Background Typically, public health systems at lower levels (district and below) do not have the required authority and/or resources to substantially improve the local health systems. Understanding factors that explain differential health outcomes allows them to improve system's effectiveness within their limited authority and resources. This paper presents an analysis of the health care provided by 24×7 primary health centres (PHCs). It provides evidence of how different components of the local health system affect PHC performance leading to differential health outcomes. Recommendations are made to improve performance of 24×7 PHCs in the study area. Methods This study was conducted in 37 24×7 PHCs in the 7C districts of North-Karnataka (Bagalkote, Bidar, Bijapur, Gulbarga, Koppal, Raicur and Yadgir). Performance of 24×7 PHCs was measured using the keystone indicator 'live deliveries per thousand population'. A modified version of WHO's health systems framework (to accommodate for local contextual factors with other systemic factors) was used to analyse factors influencing performance. PHCs were grouped into high performance (H-PHCs: 15), medium performance (M-PHCs: 9) and low performance (L-PHCs: 12). The WHO's six building blocks (service delivery, human resource, medicine availability, financing, information and governance) were contrasted among the three groups. Findings Our study found systematic differences in the quantity and quality of human resource, services provided and the overall effectiveness between the three groups of PHCs. The average monthly deliveries in the three groups were: 48.5 (H-PHCs), 18.2 (M-PHCs) and 6.4 (L-PHCs). As reported by the mothers, 80% of deliveries were conducted by staff nurses. Infrastructure, availability of medicines (both generic as well as delivery-specific) and availability of funds did not differ substantially across the three groups. The location parameters of H-PHCs do not suggest specific reasons for high patient loads or higher birth rates. H-PHCs were prompt in providing benefits like Janani Suraksha Yojana and Madilu kits. They also provided higher numbers of out- and in-patient services, emergency services and other services like laboratory tests in comparison to other groups. PHCs with women doctors had considerably higher average deliveries per thousand per year (15) compared to those without women doctors (8). 73% of H-PHCs had women doctors whereas the proportion was about 30% in L-PHCs. 80% of the H-PHCs had two or more doctors, whereas this proportion was about 30% in L-PHCs. 86% of H-PHCs had three or more staff nurses whereas the proportion was about 61.5% for L-PHCs. Staff nurses in H-PHCs were better trained. The duration of continuous service of staff nurses in H-PHCs was greater in comparison to that of M-PHCs and L-PHCs. Only five out of the 37 PHCs had staff nurses trained in basic emergency obstetric care. Discussion & conclusions PHCs in backward districts of Karnataka face systemic and contextual challenges. These include: (1) high patient density; (2) absence of basic infrastructure like clean toilets and running water; (3) vacancies and job insecurity in key positions; (4) lack of training in basic emergency obstetric care; (5) rampant prescription of steroids by registered medical practitioners; (6) bias against the female child; (7) high fertility rates; (8) malnutrition; and (9) poverty. Even in the presence of these challenges, H-PHCs are able to provide greater levels of services in comparison to other groups. They have greater proportion of women doctors, presence of two or more doctors, doctors staying in the headquarter villages and greater number of staff nurses. These factors positively influence the performance of these PHCs substantially even though the status of fund availability is same as other PHCs. An important conclusion is that in these generally backward districts, the rationing and selective provisioning of human resources in reference to patient density is short sighted. Staff nurses conduct a majority of deliveries. Investing on capacity building and provision of stable career paths for staff nurses could yield better returns in the short term. Exploring policies for attracting women medical officers for rural services is another issue that has proportionately greater impact on improving effectiveness of 24×7 PHCs. While larger systemic challenges exist in public health care in India, not all policy changes need to happen at the national and state levels. This study provides an example of a micro-level analysis of a health system that provides evidence to authorities at lower levels in the system, to respond to local contextual issues for improving service delivery within their jurisdiction. Together with larger policy reforms, these evidence based implementation level adaptations of existing policies could be crucial for rapid improvement of health status in India. Grant funding (Karnataka State Health Systems Resource Centre) for research, but no other competing interests.


