prognosis. This issue has been recognized in the Hangzhou criteria, which take tumor histopathologic grade and pre-transplant α-fetoprotein (AFP) level into consideration. However, neither histopathologic grading nor AFP level are precise enough to adequately represent tumor biology in patients with HCC. Recent research has indicated that the development and progression of HCC are driven by a subpopulation of liver cells with stem cell features (cancer stem cells, [CSCs]). Liver CSCs with cluster of differentiation (CD)133+ antigen positivity show a high tumorigenic capacity, and the increase in the percentage of CD 133+ liver cancer cells is consistent with increased levels of serum AFP. In addition, the number of CD90+ cells increases with the tumorigenicity of HCC, and a positive correlation between the number of circulating CD90+ liver CSCs and disease progression has been observed. As liver CSCs can be detected using the CD profile and could more accurately represent tumor biology in HCC, we hypothesized that liver CSCs with specific phenotypes could be used for modifying the Hangzhou criteria, thereby providing valuable guidance for the development of more accurate prognosis prediction algorithms for patients with HCC being considered for liver transplantation. We provide reliable evidence supporting this hypothesis, and offer proposals for future applications in transplant practice.


Background: Lymph node metastases on routine histology are a strong negative predictor for survival after resection of perihilar cholangiocarcinoma. Additional immunohistochemistry can detect lymph node micrometastases in patients that are otherwise node-negative, but the prognostic value is unsure. The objective of this study was to assess the effect on survival of immunohistochemically detected lymph node micrometastases in patients with node-negative (pN0) perihilar cholangiocarcinoma on routine histology. Methods: Between 1990 and 2010 a total of 146 patients underwent curative-intent resection of perihilar cholangiocarcinoma with regional lymphadenectomy in two university medical centers in the Netherlands. Ninety-one patients (62%) without lymph node metastases at routine histology were included. Micrometastases were identified by multiple sectioning of all lymph nodes and additional immunostaining with an antibody against cytokeratin 19 (K19). The association with overall survival was assessed in univariable and multivariable analysis. Median follow-up was 48 months. Results: Micrometastases were identified in 16 of 324 lymph nodes (5%), corresponding to 11 of 91 patients (12%). There were no differences in clinical variables between K19 lymph nodepositive and negative patients. Five-year survival rates in patients with lymph node micrometastases were significantly lower compared to patients without micrometastases (27% versus 54%, P=0.01). Multivariable analysis confirmed micrometastases as an independent prognostic factor for survival (adjusted Hazard ratio 2.4, P=0.02). Conclusions: Lymph node micrometastases are associated with worse survival after resection of perihilar cholangiocarcinoma. Immunohistochemical detection of lymph node micrometastases leads to better staging of patients who were initially diagnosed with node-negative (pN0) perihilar cholangiocarcinoma on routine histology. Lymph node micrometastasis


Deep generative neural networks (DGNNs) have achieved realistic and high-quality data generation. In particular, the adversarial training scheme has been applied to many DGNNs and has exhibited powerful performance. Despite of recent advances in generative networks, identifying the image generation mechanism still remains challenging. In this paper, we present an explorative sampling algorithm to analyze generation mechanism of DGNNs. Our method efficiently obtains samples with identical attributes from a query image in a perspective of the trained model. We define generative boundaries which determine the activation of nodes in the internal layer and probe inside the model with this information. To handle a large number of boundaries, we obtain the essential set of boundaries using optimization. By gathering samples within the region surrounded by generative boundaries, we can empirically reveal the characteristics of the internal layers of DGNNs. We also demonstrate that our algorithm can find more homogeneous, the model specific samples compared to the variations of ϵ-based sampling method.


This is an exploratory study aimed at addressing the epistemological basis of Knowledge Management, and its suitability to address work-based issues specifically related to Knowledge Management within Project Environments. These issues include repetition of mistakes, and a lack of timely information availability and skill possession. Following an extensive literature review of current and historic Knowledge Management, Business and Philosophical literature (in particular the work of Martin Heidegger and Michael Polanyi), an epistemological approach was generated that opposes the popular 'objective' view of knowledge implicit in common Knowledge Management literature, reinterpreting it in terms of Heidegerrian Understanding and Interpretation.
Focus groups were then used to gather thematic data to generate evidence of the suitability of this approach, and to assess any implications arising from this new epistemological stance. The results showed support for the rejection of an objective view of knowledge, and that this rejection of certainty allows the various influences on how we justify and produce 'knowledge'. The study concludes that the true dynamic and personal nature of knowledge means it cannot be managed, and that the production and dissemination of information should be assessed in terms of requirements of efficiency vs. sufficiency, and any assumptions made regarding method, and the origin of the information.


It is estimated that 40% of all individuals that experience a TIA will ultimately suffer a stroke. As many as 50% of these patients will have a stroke within one week post TIA. Given the short time interval between TIA symptomology and stroke onset, immediate treatment is warranted. Historically treatment of TIA patients has taken place in emergency rooms and as hospital inpatients. A TIA clinic was established in 2011 as an alternative option to traditional TIA treatment. This clinic was designed to expedite diagnosis and treatment while reducing cost. Utilizing the ABCD2 tool, emergency department clinicians, PCPs and ophthalmologists referred low risk patients to the clinic. Clinic patients were scheduled to be seen in the clinic within 24-48 hours. All testing, stroke/TIA education, neurological consultation and secondary treatment plan were completed during the clinic visit. To date, the clinic has evaluated 137 patients. There have been no reports of stroke 90-days post clinic visit. Stroke rates post TIA are estimated to be as high as 17% after 3 months. This data supports the TIA clinic's success in secondary stroke prevention. Patients seen in the clinic reported high satisfaction scores with the clinic and the care they received. It was initially hypothesized that the TIA clinic would provide care in a more cost effective way. A cost analysis was performed comparing TIA clinic costs and the cost of treating patients admitted to the hospital. Using fiscal year 2014 data, the average cost for treating a patient in the clinic was $423. The average cost for admitting a patient to the hospital was $1,464 per patient. The TIA clinic has shown that patients can receive timely treatment in a setting that produces the highest clinical outcomes, maintains patient satisfaction and reduces cost by 70%.


When Georgia was incorporated into the Russian Empire, the rich background of interaction with Persian culture, the result of centuries of contact, was lost to the scholar whose interest in Georgian history came to depend on Russian historiography with its focus on the period under Russian rule and its misreading of anything prior to that. Western scholarship, often oblivious of the far reach of Persian culture, devoted too little attention to the subject or gave it short shrift. Owing largely to the recent work of Georgian scholars, a century of neglect is now being reversed, but an overall picture of the breadth and depth of Georgian-Iranian interaction is still lacking. This paper proposes to offer a general overview from the third millennium BCE to the Russian conquest of Georgia, when Persian influence began its decline.


Oncogenesis can be induced by chronic and acute RNA tumor viruses through a promoter/enhancer insertion mechanism and through a transforming protein coded by a viral oncogene (v-onc), respectively. A hypothetical trans-activating mechanism is invoked by retroviruses with trans-activating regulatory proteins. So far, in humans only HTLV-I has been firmly linked to a malignancy. The same virus is also implicated in slowly progressing neurological disorders. Except for transformation by viral oncogenes, these mechanisms give rise to monoclonal tumors.


This paper is devoted to a study of $S$-curves, that is systems of curves in the complex plane whose equilibrium potential in a harmonic external field satisfies a special symmetry property ($S$-property). Such curves have many applications. In particular, they play a fundamental role in the theory of complex (non-hermitian) orthogonal polynomials. One of the main theorems on zero distribution of such polynomials asserts that the limit zero distribution is presented by an equilibrium measure of an $S$-curve associated with the problem if such a curve exists. These curves are also the starting point of the matrix Riemann-Hilbert approach to srtong asymptotics. Other approaches to the problem of strong asymptotics (differential equations, Riemann surfaces) are also related to $S$-curves or may be interpreted this way. Existence problem $S$-curve in a given class of curves in presence of a nontrivial external field presents certain challenge. We formulate and prove a version of existence theorem for the case when both the set of singularities of the external field and the set of fixed points of a class of curves are small (in main case -- finite). We also discuss various applications and connections of the theorem.


A survey of current and voltage distortion levels measured at 76 different sites is presented. Over 5000 pairs of current and voltage waveforms were recorded and analyzed for this study. In addition to summarizing the harmonic levels at the various industrial, commercial, and substation sites, the authors use data at a particular nonlinear load site to show how US utilities may be failing to collect the correct revenues from power factor penalty clauses. The instrumentation used to collect the field data is briefly described. The results of the field measurements are discussed, with particular emphasis on the problem sites identified during the project. >


This volume contains the proceedings of the 2017/2018 edition of the Academy Assistant program organized by the Network Institute of Vrije Universiteit Amsterdam (http://networkinstitute.org/research/academy-assistants/). With this program the Network Institute aims to interest bright young master students for conducting scientific research and pursuing an academic career. The program brings together scientists from different disciplines; every project combines methods & themes from informatics, social sciences and/or humanities. For each project, two student research assistants with different research backgrounds work together. The projects result in papers and/or research proposals. The program started in 2010 with 4 projects funded by the KNAW.


This article systematizes speech registers employed in in-law avoidance into a cross-linguistic typology. Such affinal avoidance registers, consisting of lexical repertoires substituting for "everyday" speech forms tabooed for certain speakers or in certain contexts, are shown to typically diverge from one another in terms of two parameters, their context-sensitivity and the relatively idiolectal or sociolectal character of their register repertoires. Comparative data illustrate that Aboriginal Australian "mother-in-law" speech registers, which are context-sensitive and exclusively sociolectal, are highly exceptional among affinal avoidance registers cross-linguistically. In the final section of the article I seek to understand this exceptionalism in terms of the broader context of Aboriginal Australian ethnolinguistics.


In women, tumors of the breast remain the most frequently diagnosed malignancy and the second leading cause of cancer-related deaths. One of the hallmarks of carcinogenesis is the abnormal silencing of tumor supprsssor genes by both genetic and epigenetic alterations, leading to defects in cell-cycle control, DNA repair, apoptosis and cell adhesion. This dissertation focuses on the elucidation of the genetic and epigenetic mechanisms associated with tumor suppressor gene silencing in human epithelial breast tumor cells, and the development of pharmacologic strategies aimed at reversing these types of repression through gene therapy and chromatin remodeling. Desmocollin 3 (DSC3) and MASPIN are anti-metastatic tumor suppressor genes that are silenced in a large percentage of breast tumors via aberrant DNA hypermethylation and histone hypoacetylation of their promoters. DSC3 and MASPIN are also p53-target genes, requiring its transcriptional activation to promote normal expression levels, yet a significant fraction of breast tumor cell lines express mutant forms of p53. Adenoviralmediated re-introduction of wild type (wt) p53 into mutant p53-expressing breast tumor cells resulted in significant up-regulation of DSC3 and MASPIN expression, although not to the levels seen in normal breast epithelial cells. Mechanistically, the addition of wt p53 to these tumor cells resulted in increased histone acetylation and enhanced chromatin accessibility of the DSC3 and MASPIN promoters, despite continued cytosine hypermethylation. Pre-treatment with the DNA methyltransferase inhibitor 5-aza-2'deoxycytidine (5-aza-CdR) prior to wt p53 addition produced synergistic reactivation of both DSC3 and MASPIN in breast cancer cells, approaching their levels in normal 17 mammary cells. However, 5-aza-CdR did not significantly reduce DNA methylation in many cases as originally theorized. Therefore, follow-up studies focused on the identification of alternative, novel mechanisms of 5-aza-CdR-mediated induction of epigenetically silenced genes, finding that it consistently reduced transcriptionally repressive histone H3 lysine 9 (K9) methylation levels in the promoter regions of both DSC3 and MASPIN in breast tumor cells, by mediating global decreases in the histone H3 K9 methyltransferase, G9A. In summary, these results clearly show that cancer treatments targeting both genetic and epigenetic facets of gene regulation may be a useful strategy towards the therapeutic transcriptional reprogramming of cancer cells.


CD9, a member of the tetraspanin family, has been implicated in hematopoietic and leukemic stem cell homing. We investigated the role of CD9 in the dissemination of B acute lymphoblastic leukemia (B-ALL) cells, by stably downregulating CD9 in REH and NALM6 cells. CD9 expression was associated with higher levels of REH cell adhesion to fibronectin and C-X-C motif chemokine receptor 4 (CXCR4)-mediated migration. Death occurred later in NOD/SCID mice receiving REH cells depleted of CD9 for transplantation than in mice receiving control cells. After C-X-C motif chemokine ligand 12 (CXCL12) stimulation, CD9 promoted the formation of long cytoplasmic actin-rich protrusions. We demonstrated that CD9 enhanced RAC1 activation, in both REH cells and blasts from patients. Conversely, the overexpression of a competing CD9 C-terminal tail peptide in REH cytoplasm decreased RAC1 activation and cytoplasmic extension formation in response to CXCL12. Finally, the inhibition of RAC1 activation decreased migration in vitro, and the depletion of RAC1 protein from transplanted REH cells increased mouse survival. Furthermore, a testis-conditioned medium induced the migration of REH and NALM6 cells, and this migration was impeded by an anti-CD9 antibody. The level of CD9 expression also influenced the homing of these cells in mouse testes. These findings demonstrate, for the first time, that CD9 plays a key role in the CXCR4-mediated migration and engraftment of B-ALL cells in the bone marrow or testis, through RAC1 activation.


Inulooligosaccharides (IOS) represent an important class of oligosaccharides at industrial scale. An efficient conversion of inulin to IOS through endoinulinase from Aspergillus niger is presented. A 1482 bp codon optimized gene fragment encoding endoinulinase from A. niger DSM 2466 was cloned into pPIC9K vector and was transformed into Pichia pastoris KM71. Maximum activity of the recombinant endoinulinase, 858 U/mL, was obtained at 120 h of the high cell density fermentation process. The optimal conditions for inulin hydrolysis using the recombinant endoinulinase were investigated. IOS were harvested with a high concentration of 365.1 g/L and high yield up to 91.3%. IOS with different degrees of polymerization (DP, mainly DP 3-6) were distributed in the final reaction products.


The following report outlines the results of focus group discussions that were conducted to help researchers learn what it is about wetlands, wetland services, and wetland characteristics that matter to people. The participants were asked questions in the areas of natural resources, their prior knowledge of wetlands, wetland types, public policies relating to wetlands, and wetland functions. The focus group discussions reported here were the first set of qualitative discussions in the research project. The purpose of the discussions was to create a basis of information concerning the respondents' perceptions and understanding of wetland uses and functions. These initial focus groups represent a first step in a larger project that will develop and test stated preference instruments for valuing ecosystem characteristics associated with freshwater wetlands. The information on respondents' uses, perceptions, and knowledge of wetland functions will be used to develop survey instruments and serve as the starting point for out wetlands research.


The detection of defects or cracks in rail track plays an important role in railway management, which prevents train accidents in both summer and rainy seasons. During summer, the cracks are formed on the track which slips the train wheel. In rainy environment, the rail tracks are affected by corrosion which also produced cracks on it. Methods: In present method, the cracks or defects are detected Echo image display device or semi conduction magnetism sensor devices which consumes more time. The proposed method enhances the track image using adaptive histogram equalization technique and further features as Grey Level Co-occurrence Matrix (GLCM) and Local Binary Pattern (LBP) feature are extracted from the enhanced rail track image. These extracted features are trained and classified using neural network classifier which classifies the rail track image into either cracked or non-cracked image. The novelty of this work is to use soft computing approach for the detection of cracks in rail tracks. This methodology is trained by several crack images which are obtained from different environment. This method automatically classifies the current image based on the trained patterns, thus improves the classification accuracy. Findings: The performance of the proposed system achieves the accuracy rate of 94.9%, with respect to manually crack detected and segmented images.


Doctors and nurses working at the accident and emergency (A&E), and intensive care departments are at risk of burnout. They often spend substantial time in intense interactions with other people, centered on patients? health problems (physical, psychological and social) that may lead to feelings of anger, anxiety and frustration, and eventually to burnout. Burnout is a syndrome of emotional exhaustion, depersonalization and reduced personal accomplishment (Maslach & Jackson, 1981) The purpose of this chapter is to assess work stressors, burnout and stress-coping mechanisms among doctors and nurses at the A&E and intensive care departments. A quantitative design using the survey approach was used to collect data from a sample of 200 participants with a response rate of 71% (n=154) Work stressors were associated with burnout in both doctors and nurses. Workload was the most salient work stressor in the sample. Nurses experienced more stress (M=1.5, SD=0.4) than doctors (M=1.2, SD=0.4) in all the work stressor variables examined. The A&E department was reported as more stressful than the intensive care department. Avoidance-oriented and task-oriented coping were the most and the least frequently reported coping strategies respectively. Additionally, only emotion-oriented coping strategy was significantly different between doctors and nurses, and this strategy was also significantly positively correlated with all the variables in the adapted nursing stress scale, and the three burnout variables. Death and dying was most strongly correlated with emotion-oriented coping. This chapter provides an assessment of stress, burnout and coping experienced by both doctors and nurses within the A&E and intensive care departments. Methods that may mitigate stress in these environments may be adequate staffing, supportive management, stress management programs, as well as improvement in communication strategies between doctors and nurses.


Individuals increasingly rely on healthcare virtual support communities (HVSCs) for social support and companionship. While research provides interesting insights into the drivers of informational support in knowledge-sharing virtual communities, there is limited research on the antecedents of emotional support provision and companionship activities in HVSCs. The unique characteristics of HVSCs also justify the need to reexamine members' voluntary provisions of help in such communities. This paper develops a model that examines the relationships between the structural, relational, and cognitive dimensions of social capital and the provision of informational and emotional support, and engagement in companionship activities in HVSCs. The model is tested based on data generated through an automated method that classifies and analyzes user-generated text in three healthcare virtual support communities (breast, prostate, and colorectal cancer). The results show that all three dimensions of social capital impact the provision of emotional support; both structural and relational capital facilitate engagement in companionship activities; and only cognitive capital enables the provision of informational support. Research and practical implications on the need to facilitate informational and emotional support provision and companionship activities in healthcare virtual support communities are discussed.