Introduction In patients presenting with chest pain, the presence of Left Bundle Branch Block (LBBB) on the ECG may obscure the diagnosis of acute myocardial infarction (AMI). Patients with LBBB caused by AMI are shown to benefit significantly from rapid provision of reperfusion therapy, yet evidence suggests this is often underprovided. Difficulties in the identification of AMI in these patients is the most commonly cited reason. Aims To determine whether the application of the simplified Sgarbossa criteria to undifferentiated chest pain patients presenting with ECG changes of LBBB, transmitted during the prehospital phase of care, will be positively predictive of a discharge diagnosis of AMI. Methods 785 ECGs were reviewed retrospectively and categorised based on their features. Those displaying LBBB and complete patient data were evaluated using the simplified Sgarbossa criteria and a decision made as to whether the patient had suffered AMI, a process which was blind peer reviewed. Results of cardiac biomarkers were traced and the diagnosis of AMI confirmed or refuted. Results Of the 785 ECGs reviewed and categorised 56 (7.1%) displayed the features of LBBB and 18 were eligible for inclusion in the study. The sensitivity and specificity of the Sgarbossa criteria were 50% and 75% respectively. Inter-observer reliability was κ=0.93 (almost perfect). Conclusion Despite excellent inter-observer agreement, the Sgarbossa criteria is too insensitive to be implemented in clinical practice as it cannot be relied upon to identify correctly, patients who have suffered AMI. Instead, diagnosis and management should proceed according to clinical judgement with reperfusion therapy administered following evaluation of risk verses benefit.


One hundred and thirty-six years ago six immigrant small selectors formed the Herbert River Farmers' Association (HRFA). On the Herbert a plantation mode of sugar production began in 1872. The selectors there, used the HRFA to actively participate in the transition of the tropical Australian sugar industry from plantation to small, family farms by 1914. Associations such as theirs formed the cornerstone of the institutional foundations of a globally unique and successful industry farmed by small, family farmers.

Principal exponents of sugar industry organization history have consistently dismissed the small sugar cane farmers' associations. Broader sugar industry scholarship however, identified them as having contributed to the demise of plantation production and the development of farm-based central milling. This assessment recognized that the HRFA and fellow small associations promoted small farming and that their members proved that white, small sugar farmers could farm in a tropical environment without detriment to their health and could provide a reliable supply of high-quality cane.

Agricultural associations in sugar growing regions in the period 1872 to 1914 were dominated by white elite planters, practising an exploitative mode of production that used unfree or indentured coloured labour. Furthermore, land was not distributed equally to planters and small farmers alike, denying the small farmers, white or otherwise, the type of independence that came to characterise Australian white, small, sugar farmers. Land ownership and the freedom to form associations allowed the small selectors of the Herbert River Valley in tropical north Queensland in the late nineteenth century to negotiate with the planters in a way that the tenant farmers and share-croppers in other sugar growing regions could not.

Accounts of the origins and nature of the sugar industry agricultural association movement focus exclusively on the planter associations while small sugar farmer associations are virtually invisible in the scholarship. Agricultural associations were vehicles both planters and farmers used to access rural extension, promote agricultural skills and innovation, and lobby with one voice. A top-down approach has made for a void in the understanding and appreciation of the development and role of small sugar industry agricultural associations in Australia. The Australian small sugar farmers' association was unique in the global sugar industry association movement and the HRFA was the first of its kind in the plantation era in tropical Australia.