Pseudomonas aeruginosa is a germ of hospitalism respon- sible for nosocomial infections; it is naturally resistant to many antibi- otics and has a high susceptibility to the acquisition of acquiring new resistance. The observation of strains highly resistant to antibiotics, has led us to look for possible alternative therapeutics. This study was a descriptive and cross-sectional one, conducted from October 2010 to March 2011. All patients hospitalized for at least 48 hours and showing sign of infection were included after obtaining their consent. Forty nine of 150 samples were positive to the cultivation of Pseudomonas aerug- inosa showing a prevalence of 32.66%. For the antibiotic susceptibility, we obtain amikacin 57.14%, netilmicin 59.20%, ceftazidime 52.60%, imipenem 33%, colistin 97.95%, and ciprofloxacin 51%. Seven strains were resistant to all antibiotics tested other than colistin. One strain was resistant to colistin. Colistin retains high sensitivity to Pseudomonas aeruginosa. However, there are some strains multiresistant to antibi- otics.


Objective: To utilize clinical data from emergency department admissions and published clinical case reports from the 2001 bioterrorism-related inhalation anthrax (IA) outbreak to develop a detection algorithm for syndromic surveillance.

Methods: A comprehensive review of case reports and medical charts was undertaken to identify clinical characteristics of IA. Eleven historical cases were compared to 160 patients meeting a syndromic case definition based on acute respiratory failure and the presence of mediastinal widening or lymphadenopathy on a chest radiograph.

Results: The majority of syndromic group patients admitted were due to motor vehicle accident (52%), followed by fall (10%), or other causes (4%). Positive culture for a gram positive rod was the most predictive feature for anthrax cases. Among signs and symptoms, myalgias, fatigue, sweats, nausea, headache, cough, confusion, fever, and chest pain were found to best discriminate between IA and syndromic patients. When radiological findings were examined, consolidation and pleural effusions were both significantly higher among IA patients. A four step algorithm was devised based on combinations of the most accurate clinical features and the availability of data during the course of typical patient care. The sensitivity (91%) and specificity (96%) of the algorithm were found to be high.

Conclusions: Surveillance based on late stage findings of IA can be used by clinicians to identify high risk patients in the Emergency Department using a simple decision tree.

Implications for public health: Monitoring pre-diagnostic indicators of IA can provide enough credible evidence to initiate an epidemiological investigation leading to earlier outbreak detection and more effective public health response.


OBJECTIVE
Considerable research indicates that both high levels of anxiety and female sex are associated with increased sensitivity to experimental pain and greater experience of clinical pain. In general, however, previous research has not investigated the joint effects of sex and anxiety on pain responses. A single previous laboratory-based study indicated that anxiety was inversely related to pain thresholds among men but not among women. The present study examined the relation between pain-related anxiety and adjustment to chronic pain in a sex-dependent manner.

DESIGN AND SETTING
A total of 215 (114 women, 101 men) chronic pain patients referred to a multidisciplinary treatment center completed questionnaires assessing anxiety and adjustment to chronic pain.

RESULTS
Results generally supported the previous laboratory-based finding indicating that an inverse relation between anxiety and adjustment to chronic pain was present only among male patients. Although male patients with high pain-related anxiety reported greater pain severity, greater interference of pain, and lower levels of daily activity than male patients with low anxiety, this effect was not present among female patients. Moreover, the effects of pain-related anxiety on adjustment to chronic pain were not attributable to either hypervigilance or use of passive coping strategies. Potential explanations and implications for the present findings are discussed.


We used cDNA probes from Aedes albopictus mosquito cecropins AalCecA, B, and C to obtain genomic DNA copies and flanking DNA. Two gene copies (AalCecA1 and A2, AalCecB1 and B2, AalCecC1 and C2) encoding each of the three mature cecropin peptides were recovered. All these genes had a similar organization, into two exons interrupted by a single short intron. AalCecA1 and AalCecA2 encode mature protein products that differ by one amino acid residue, while AalCecB1 and AalCecB2, AalCecC1 and AalCecC2 encode identical mature cecropin peptides, respectively. The AalCecB and C gene pairs each share a common intergenic region of approximately 1 kb, with the two coding regions transcribed in opposite directions. With the exception of small insertions/deletions, the intergenic spacer region was highly conserved between the B1/C1 and B2/C2 clones. In transfected cells, 0.8 kb of upstream sequence was sufficient for inducible expression of AalCecA1. Within this region, a 28 bp sequence at positions –192 to –165 upstream of the transcription initiation site was found to contain a potential regulatory element. In electrophoretic mobility shift assays, synthetic double‐stranded DNA containing this 28 bp sequence retarded protein in cytoplasmic and nuclear extracts from C7‐10 cells.


In this study, the Golgi method for light microscopy, transmission and conventional scanning electron microscopy, the ethanol-cryofracturing technique, the freeze-fracture method for SEM, and the freeze-etching method have been used in conjuction to analyze the three-dimensional cytoarchitectonic arrangement and intracortical circuits of vertebrate cerebellar cortex. Approximately more than 100 specimens of mice, rat, teleost fishes and human cerebelli were processed by the above mentioned techniques. A chronological review of other methods for studying hidden surfaces of cerebellar nerve cell has been also described. The three-dimensional morphology, outer and inner surfaces of granule, Golgi, Purkinje and stellate cells were reviewed by means of a correlative and comparative study. The cerebellar circuits formed by mossy and climbing fibers with granule cell dendrites and Purkinje cell-granule cell synapses have been traced by ethanol-cryofracturing technique, freeze-fracture method for SEM and freeze-etching technique. These findings have been correlated with previous light and electron microscope findings published in the last century. Some advantages and limitations of each method are pointed out. The review emphasizes the paramount importance of correlating light microscope Golgi method with ethanol-cryofracturing and slicing techniques for SEM. The correlation between freeze-fracture method for SEM and freeze-etching technique provides a new approach for studying three-dimensional morphology of nerve cells at cellular and macromolecular levels. This modern methodology of three-dimensional analysis offers new potential areas for future experimental investigation in embryology and pathology of the central nervous system.


BACKGROUND
Exercise training may reduce blood pressure.

AIM
To determine the effects of a high intensity interval training (HIIT) exercise protocol on systolic and diastolic blood pressure in hypertensive subjects.

MATERIAL AND METHODS
Eleven men and 27 women aged 46.4 ± 9.8 years were divided in two groups according to their blood pressure. Sixteen were classified as normotensive and 22 as hypertensive. All attended an exercise program with 3 sessions per week for a total of 24 sessions. Each session consisted of one minute of intense exercise performed on a stationary bike, followed by an inactive pause lasting two minutes. This cycle was repeated 10 times and it was thus called 1 * 2 * 10. Blood pressure, weight (kg) and body fat were assessed.

RESULTS
In the hypertensive group, there was a significant reduction in systolic blood pressure from 145.4 ± 9.0 to 118.3 ± 15.6 mm Hg (p < 0.05). No significant change was observed in diastolic blood pressure (84.9 ± 3.9 and 85.8 ± 17.6 mmHg. Thus, there was a mean reduction in systolic pressure of 27. 7 ± 18.9 mmHg. Therefore, 73% of patients achieved systolic pressures within normal range, without medication.

CONCLUSIONS
The 1 * 2 * 10 exercise method is effective to improve and restore normal blood pressure in persons with hypertension in a period of two months and 24 sessions.


Very small domains are recorded on the MAMMOS disk and they ran be detected using RF readout field. The MO signal amplitude of 20 nm domains can be enhanced to the saturated signal level. For these small domains, the thermal stability problem is investigated. Even if high laser power for readout is irradiated to the small domains, the reproduced signal was maintained. The result indicates that the recording layer of TbFeCo possesses an advantage for paramagnetic limit problem over 100 Gbits/in/sup 2/.


Information relating to the resistance of food allergens to thermal and/or chemical denaturation is critical if a reduction in protein allergenicity is to be achieved through food-processing means. This study examined the changes in the secondary structure of an almond allergen, amandin, and its acidic and basic polypeptides as a result of thermal and chemical denaturation. Amandin ( approximately 370 kDa) was purified by cryoprecipitation followed by gel filtration chromatography and subjected to thermal (13-96 degrees C) and chemical (urea and dithiothreitol) treatments. Changes in the secondary structure of the protein were followed using circular dichroism spectroscopy. The secondary structure of the hexameric amandin did not undergo remarkable changes at temperatures up to 90 degrees C, although protein aggregation was observed. In the presence of a reducing agent, irreversible denaturation occurred with the following experimental values: T(m) = 72.53 degrees C (transition temperature), DeltaH = 87.40 kcal/mol (unfolding enthalpy), and C(p) = 2.48 kcal/(mol degrees C) (heat capacity). The concentration of urea needed to achieve 50% denaturation was 2.59 M, and the Gibbs free energy of chemical denaturation was calculated to be DeltaG = 3.82 kcal/mol. The basic and acidic polypeptides of amandin had lower thermal stabilities than the multimeric protein.


The focus of this paper is on the design of robust controllers based on the range of expected variation of uncertain parameters from their nominal values. A minimax optimization problem is formulated with the objective of minimizing the maximum value of the cost function over the range of the uncertain parameter. To expedite the optimization process, equations are derived for the gradient of the cost and constraint functions with respect to the parameters of the controller. The proposed technique is illustrated on two examples. The first is a spring-mass-dashpot and the second is a two-mass-spring benchmark problem.


Human T-cell leukemia virus type I (HTLV-I)-infected T-cells constitutively express surface Fas ligand (FasL), which may serve as a mechanism of viral pathogenesis. HTLV-I induces transcription of FasL gene through the viral transactivator Tax, although the underlying molecular mechanism remains unclear. In the present study, we have analyzed both the cis-activating element and transactivating factors involved in Tax activation of the FasL promoter. We show that the 486-base pair upstream region of the human FasL gene is sufficient for Tax-mediated transactivation in Jurkat T-cells. Interestingly, a palindromic DNA sequence (GGAAACTTCC) covering the consensus NF-ATp binding site (GGAAA), is required for Tax activation of FasL promoter. The involvement of NF-AT in this transactivation event is suggested by the finding that Tax fails to activate the FasL promoter in a Jurkat T-cell line defective in capacitative calcium entry, a signaling mechanism involved in NF-AT activation. Furthermore, activation of FasL promoter by Tax is largely attenuated in the nonlymphoid F9 embryonal and COS kidney cells deficient in NF-ATp expression. DNA-protein interaction assays reveal that the NF-AT-like motif in the FasL promoter is bound by both NF-ATp and NF-AT4 in Jurkat T-cells expressing Tax. The binding of NF-ATp, although not NF-AT4, to this enhancer also occurs along with HTLV-I-mediated infection of human peripheral blood T-cells. Furthermore, exogenously transfected NF-ATp binds to the NF-AT-like enhancer and participates in Tax-mediated FasL promoter transactivation. These results suggest an important role for proteins of the NF-AT family in HTLV-I Tax-mediated FasL gene transactivation.


The mouse anti-idiotypic (anti-id) mAb MK2-23 bears the mirror image of the antigenic determinant defined by antihuman high molecular weight-melanoma associated antigen (HMW-MAA) mAb 763.74. The purpose of this study was to evaluate the effect of conjugation to a carrier and administration with an adjuvant and cyclophosphamide (CTX) on the immunogenicity of anti-id mAb MK2-23 in patients with malignant melanoma and to analyze the relationship between development of humoral immunity and survival time of patients. Fifty-eight patients were sequentially entered into four immunization protocols which included administration of mAb MK2-23, mAb MK2-23 conjugated to keyhole limpet hemocyanin (KLH) and mixed with Bacillus Calmette-Guérin (BCG), mAb MK2-23 and CTX, and mAb MK2-23 conjugated to KLH and mixed with BCG and CTX. Six patients could not be evaluated since they withdrew from the clinical trial after the first immunization. Sera were tested for the development of anti-anti-id antibodies, including those reacting with HMW-MAA. Testing of sera for development of antimouse Ig antibodies was used to monitor the immune competence of patients. Conjugation to KLH and administration with BCG markedly enhanced the ability of mAb MK2-23 to induce anti-anti-id antibodies, including those reacting with HMW-MAA. In contrast, pretreatment with CTX had no detectable effect on the ability of mAb MK2-23 to elicit a humoral anti-anti-id response. Kaplan-Meier survival analysis showed that the performance status of patients, anti-anti-id antibody level, and development of anti-HMW-MAA antibodies had an effect on survival time. This effect was found when the survival time was calculated both from the day of the first immunization and from 4 weeks after the first immunization to the end of the study. A multivariate analysis by Cox regression showed that the development of anti-HMW-MAA antibodies was the most important variable for predicting survival, and that performance status was the only variable that significantly added to the prediction of survival. These data have to be interpreted with caution because of the retrospective nature of the analysis. Nevertheless, the present study suggests that mAb MK2-23 represents a useful immunogen to implement active, specific immunotherapy in patients with malignant melanoma.


Microbial activities are key to our planet's habitability and sustainability since they play essential roles in shaping and controlling virtually every natural system including our atmosphere, oceans, soils, and every plant and animal. Microbes exist in different metabolic states in these systems: growing, active, dormant, and recently deceased. These metabolic states correspond to different degrees of influence that a microbe can have on its environment. Therefore, to understand the relationships between microbial community patterns and ecosystem functions, it is important to accurately associate microbial identity with concurrent metabolic state. Through my research I strive to improve our understanding of microbial population, community, and process dynamics in soils and how to apply this information to better predict changes in ecosystem function. I applied a combination of community molecular analyses, chemical and physical characterizations, and process measurements to explore microbial mechanisms, interactions, and responses to changes in their environment. Nucleic acid analysis has proven to be an effective avenue for characterizing the phylogenetic, taxonomic, and functional structure of microbial assemblages, but this approach has limitations when attempting to assess current metabolic state. Ribosomal RNA genes (rRNA genes) have frequently been used to identify microorganisms present in environmental samples regardless of metabolic state, while ribosomal RNA (rRNA) has been widely applied to identify the active fraction of microbes. Chapter 1 re-evaluates utilizing rRNA as an indicator of microbial activity in environmental samples. A growing body of evidence indicates that the general use of rRNA as an indicator of metabolic state in microbial assemblages has serious limitations. This chapter highlights the complex and often contradictory relationships between rRNA, growth, and activity. Potential mechanisms for confounding rRNA patterns are discussed, including differences in life histories, life strategies, and non-growth activities. Ways in which rRNA data can be used for meaningful characterization of microbial assemblages are presented.Chapter 2 presents direct measurements of growth, mortality, and survival for bacteria and fungi following the rewetting of dry soil. The rapid stimulation of microbial activity that occurs when a dry soil is rewetted has been well documented and is of great interest due to implications of changing precipitation patterns on soil C dynamics. Many studies have characterized net changes in microbial populations, but gross population dynamics for bacteria and fungi following wet-up are not well understood. Here, DNA stable isotope probing with H2 18 O was coupled with quantitative PCR to characterize new growth, survival, and mortality for bacteria and fungi following the rewetting of a seasonally dried California annual grassland soil. This study documents both net and gross changes that bacterial and fungal populations underwent over the course of 7 days after wet-up. A pulse of non-growth activity appears to immediately follow wet-up followed by linear growth for both bacteria and fungi. Mortality dynamics indicate that dead microbial bodies provide a large pool of available C and nutrients, thus offering insight into possible C sources fueling the CO2 pulse following wet-up. Results reveal that a vibrant assemblage of growing and dying organisms may comprise a seemingly static microbial community following a change in the environment. The bacterial growth stimulated by the rewetting of dry soil was further characterized using high throughput sequencing of 16S rRNA genes, and results are presented in Chapter 3. Of the 25 different phyla present in the pre-wet community, members of the Firmicutes Bacillales order were the only detectable early responders with close to a 5% increase in relative abundance from growth in the first 3 h after wet up. The second group of growers detected at 24 h included only Betaproteobacteria and Bacteroidetes. Members of the Burkholderiales order in the Betaproteobacteria phylum were by far the dominant growers during this period with a 21% increase in relative abundance. The highest richness of growing bacteria was detected during the third time-period (between 24-72 h), with significant changes in relative abundance due to growth found in 11 phyla. Nonmetric multidimensional ordination of community composition data through time shows a somewhat cyclical pattern for phylogenetic composition of growing bacteria with composition at 3 hours differing slightly from the pre-wet community, differing greatly at 24 h, and then becoming progressively more similar to the pre-wet community at 72 and 168 h. This suggests a degree of community resilience in response to this abrupt environmental change. However, some net compositional changes were observed following wet-up. Actinobacteria were the most dominant pre-wet phylum, but Proteobacteria became the most dominant phylum by 168 h. This change in composition was likely driven by new growth since Proteobacteria were found to grow in abundance for most of the incubation while Actinobacteria only grew during two later time periods and with smaller increases in relative abundance. Sequential growth patterns found at the phylum and order level suggest that ecologically coherent response was observable at a high taxonomic level.Chapter 4 shifts emphasis to anaerobic oxidation of methane (AOM) in Tropical and Boreal soils. AOM is a considerable sink for the greenhouse gas methane (CH4) in marine systems, but the importance of this process in terrestrial systems is less clear. Lowland boreal soils and wet tropical soils are two hotspots for CH4 cycling, yet AOM has been essentially uncharacterized in these systems. We investigated AOM in soils from sites in Alaska and Puerto Rico. Isotope tracers were utilized in vitro to enable the simultaneous quantification of CH4 production and consumption without use of biological inhibitors. Boreal peat soil and tropical mineral soil oxidized small but significant quantities of CH4 to CO2 under anoxic conditions. Potential AOM rates were 21 p 2 nmol gdw -1 d -1 and 2.9 p 0.5 nmol gdw -1 d -1 for the boreal and tropical soils, respectively. The addition of terminal electron acceptors (NO3 - , Fe(III), and SO4 2- ) inhibited AOM and methanogenesis in both soils. In all incubations, CH4 production occurred simultaneously with AOM, and CH4 production rates were always greater than AOM rates. There was a strong correlation between the quantity of CH4 produced and the amount of CH4 oxidized under anoxic conditions. CH4 oxidation under anoxic conditions was biological and likely mediated by methanogenic archaea. While only a small percentage of the total CH4 produced in these soils was oxidized under anoxic conditions (0.3% and 0.8% for Alaskan and Puerto Rican soils), this process is important to understand since it could play a measurable role in controlling net CH4 flux.