Abstract Background Experience with providers shapes the quality of adolescent health services, including voluntary medical male circumcision (VMMC). This study examined the perceived quality of in-service communication and counseling during adolescent VMMC services. Methods A postprocedure quantitative survey measuring overall satisfaction, comfort, perceived quality of in-service communication and counseling, and perceived quality of facility-level factors was administered across 14 VMMC sites in South Africa, Tanzania, and Zimbabwe. Participants were adolescent male clients aged 10–14 years (n = 836) and 15–19 years (n = 457) and completed the survey 7 to 10 days following VMMC. Adjusted prevalence ratios (aPRs) were estimated by multivariable modified Poisson regression with generalized estimating equations and robust variance estimation to account for site-level clustering. Results Of 10- to 14-year-olds and 15- to 19-year-olds, 97.7% and 98.7%, respectively, reported they were either satisfied or very satisfied with their VMMC counseling experience. Most were also very likely or somewhat likely (93.6% of 10- to 14-year olds and 94.7% of 15- to 19-year olds) to recommend VMMC to their peers. On a 9-point scale, the median perceived quality of in-service (counselor) communication was 9 (interquartile range [IQR], 8–9) among 15- to 19-year-olds and 8 (IQR, 7–9) among 10- to 14-year-olds. The 10- to 14-year-olds were more likely than 15- to 19-year-olds to perceive a lower quality of in-service (counselor) communication (score <7; 21.5% vs. 8.2%; aPR, 1.61 [95% confidence interval, 1.33–1.95]). Most adolescents were more comfortable with a male rather than female counselor and provider. Adolescents of all ages wanted more discussion about pain, wound care, and healing time. Conclusions Adolescents perceive the quality of in-service communication as high and recommend VMMC to their peers; however, many adolescents desire more discussion about key topics outlined in World Health Organization guidance.


Exposure of lectin‐stimulated (concanavalin A, phytohemagglutinin and pokeweed mitogen) blood lymphocytes to human serum or to purified C3 increased their cytotoxic capacity towards complement receptor positive targets such as Raji and Daudi cells. The lysis of complement receptor‐negative lymphoblastoid cell lines was not influenced. The lytic capacity of lymphocytes exposed to 12‐O‐tetradecanoylphorbol 13‐acetate was not elevated by human serum. Lectin‐stimulated lymphocytes were previously shown to activate and bind C3. The results using lymphocytes activated in different ways and targets with or without complement receptor expression suggest that the C3b deposited on lymphocytes binds to the complement receptor on the targets. This contact elevates the avidity between the two cells as indicated also by the increased frequency of the lymphocyte‐target conjugates. On the basis of immune adherence the C3 fragment bound on the lymphocytes was identified as C3b. The increase of the conjugate formation and cytotoxicity was abrogated when the target cells, Raji, were pre‐exposed to purified C3d which occupy the CR2 receptor. The majority of lymphocytes responsible for the cytotoxicity were CD8+.


Objectives: Carpal tunnel release is one of the most commonly performed operations in hand surgery. Carpal tunnel release is simply defined as division of transverse carpal ligament. Ancillary procedures such as neurolysis, mass removal, and synovectomy may be indicated in selected cases. The purpose of this study is to analyse the range and frequency of ancillary procedures in a series of open carpal tunnel releases.
Methods: In this study, an analysis of 972 consecutive open carpal tunnel releases was performed in 694 patients to assess the frequency of required additional procedures. Operation notes of these patients were reviewed in terms of ancillary procedures to standard carpal tunnel release.
Results: Fifty-six of 972 (5.76%) cases required an ancillary surgical intervention. Ganglia removal for 9 (0.92%), synovectomy for 8 (0.82%), internal neurolysis for 13 (1.33%), external neurolysis for 23 (2.36%), segmental neurectomy and nerve repair for 3 (0.3%) patients were performed.
Conclusion: Additional procedures is advocated as adjuncts to the carpal ligament release, in an effort to decrease the failure rate after operation in indicated cases.