A pilot study on acceptability of voluntary HIV testing with counselling was performed in a rural village in Kagera, Tanzania as a potential intervention against HIV transmission. Village residents were prepared by their leaders and subsequently invited to health education group meetings to volunteer for the test. Consenting individuals were interviewed to determine awareness and acceptance of the offer followed by pre-test counselling and taking of a blood sample for subsequent HIV testing. Two months later, the results of the test were returned with post-test counselling coupled with a short interview of a random sample of adults in the village. Of the 245 adults responding to the call, 137 (55.9%) subsequently volunteered. The main reason for volunteering was to know the HIV status (96%). Among those who were aware of the offer, the main reason for not volunteering was that they felt unlikely to catch AIDS, implying that they had a false perception of being at low risk. In this study a significant proportion were willing to volunteer for the HIV test and to receive the results, indicating a moderate level of acceptability. The results also indicate the need for developing innovative ways of enhancing acceptability of voluntary HIV testing with counselling. However, the relationship between knowledge of HIV status and behavioural change is complex and therefore several potential mechanisms may exist by which HIV testing in combination with counselling can influence behaviour. For this reason, people should be given the choice of knowing their HIV status since it may constitute a potential mechanism for influencing behaviour towards reduction of HIV transmission.


BACKGROUND AND OBJECTIVES
Hypothyroidism is highly prevalent among ESRD patients, but its clinical significance and the benefits of thyroid hormone replacement in this context remain unclear.

DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS
This study examined the association between hypothyroidism and all-cause mortality among 2715 adult dialysis patients with baseline thyrotropin levels measured between April of 2005 and April of 2011. Mortality was ascertained from Social Security Death Master Index and local registration systems. The association between hypothyroidism (thyrotropin greater than assay upper limit normal) and mortality was estimated using Cox proportional hazards models. To reduce the risk of observing reverse-causal associations, models included a 30-day lag between thyrotropin measurement and at-risk time.

RESULTS
Among 350 (12.9%) hypothyroid and 2365 (87.1%) euthyroid (assay within referent range) patients, 917 deaths were observed during 5352 patient-years of at-risk time. Hypothyroidism was associated with higher mortality. Compared with thyrotropin in the low-normal range (0.4-2.9 mIU/L), subclinical hypothyroidism (thyrotropin >upper limit normal and ≤10.0 mIU/L) was associated with higher mortality; high-normal thyrotropin (≥3.0 mIU/L and ≤upper limit normal) and overt hypothyroidism (thyrotropin >10.0 mIU/L) were associated with numerically greater risk, but estimates were not statistically significant. Compared with spontaneously euthyroid controls, patients who were euthyroid while on exogenous thyroid replacement were not at higher mortality risk, whereas patients who were hypothyroid were at higher mortality risk. Sensitivity analyses indicated that effects on cardiovascular risk factors may mediate the observed association between hypothyroidism and death.

CONCLUSIONS
These data suggest that hypothyroidism is associated with higher mortality in dialysis patients, which may be ameliorated by thyroid hormone replacement therapy.


This paper presents projections of demand for social care and disability benefits for older people (aged 65 and over) in England to 2041 and associated future expenditure. The projections were produced using an updated and expanded version of the Personal Social Services Research Unit's (PSSRU) long-term care projections model. The version of the model used here has a base year of 2005 and incorporates the 2006-based official population projections. This set of projections was commissioned jointly by the Department of Health (DH) and the Strategy Unit (Cabinet Office) (SU). The projections presented in this paper are an updated version of those discussed in Wittenberg et al (2006). They cover publicly and privately funded social care –assessments, community-based services and residential care. They also cover disability benefits relevant for care – attendance allowance (AA) and disability living allowance (DLA) care component. They do not cover supported housing because of lack of suitable data, nor do the projections reported here cover health care which was not part of the remit.


Under certain exposure conditions, a femtosecond laser beam focused in the bulk of fused silica leads to the formation of self-organized structures consisting of a series of "nanolayers," parallel to one another. Remarkably, this laser-induced nanoscale anisotropy offers the possibility to locally engineer macroscopic properties of a given substrate by selectively exposing it in arbitrarily chosen locations to a laser beam with designed polarization states. Although various physical properties are affected by the laser, this paper specifically discusses in-plane elastic properties of these nanostructures. Using a method based on monitoring resonant properties of vibrating cantilevers combined with a mechanical model of the nanostructures, the Young's moduli of individual nanolayers are calculated and used to define the stiffness matrix of the composite structure. The model shows a good agreement with measured mechanical properties of arbitrarily oriented nanostructures. This work demonstrates the predictability and controllability of laser-induced nanoscale mechanical properties and offers a framework for engineering arbitrary elastic properties through 3D laser writing.


Structural integrity practitioners can encounter countless, complex and often unknown uncertainties when dealing with myriad applications. The existence of such uncertainties can span the lifecycle of engineering assets: commissioning, design, prototyping, material testing, manufacturing, physical testing, in-service data, inspection data, fitness-for-service assessments and decommission. Traditionally, a deterministic mindset has prevailed amongst the engineering community at large. However, given the widening acceptance of data science and machine-learning across a plethora of industries, trends towards accepting more probabilistic and data-driven solutions have emerged in engineering. Structural integrity is facing a similar change, with the nuclear sector now slowly recognising that there are strong needs that can be fulfilled by probabilistic paradigms. Presently the use of probabilistic approaches in the nuclear sector has been limited, bespoke and mainly summoned when traditional deterministic approaches fail to deliver business targets due to over conservatism. This work formulates a complete methodology based on the Monte-Carlo approach for conducting probabilistic calculations, focusing on applications considering the R5 Volume 2/3 procedure for high-temperature Advanced Gas Reactor (AGR) components. The presented methodology is generic enough to be applicable to a host of structural integrity applications. A number of case-studies are presented in Chapter 3-6 which consider specific implementation issues including the probabilistic representation of input parameters, treatment of correlations, loading uncertainties, conducting post-assessment sensitivity analyses, the extrapolation of assessment location probabilities to component-level and, thereafter, to population-level estimates. With the presented methods having implications for structural integrity applications in general, one of the aims of this work is to bridge the gap between the knowledge of statistical and probabilistic methods on one side, and the general structural integrity community on the other end. Consequentially, this work is intended to promote further implementation and engagement, aiding further acceptance within a wide range of structural integrity fields, and ultimately encouraging the creation of a unified probabilistic framework for structural integrity.


Abstract Analyses of feces, stomach contents, and regurgitated pellets are common techniques for assessing diets of vertebrates and typically contain more than 1 food item per sampling unit. When analyzed, these individual food items have traditionally been treated as independent, which represents pseudoreplication. When food types are recorded as present or absent, these samples can be treated as multinomial vectors of food items, with each vector representing 1 realization of a possible diet. We suggest such data have a similar structure to capture histories for closed-capture, capture–mark–recapture data. To assess the effects of landscapes and presence of a potential competitor, we used closed-capture models implemented in program MARK into analyze diet data generated from feces of swift foxes (Vulpes velox) and coyotes (Canis latrans) in northwestern Texas. The best models of diet contained season and location for both swift foxes and coyotes, but year accounted for less variation, suggesting that landscape type is an important predictor of diets of both species. Models containing the effect of coyote reduction were not competitive (ΔQAICc  =  53.6685), consistent with the hypothesis that presence of coyotes did not influence diet of swift foxes. Our findings suggest that landscape type may have important influences on diets of both species. We believe that multinomial models represent an effective approach to assess hypotheses when diet studies have a data structure similar to ours.


We develop a systematic approach to synthesize distributed control laws for motion coordination in a group of constant-speed kinematic rigid bodies. Parallel and balanced circular formations of mobile agents moving in a three dimensional space are studied, and provably correct steering laws are presented. The resulting steering laws have simple geometric intuitions which are based on the structure of each particular formation.


Judicial review establishes whether the mandate of Congress is observed by an agency's rule-making mechanisms for setting environmental standards or other regulations. Central issues in risk assessment now include whether a risk is significant, what the burden of proof for significance is, how to resolve the tension between the effort to reduce hazardous exposures and the goal of efficient regulation, and precisely how and in what detail the costs of regulation must be measured. Under current regulatory statutes, there are several paradigms for balancing costs and benefits.


Characterized by limited or almost inexistent social skills, autistic children imperatively need social integration, in order to ensure a positive social environment in which they could imitate their colleagues and develop better means of communication. A sample of 60 teachers from public and special schools, aged between 29 and 50 years old, was assessed using Inclusion of Children with Special Needs in Public Schools Questionnaire (Chițu, Barcau & Blaga, 2016) in order to analyse their opinions and attitudes towards inclusive education. A sample of 75 children (aged between 8 and 12 years old) with Autistic Spectrum Disorder, with whom these teachers interact, was assessed with Adaptive Behaviour Assessment System II (ABAS II, Harisson & Oakland, 2012). We found significant differences regarding communication, community use and self-care, social skills and general adaptive composite (GAC score), between children in special and public schools. Furthermore, teachers emphasize that: (1) society, in general, has a tolerant attitude toward children with educational special needs; (2) families with such children choose a public school mostly in order to integrate their children in society and to ensure them the right to equal chances; (3) differential assessment strategies are needed for these children and adaptation of the curriculum to their needs; (4) children with special needs have a real chance of success in a public school. Results are analysed in relationship with teacher's roles, opinions and attitudes toward the integration of autistic children in public schools.


Background and Objectives
Focusing on sex, the most salient topic featured in ageist jokes, this study aims at exploring the extent to which seniors' own humor reflects common ageist stereotypes or rather echoes contemporary consumer society representations of seniors' sexuality.

Research Design and Methods
The study was based on a quantitative content analysis of 300 humorous sex-related messages posted during one full year by members of 14 leading online communities for seniors.

Results
Findings indicated that whereas the portrayal of older adults in humor typically relied on negative ageist stereotypes, their representation in seniors' online sex-related humor depended on the social identity of the butt of this humor. If it was an in-group member (oneself, another community member, or the community as a whole), the portrayal was rather positive, but when the butt belonged to the out-group (older adults in general), the depiction was far more ageist. Nonetheless, the representation of older butts of humor was generally more positive than that of the younger ones.

Discussion and Implications
These findings suggest that seniors tend to identify with current cultural representations of sexuality in later life and use sex-related humor as a personal means of resisting ageism. They apply two principal strategies: Distancing-reproducing certain ageist stereotypes by ascribing them to other older adults, but less so to their own group and even less than that to themselves-and equalizing older and younger individuals, even according the former an advantage regarding sexuality.


The seedlings quality is one of the most important factors in the implantation of new orchards. In this sense, this work aimed to evaluate the emergence and initial development of Cape gooseberry seedlings with different substrate compositions. The experiment was performed in the experimental area of Federal Technological University of Parana, Campus of Dois Vizinhos, Brazil. The experimental design used was a randomize block design, with four replications, being evaluated the following substrates: Soil + chicken manure (2:1 v/v); soil + chicken manure + sand (2:1:1); soil + humus + vermiculite (2:1:1); soil + humus (2:1) and Macplant® (commercial substrate). The emergence percentage, number of leaves, height of plants, dry mass of root system and dry mass of the shoot system was evaluated. The substrate compound by soil + humus + vermiculite and the substrate compound by soil + humus allowed higher emergence of plants, however not contributing for the development of the Cape gooseberry seedlings. Nevertheless, the substrate with soil + chicken manure and the substrate with soil + chicken manure + sand only provided the initial development of the seedlings. On the other hand, the use of the substrate Macplant® must be avoided in the propagation of this culture.

 Key words: Exotic fruits, propagation, germination, Macplant®, vermiculite.


Sharks are commonly caught in Indonesian waters both by target fisheries and as bycatch. Fishers targeting sharks mostly employ drift longlines, whereas tuna longlines and gillnets are the gear mostly responsible for shark bycatch. Our studies on shark fisheries have been conducted since 2006 and have focused on the eastern Indian Ocean region, the most exploited area in Indonesian waters. Sharks are mostly landed as bycatch in the tuna fishery (using longlines and gillnets) in Cilacap, Central Java province, and as targeted catch by the pelagic shark fishery at Tanjung Luar (Lombok, West Nusa Tenggara province), one of the largest targeted shark fisheries in Indonesia. Eight years (2006–2013) of monthly shark bycatch data from the fishing port at Cilacap and one year (February 2012–January 2013) of daily catch data from Tanjung Luar were analysed to determine their respective contributions to shark landings in Indonesia's Eastern Indian Ocean Fisheries Management Region. A total catch of 1 364 t of sharks was recorded at Cilacap, with an average monthly catch of 14.2 t (SD 18.5). A total of 1 426 sharks were recorded at Tanjung Luar, with an average daily catch of five individuals. Whaler sharks (Carcharhinidae) were the most commonly caught in both fisheries, consisting primarily of silky sharks Carcharhinus falciformis in the targeted fishery and blue sharks Prionace glauca in the tuna fishery. Overall, the Cilacap bycatch contributed 4.7% of the annual shark landings in the region. In 2012, the fishery at Tanjung Luar contributed 5.2% of the regional shark landings. The relatively low recorded contributions of these two fisheries may be inaccurate and may reflect double‑counting at the provincial level. Given the different shark species composition, the two fisheries require different management and conservation strategies to be included in Indonesia's National Plan of Action for the Conservation and Management of Sharks (NPOA‑Sharks).


In this essay prepared for the Connecticut Law Review's 2012 symposium, Reform of the Legal Education System for the 21st Century, I propose an alternative to the dominant metaphor of "lawyer as warrior" for educating the many lawyers whom clients will seek out as counselors even at early stages in their careers. My preferred metaphor is "lawyer as psychoanalyst" because it invokes the need for lawyer-counselors to understand clients' idioms and meanings, or more generally "what's going on" beyond the mere analysis and application of the rules of positive law. Like lawyers, psychoanalysts learn a technical discipline (whether either discipline constitutes a science) but need to apply it non-technically in the process of counseling patients. I consider implications of the metaphor for lawyer-counselors and their education, concluding with some preliminary and modest suggestions about how reflection on the "repressed positivistic" and "courting surprise" might benefit our students in the "what's going on" aspect of client-centeredness.


We study the nurse staffing problem under random nurse demand and absenteeism. While the demand uncertainty is exogenous (stemming from the random patient census), the absenteeism uncertainty is endogenous, i.e., the number of nurses who show up for work partially depends on the nurse staffing level. For the quality of care, many hospitals have developed float pools of nurses by cross-training, so that a pool nurse can be assigned to the units short of nurses. In this paper, we propose a distributionally robust nurse staffing (DRNS) model that considers both exogenous and endogenous uncertainties. We derive a separation algorithm to solve this model under an arbitrary structure of float pools. In addition, we identify several pool structures that often arise in practice and recast the corresponding DRNS model as a monolithic mixed-integer linear program, which facilitates off-the-shelf commercial solvers. Furthermore, we optimize the float pool design to reduce the cross-training while achieving a specified target staffing costs. The numerical case studies, based on the data of a collaborating hospital, suggest that the units with high absenteeism probability should be pooled together.


Author(s): Clarke, Lorraine Weller | Advisor(s): Jenerette, Darrel | Abstract: Urban agricultural systems, like community and home gardens, may act as oases of biodiversity in cities dominated by impervious surfaces. They have also been shown to bridge gaps in food security and provide socio-cultural benefits. Despite these benefits, little research has been conducted that evaluates factors influencing garden plant biodiversity and ecosystem services (ES). Also less intensively researched are ecosystem disservices that gardens can contribute to, like gardener exposure to heavy metals. Urban soil can act as a sink for heavy metal contamination, which is mostly deposited through anthropogenic pollution. This dissertation addresses knowledge gaps about ES with two comprehensive surveys of garden biodiversity and ES production, one on community gardens in Los Angeles (LA), CA and one on home gardens across an urbanizing gradient in Beijing, China. It also addresses disservices and bioavailability of three heavy metals (lead, arsenic, and cadmium) through a soil survey and sequential analysis of heavy metals in LA gardens. My main results indicate an overall shift in biodiversity from provisioning (food and medicinal production) to cultural (ornamental) services with increased gardener income and access to city resources (like grocery stores or markets) in both U.S. and Chinese gardens. This result supports a hierarchy of need, where gardeners preferentially plant species that support their most pressing needs, like food security. Urbanized regions in Beijing and immigrant-run gardens in Los Angeles also formed culturally distinct assemblages of edible species based on shared agricultural experiences. As the most common use for species was food, understanding metal bioavailability is important for accurate risk assessments. Lead, particularly in reducible form, increased the most with age of neighborhood, indicating oxidized lead paint buildup. Cd and As exchangeable fractions increased with proximity to road, indicating sources from air pollution. Finally, while Cd became less bioavailable with increased organic matter, reaction with organic humic acids released reducible As into the bioavailable fraction. These quantitative results can inform land managers about valued biodiversity and provisioning service from gardens in food insecure regions, as well as valuable information on how to predict metal accumulation hotspots and reduce plant uptake of metals.


Metabolism involves multiple elements. While we know much about the allometry in metabolic response of organisms to energy (carbon, C) availability, little is known about how different-sized organisms respond to the relative availability of elements. I experimentally manipulated availability of phosphorus (P) relative to C, to test whether dietary C : P affects metabolism in four species of Daphnia, spanning an order of magnitude in body mass. Results indicated that the slope of the relationship between individual respiration and body mass was M(0.83) under a balanced diet (C : P c. 150), and M(0.67) under an imbalanced diet (C : P c. 800). Increased respiration under dietary imbalance was not due to increased ingestion. The change in the scaling exponent was due to the greater respiratory response of smaller species to altered diets. Diet-induced metabolic plasticity contributes to variation in metabolic allometry, at least at such small scales of body size.