Abstract Tsukimoto, M., Homma, T., Mutou, Y. and Kojima, S. 0.5 Gy Gamma Radiation Suppresses Production of TNF-α through Up-regulation of MKP-1 in Mouse Macrophage RAW264.7 Cells. Radiat. Res. 171, 219–224 (2009). Low- or intermediate-dose γ radiation appears to have the capacity to ameliorate certain types of diseases, including allergic conditions, when examined under specific exposure conditions and with specific animal models, though the molecular mechanisms involved remain to be fully clarified. We investigated the anti-inflammatory effects of intermediate-dose γ radiation by examining its effects on the activation state of p38 MAPK and the production of cytokines in mouse macrophage RAW264.7 cells. Dephosphorylation of both ERK1/2 and p38 MAPK was observed at 15 min after irradiation (0.5–1 Gy from a 137Cs source) concomitant with a significant increase in the expression of MKP-1, which dephosphorylates ERK1/2 and p38 MAPK. Since activated p38 MAPK mediates TNF-α production, we examined the effect of radiation on LPS-induced activation of p38 MAPK and TNF-α production. The activation of p38 MAPK and production of TNF-α induced by LPS treatment were both suppressed in preirradiated cells. LPS-induced production of TNF-α was enhanced by knockdown of MKP-1. These results indicate that 0.5 Gy γ radiation would cause up-regulation of MKP-1, leading to inactivation of p38 MAPK and suppression of TNF-α production, in cells of mouse macrophages cell line.


Enhanced recovery programs (ERPs) can improve outcomes following bowel surgery, but implementing an ERP across a large healthcare system remains challenging. In this study, a simplified ERP that focused on two process steps, early and frequent ambulation and early alimentation, was evaluated to determine its impact on outcomes. Data were collected on 5,000 adult patients undergoing elective small and large bowel operations over a 3-year period. Complication, readmission, and mortality rates were evaluated before and after ERP implementation. A composite score was calculated based on the successful completion of the two process steps. Following implementation, there was a 35.1% increase in the composite score, which was associated with significant (p < .05) reductions in overall complications, gastrointestinal complications, pulmonary complications, and readmissions. A system-wide ERP focusing on early and frequent ambulation and early alimentation is associated with decreased complications and readmissions in adult patients admitted for elective small or large bowel operations.


ABSTRACT Pb isotope data from U-rich dolostones from the Wahoo Formation (Pennsylvanian) from the subsurface at Prodhoe Bay, Alaska, demonstrate that the U-Th-Pb system can be a powerful geochemical and geochronological tool in understanding carbonate diagenesis. These U-rich dolostones are developed beneath a major, Late Permian to Early Triassic truncational unconformity. U enrichment is uniquely associated with the mineral dolomite, but anomalously high concentrations of U are not present within the dolomite crystal lattice. Major mineral or fluid phases can be ruled out as U hosts. SEM analyses indicate that U anomalies are present in an unknown mineral phase associated with authigenic clays and are commonly concentrated along stylolites. The Pb isotopic composition of the U-rich dolostones shows considerable spread in 206Pb/204Pb (32-79) and 207Pb/204Pb (16.3-18.7) but little spread in 208Pb/204Pb (38.4-39.5). The high U/Pb and low Th/U ratios implied from these ratios reflect the greater mobility of U relative to Th and Pb under near-surface oxidizing conditions. The spread in Pb isotopic composition of 16 samples from a single core chip yields a Pb-Pb age of 255 ± 47 Ma (2s), which is consistent with the Pb-Pb age of 263 ± 41 Ma for the entire data set (n = 28). A subset of pyrolized samples yields 238U-206Pb and 235U-207Pb ages of 26 ± 31 Ma and 274 ± 28 Ma. The Pb-Pb and U-Pb ages are in excellent agreement with the timing of the development of the overlying unconformity at about 270 Ma. The relatively large uncertainties in Pb-Pb and U-Pb ages are the result of scatter of data outside that expected from analytical uncertainties. The scatter can be attributed to a prolonged period of exposure (30-40 million years) associated with the development of the unconformity. Initial isotopic heterogeneity and multicomponent mixing may also contribute to this scatter. Scatter on U-Pb isochron plots has been enhanced by recent U loss. Regardless of the age uncertainties, the data preserve evidence of a U enrichment event during the Permian. We suggest that U was introduced into the sequence by oxidized groundwat r and enrichment occurred in response to local redox conditions at or near the unconformity surface. The Pb isotopic ages, coupled with the observation that anomalous U concentrations are restricted to dolomitic zones within the Upper Wahoo Formation, suggests that U enrichment was concurrent with much of the dolomitization. The U-Pb system was not reset during uplift and exposure in the Late Cretaceous and subsequent burial in the Tertiary, revealing that Pb isotopic ages can be preserved in complex disgenetic systems. This observation may indicate that this part of the upper Wahoo Formation was completely cemented during Mesozoic burial and/or that the youngest phase of porosity development took place under reducing conditions in which U, Th, and Pb were not mobilized. Thus, redox cond tions appear to have been important to both the U enrichment process and the preservation of the Pb isotopic ages.