To acquire images of dynamic scenes from multiple points of view simultaneously, the acquisition time of vision sensors should be synchronized. Although the influences of background light and the amplitude fluctuation have been successfully eliminated, it is still necessary to distinguish the frame indexes of multiple synchronized vision sensors. In this paper, an illumination-based synchronization derived from the phase-locked loop (PLL) mechanism based on the Manchester Encoding technique is proposed and evaluated. The blinking illumination signal can carry the sequential information by being arbitrarily modulated as pseudo random sequence. Simulated results demonstrated the successful synchronization result that 1,000-Hz frame rate vision sensors can be successfully synchronized to a LED illumination modulated to be 250 Hz with satisfactory stability and jitters.


Aiming to identify new opportunities for future research on joint audits (JAs), a literature review is conducted to reveal the major insights arising from the last ten years (e.g. the countries implementing JA, the number of ordinary and pilot project cases, costs and failures of JAs). In terms of the methodology applied, a total of 116 published works, spanning authors from 17 countries, were found. The analysis included: the year of publication; most-cited articles and authors; most-active journals and publishers; authorship and affiliation; type of study; and related topics addressing the JA. The findings provide evidence that there are an increasing number of JA studies, approximately 11 publications per year, but that this overall trend is mainly the result of an increase in studies published in Germany. The data suggests that the number of publications addressing JA is decreasing in other countries. The data demonstrates a strong correlation between the number of JA cases and the number of publications. Ninety-five per cent of German studies are published in German, which makes it difficult to capture the experience and knowledge worldwide. None of the research papers found address the topic of JAs on an empirical basis. Most publications have focused on an examination of the legal framework, JA pilot projects analysis, real cases discussion and research on the obstacles to an efficient JA procedure. Various authors have presented their own approach to defining, providing a final result and the legal bases of the JA, which are sometimes similar to the OECD proposal to audit cross-border activities jointly, and sometimes different. Representatives of the tax administration are responsible for publishing half of all publications. The Bavarian Ministry of Finance seems to be the world's leading testing ground on JAs to date.


BACKGROUND
The use of the Internet for health purposes increases in the Norwegian population, more in some demographic groups than in others. In this questionnaire-based study, we explore the use of the Internet for such purposes.

MATERIAL AND METHOD
1007 Norwegians aged 15 years and older were interviewed by telephone in October 2005.

RESULTS
58% of the respondents in 2005 had used the Internet for health purposes, compared to 31% in 2001. Having visited the GP last year, being female, being young, living in a urban area, and having a white-collar occupation were positively related to the use of the Internet for health purposes. 37% of the respondents considered the Internet to be an important or very important source of health information. 72% considered face-to-face communication with health care personnel to be important or very important. Nearly a quarter of the users (23%) reported that they had felt reassured by health information found on the net, whereas 10 % experienced increased anxiety from the same type of information.

CONCLUSIONS
Norwegians' use of the Internet for health purposes continues to grow, but doctors and other health care personnel remain the most important sources of health information in the Norwegian population.


The goal of this research is to develop an integrative modelling technique that is easy enough to be used by most business users with little training, but robust and structured enough to be used in subsequent Information Systems Development (ISD) modelling. This technique attempts to bridge the current gap between modelling on a business level and modelling on a technical level. The overall research methodology is design science research, embedding a grounded approach, to develop an integrative modelling technique. The resultant artefact is applied to a case study to test its applicability and suitability, and the results are evaluated. The results show that the proposed integrative modelling technique that is based on a better understanding of the fundamental entities in business and ISD modelling and their properties, attributes and relationships, can be used as a method to model business situations easily and expressively. By overcoming the divide between business and ISD modelling, the technique also advances informal, mostly textual, business modelling. The paper makes a methodological contribution by establishing a new technique that integrates business analysis with ISD, as well as demonstrating how a single case study could serve as an exemplar of a theory.


Civic integration policies shape migrants' pathway to residence and citizenship in Europe and North-America. These policies invite or oblige migrants to learn the customs and language of their new country of residence. Either by inculcating migrants with certain skills and knowledge, or by barring certain migrants from accessing national territory and citizenship, civic integration policies are instruments through which states purport to shape their nations. In this epilogue to the thematic dossier on civic integration policies in France and Canada, I explore this state endeavour to shape the nation through civic integration, high-lighting paradoxical features that are common to civic integration policies in Canada, France, and elsewhere in the "Western" world. The paradoxical nature of civic integration policies has been noted by scholars in this thematic dossier and beyond. Civic integration policies appear to vacillate between civic education and selection: aiming to emancipate, assimilate, and exclude migrants — all at the same time. Civic integration policies emphasize the national values that found the national identity — but these values are defined very similarly in all countries which introduced civic integration policies. Civic integration policies impose a legal obligation on migrants to prove their will to integrate — as if free will were compatible with compulsion. In order to elucidate these paradoxes in civic integration policies, I propose to draw parallels with the colonial governance and production of ethnoracial difference. In drawing these parallels, I take to heart the warning of Sayad (1994: 10) that "while the comparison between the colonial situation yesterday and the immigration situation today is very illuminating" it cannot and should not "mask the essential difference, difference in nature, between these two cases." Indeed, racial hierarchies persist in contemporary European and North American social structures and informal state practices and discourses, they are no longer laid down either in law or in official state ideology, as the case in colonial contexts (Hajjat, 2012: 35). in governance as in civic integration (re)produce


Livestock produce gaining popularity in recent years is helping in sustainable livelihood security and poverty alleviation. It has given rise to the need for a critical analysis on various aspects of climate, sustainability, preference and performance etc. With a stratified random sampling technique a study was conducted in Dibrugarh, Kamrup and Bongaigaon districts of Upper Assam, Middle Assam and Lower Assam respectively in flood affected blocks selected for data collection. At the village level, random sampling method on the basis of lottery was adopted to select the respondents. Precision investigations were ensured by the check lists and methods specially prepared for the purpose of this study. Information was collected personally by the researchers in a pre-tested, reliable and valid interview schedule containing the features of micro climate indicators. The data such collected were arranged, tabulated and analyzed so as to arrive at useful conclusion and interpretation. Flood was recognized as the most important factor affecting livestock in all the three districts. The micro-climate factors affecting livestock production had no significant mean difference among the districts in Assam. The major micro-climatic factors affecting livestock production in order of their impact were Flood (6.09%), Less availability of grass (5.82%), Parasitic infestation (5.72%), Education (5.66%) and Draught (5.56%). Flood had significant affect and the five critical indicators of micro-climate could express as high as 35.00 per cent of the variations in livestock production, although there was a significant difference as far as R value (1.75*) was concerned.


Abstract A histopathological survey of wild blue shrimp Penaeus stylirostris from the Gulf of California, Sonora, Mexico, revealed the presence of infectious hypodermal and hematopoietic necrosis virus (IHHNV). The survey performed at 39 sampling stations during August–September 1990, showed the prevalence of IHHNV infection to be 46% in the upper Gulf zone and 26% in the central–lower Gulf zone. The presence of IHHN virus was confirmed with the IHHNV-specific gene probe BA401 by means of in situ hybridization. Specimens of the Pacific brown shrimp P. californiensis (also known as yellowleg shrimp) and Pacific white shrimp P. vannamei, incidentally captured during the survey, were also analyzed and found to be infected by IHHNV. The survey demonstrated that IHHNV had widespread distribution in a region where it had not been previously detected and, presumably, was not present before 1987. These findings suggest that IHHNV has become established in wild populations of P. stylirostris, and perhaps in P. cal...


Mammary epithelial cells were isolated from either abdominal-inguinal glands or mammary tumours of rats, after enzymic digestion of the tissues, and were analysed for polyamine content. Optimum conditions were developed for the isolation of cells in sufficient yield for the analysis of polyamines from 1 g of mammary gland or 0.5 g of tumour tissue. Complete recoveries of the polyamines in the tissues were achieved in the isolated epithelial cells.


The aging of the Romanian population is a phenomenon that begins to manifest increasingly. With an average of 16.14% old people, there are significant differences both between residential areas and at the territorial level. The problems of the older people are multiple and increasingly intractable in the context of the external migration of young adults and of the health system challenges. This article aims, on the one hand, to analyze the size of the aging population at the local level and secondly, to identify possible answers of the Romanian society to the problems of older people. In this context the attitude of the members of the society, old or not, towards the problems of older people is analyzed. How does the society respond to the needs of older people? Who are the actors involved in solving the problems of older people? Do Romanian authorities succeed in dealing with this challenge? Is the Romanian society aware of the change of the family structure and of the consequences that this implies?


PURPOSE
We present a new single-step algorithm for volumetric modulated arc therapy (VMAT) planning. The algorithm is inspired by the observation that IMRT plans with a large number of beams (e.g., N=20) yield near-optimal treatment plans. However, an arc sequencing step to convert an IMRT plan into a deliverable VMAT plan compromises quality or delivery efficiency. To avoid this caveat, we devise a single-step method to directly optimize the MLC leaf trajectories.