Background: Non-adherence to hand hygiene practices is a well-known factor contributing to healthcareassociated infections in any healthcare setting. Mere knowledge of such practices doesn't guarantee the compliance to the practices by healthcare personnel. In this study we explored the quantum of adherence to handhygiene practices, the opportunity missed, the steps and the duration to be followed for hand hygiene practices and the training gap among the healthcare providers. Methodology: A six-month cross-sectional study using a mixed-method approach of observations, interview and feedback mechanism is used to find the effectiveness of hand hygiene practices and any training gap to prevent healthcare-associated infections. Observations for two thousand opportunities for hand washing and written interview of 40 healthcare workers is carried out on hand hygiene practices at a neonatal intensive care unit of coastal Karnataka, India. Results: The hand hygiene practices were as low as 0% observed while performing an non-invasive activity like clearing an alarm at the bedside. There is a gap found in the duration of hand-washing practices, hand hygiene before and after any care activity is performed on the neonate. This gap resulted in the spread of healthcare-associated infections. Conclusion: During the infections control training emphasis should also be given on the opportunities and hands on practices of hand hygiene.


KAIST has developed the Shaped Magnetic Field in Resonance (SMFIR) technology that transfers a large amount of energy to electric vehicles when they are running or stationary. The wireless charging SMFIR technology provides a solution to the commercialization barriers of electric vehicles such as the problems of batteries and charging infrastructure.Using 20-kHz wireless power transfer system based on the SMFIR technology, our eco-friendly On Line Electric Vehicle (OLEV) bus was wirelessly powered by 100 kW through a power grid embedded under the road. On the other hand, using high-capacity, high-efficiency and low-cost 60kHz power supply and pickup systems based on the SMFIR technology, tram and high speed train were wirelessly powered by 180 kW and 1 MW through a power grid built in rail roads, respectively.The commercial OLEV tram has been operated commercially from July 2011 in Seoul National Grand Park. Also, the OLEV shuttle bus has been operated for convenience of students and faculty members at KAIST campus since Oct. 2012. In addition, the world's first intra-city OLEV bus with 100 KW pickup capacity has been operated commercially at Gumi city from March 2014. Then, airgap is about 20 cm and maximum power transfer efficiency is 85 %.Copyright © 2015 by ASME


Aim: Nigella sativa seeds contain a high amount of Thymoquinone (TQ), an antioxidant. We therefore hypothesized that Nigella sativa oil would, through the antioxidant properties of TQ ameliorate obesity-induced hyperglycemia and decrease blood pressure and OX-LDL in obese mice.

Methods: Commencing at eight weeks of age, C57B16 male mice were fed a high fat diet (HF) for 20 weeks. Mice were divided into three groups of five animals each as follows: group 1) Lean, group 2) HF diet, group 3) HF diet treated for the last 8 weeks with 3%TQ. Inflammatory biomarkers, antioxidant biomarkers, mitochondrial biogenesis and tissue fat accumulation and hepatic steatosis were determined.