METHODS
In our approach, a full 360-degree arc is divided into N arc segments in which the leaves move unidirectionally, i.e. an intensity-modulated field is delivered over each arc segment using a sliding window technique. We formulate the VMAT optimization problem in terms of the leaf trajectories over each arc segment, including all machine and time constraints. Assuming constant dose-influence matrices in each arc segment and constant gantry speed, this optimization problem is convex. Thus, we can reliably determine the optimal VMAT plan under these restrictions. An extension of this basic model is devised that accounts for a varying dose influence matrix within each arc segment.

RESULTS
The algorithm allows us to find highly conformal treatment plans, deliverable in a short time. Allowing for enough delivery time, the algorithm is guaranteed to match the ideal IMRT plan. For prostate cases, the plans are observed to closely approximate the ideal plan with 3-4 minutes delivery time. Head-and-neck results are similarly promising.

CONCLUSION
The results indicate that high quality single-arc treatments can be delivered with 20 arc segments if sufficient time is allowed for modulation in each segment. Our current implementation is customized towards finding optimal VMAT plans for constant gantry speed and dose rate, which is desirable in practice. In the future, the model can be extended to allow variable dose rate and more general leaf trajectories. Research supported by Philips Radiation Oncology Systems.


The female reproductive organs such as ovary, uterus, and placenta are some of the few adult tissues that exhibit regular intervals of rapid growth, and are highly vascularized and have high rates of blood flow. Angiogenesis is a process of vascular growth that is mainly limited to the reproductive system in healthy adult animals. The development of new blood vessels in the ovary and uterus is essential to guarantee the necessary supply of nutrients and hormones. The genetic and molecular mechanisms that control the development of capillary blood vessels in the reproductive organs are beginning to be elucidated. Reproductive organs contain and produce angiogenic factors which may act alone or in concert to regulate the process of vasculature. Vascular endothelial growth factors (VEGFs) and fibroblast growth factor (FGFs) are key factors for vascular system in the reproductive organs. Recent numerous studies reported several roles of VEGFs and FGFs on ovarian and uterine functions. In this review, we focus on the involvement of VEGFs and FGFs as angiogenic factors on reproductive organs and vascular therapy for diseases of reproductive organs using anti-angiogenic agents.


Systematics and the Origin of Species from the Viewpoint of a Zoologist has remained an essential text on the bookshelves of evolutionary biologists since it was first published. Here, I expand upon several topics touched upon by Ernst Mayr to look at how our thinking has evolved, and is evolving, with particular reference to molecular phylogenetic studies on islands. At the time of publication, apart from the fossil record, inferences of temporal trends or patterns could only be speculative, deduced from the distributions of species and the patterns that these present. Much like the subject material itself, evolutionary biology evolves as a discipline, with an increasing availability of tools and resources. The development of molecular phylogenetics and molecular markers has given biologists a new window on the past and, as such, the ideas and explanations of Mayr have become more accessible to testing.


We describe an alternative syntactic binding for C++. This new binding includes a completely redesigned declaration/definition syntax for types, functions and objects, a simplified template syntax, and changes to several problematic operators and control structures. The resulting syntax is LALR(1) parsable and provides better consistency in the specification of similar constructs, better syntactic differentiation of dissimilar constructs, and greater overall readability of code.


BACKGROUND
The hepatoid variant of yolk sac tumor (H-YST) is an exceedingly rare and highly malignant neoplasm. We present and discuss our experience with cytologic and histopathologic features of a mediastinal H-YST presenting with sternum metastasis, which to the best of our knowledge has not been previously reported.

CASE
A 38-year-old man presented with a large mass on the sternum. Computed tomography of the thorax showed a large anterior mediastinal mass with sternum metastsis and multiple lung metastases. Laboratory examination revealed elevated serum alpha-fetoprotein (60,000 IU/mL). No tumor was found in the other organ systems. A percutaneous fine needle aspiration biopsy and subsequent open surgical biopsy were performed on the sternum metastasis. Cytologically, the tumor was composed of monotonous, large, round to polygonal hepatoid cells forming solid sheets and trabeculae entrapped with endothelial cells resembling hepatocellular carcinoma. Histopathologic sections of tumor showed tumor cells with eosinophilic to clear cytoplasm arranged in a solid, trabecular growth pattern, with some acinar formations. Immunohistochemical study supported the hepatoid origin.

CONCLUSION
Fine needle aspiration cytology, together with the characteristic clinical presentations and specific tumor markers, is crucial to the initial diagnosis of H-YST.


ABSTRACT Cryptococcus gattii is a primary pathogenic yeast, increasingly important in public health, but factors responsible for its host predilection and geographical distribution remain largely unknown. We have characterized C. gattii STE12α to probe its role in biology and pathogenesis because this transcription factor has been linked to virulence in many human and plant pathogenic fungi. A full-length STE12α gene was cloned by colony hybridization and sequenced using primer walk and 3′ rapid amplification of cDNA ends strategies, and a ste12αΔ gene knockout mutant was created by URA5 insertion at the homologous site. A semiquantitative analysis revealed delayed and poor mating in ste12αΔ mutant; this defect was not reversed by exogenous cyclic AMP. C. gattii parent and mutant strains showed robust haploid fruiting. Among putative virulence factors tested, the laccase transcript and enzymatic activity were down regulated in the ste12αΔ mutant, with diminished production of melanin. However, capsule, superoxide dismutase, phospholipase, and urease were unaffected. Similarly, Ste12 deficiency did not cause any auxotrophy, assimilation defects, or sensitivity to a large panel of chemicals and antifungals. The ste12αΔ mutant was markedly attenuated in virulence in both BALB/c and A/Jcr mice models of meningoencephalitis, and it also exhibited significant in vivo growth reduction and was highly susceptible to in vitro killing by human neutrophils (polymorphonuclear leukocytes). In tests designed to simulate the C. gattii natural habitat, the ste12αΔ mutant was poorly pigmented on wood agar prepared from two tree species and showed poor survival and multiplication in wood blocks. Thus, STE12α plays distinct roles in C. gattii morphogenesis, virulence, and ecological fitness.


"Instead of applying Western concepts of historical analysis to China, [Schrecker] seeks to understand modern history, both of China and of the West, through Chinese historiographical categories. The reader will appreciate not only the Chinese historiographical tradition but also the way this tradition enriches one's understanding of world history. An ambitious, much needed study." Akira Iriye, Harvard University, Past President, American Historical Association "John Schrecker has written a historical narrative certain to be of great value to students of politics and society. It is at once lively and engaging and theoretically sophisticated. By adopting a Chinese perspective and applying it not only to China itself but also to the interventions of the West, Schrecker opens the way for a new comparative history." Michael Walzer The Institute for Advanced Study Princeton


One of the most controversial Medicare issues has been the timing of reimbursement for losses incurred on advance refundings of bond indebtedness. The U.S. Court of Appeals for the Sixth Circuit has handed down a decision on this issue. In Guernsey Memorial Hospital v. Secretary of Health and Human Services, the court ruled in favor of providers.


Following the discovery in the early 1960s that mitochondria contain their own DNA (mtDNA), there were two major advances, both in the 1980s: the human mtDNA sequence was published in 1981, and in 1988 the first pathogenic mtDNA mutations were identified. The floodgates were opened, and the 1990s became the decade of the mitochondrial genome. There has been a change of emphasis in the first few years of the new millennium, away from the "magic circle" of mtDNA and back to the nuclear genome. Various nuclear genes have been identified that are fundamentally important for mitochondrial homeostasis, and when these genes are disrupted, they cause autosomally inherited mitochondrial disease. Moreover, mitochondrial dysfunction plays an important role in the pathophysiology of several well established nuclear genetic disorders, such as dominant optic atrophy (mutations in OPA1), Friedreich's ataxia (FRDA), hereditary spastic paraplegia (SPG7), and Wilson's disease (ATP7B).The next major challenge is to define the more subtle interactions between nuclear and mitochondrial genes in health and disease.


The majority of the US population is affiliated with faith-based organizations (FBO). Health and wellness activities (HWAs) within FBOs have great potential for reach, though the factors influencing faith-based HWA are not well understood. The purpose of this study was to examine individual faith leader and institutional influences on HWAs offered within FBOs. A national convenience sample of faith leaders (N = 844) completed an online survey assessing individual (demographics, health, health behaviors and attitudes) and institutional influences (size, location and external support) on health and HWA within FBO. Respondents were primarily White (93%), male (72%), middle-aged and affiliated with Methodist (42.5%) or Lutheran (20.2%) religions. Respondents reported 4.8 ± 3.2 HWA within their FBO per year. Faith leader education, length of service to the FBO, physical activity and fruit/vegetable intake were positively related to HWA and body mass index was negatively related. Denomination, congregation diversity, location and size were also related to HWA. Results show a strong relationship between faith leaders' health and HWA, indicating the influence of the social environment on health promotion in FBOs. Institutional variables, though not modifiable, were significant predictors of HWA and should be considered when delivering interventions to achieve a significant impact.