Results: 3% TQ treatment resulted in an increase of oxygen consumption decreased fasting glucose and blood pressure (P<0.05) as compared in obese mice. TQ treatment increased both the quantity of hepatic HO-1, and HO activity in response to 3% TQ. Additionally, mitochondrial Mfn2, PGC1α, insulin receptor phosphorylation in response to TQ while decreased LDL and OX-LDL (P<0.05) and haptic lipid accumulation.

Conclusion: Fundamentally, TQ intervention attenuated the obesity-mediated decrease of oxygen consumption, fasting glucose, improved mitochondrial biogenesis through an increase and in levels of HO-1 that is associated with ablated HF-induced LDL. Our findings indicate a potential clinical role for TQ in the prevention of obesity-related steatosis in metabolic disease.


Microseismic mapping is a valuable tool for assessing hydraulic fracture stimulations. During a stimulation treatment, borehole, near-surface, or surface geophones record passive seismic data. The microseismic events are thought to be shear failures that occur around the opening of a tensile hydraulic fracture as it grows. Over the past several years, there has been a large growth in the number of hydraulic fracture monitoring surveys, along with the number of vendors who acquire and process microseismic data. Here we discuss two attributes of microseismic data which are associated with the size of the passive event: seismic moment and magnitude.


This thesis investigates the use of SABRE as a hyperpolarisation method within the Earth's magnetic Field (EFNMR) and develops an EFNMR apparatus to optimise sensitivity, resolution and performance.
A fundamental problem in NMR and MRI is the inherent low sensitivity of the techniques due to the nature of the normal spin distribution at room temperature and in currently available magnets.This Boltzmann distribution means that few nuclear magnetic moments contribute to the detected signal. Hyperpolarisation is a method used to counter this by enhancing the NMR signal. SABRE, a new hyperpolarisation method for creating a very skewed distribution in the population of spins in a substrate does so without changing its chemical structure and offers the potential to make measurements at lower concentrations previously thought possible. Moreover, this method achieves its novel spin distribution in low field, and therefore provides an opportunity to also detect signals in low field thus, obviating the need for a high field magnet for specific applications.

This project is concerned with the investigation and use of a low field magnetic resonance device to optimize the detection and imaging of nuclear spin from molecules that have been subject to SABRE hyperpolarisation. It includes the description of the background for the investigations, the creation of an optimal devices for imaging and detection as well as for a study of the optimization of hyperpolarisation for molecules that are of biological significance.

The thesis focuses on optimising the SABRE technique in the earth's magnetic field and the primary results show how the signal enhancement is affected by several factors such as the amplitude of the pre-polarisation field, its duration, and the flip angle of the excitation pulse. The relationship between signal enhancement and a range of
dependencies such as the parahydrogen pressure in the test tube, the effect of multiple shakes of the sample and the possibility of achieving 2D imaging by using SABRE in the earth's field have been investigated.

The improvement of the hardware and the software of a purpose-built system employed to produce a versatile earth's field spectrometer is described. Therefore, instead of being limited to a hard excitation pulse it is possible to employ this new system to generate trains of sine excitation pulses. In particular it is possible to create long sequences of, differing, arbitrary shapes (composite pulses).

The observations shown in the final chapter highlight the efforts made to progress the SABRE technique into advanced measurements in the earth's magnetic field such as polarising the sample in one place and performing the excitation/detection in another location. In addition, dedicated measurements were done to observe the long lived states of Aminothiazole and Fluoropyridine in the earth's magnetic field. However, these initial studies did not reveal evidence of a long-lived states, but a proposed plan to complete the long-lived SABRE measurement is given as future work.


. We examined woody species composition and its relation to environmental variables in native forest growing on four limestone islands in the southern Cook Islands: Atiu, Mangaia, Ma'uke, and Miti'aro. Relative dominance (percent basal area) of woody species in 74 sites was sampled using the point-centered quarter method, and the data were analyzed using clustering and ordination techniques. These tropical forests have a relatively low diversity of native woody species (32 native and 10 introduced species occurred in our sites). Four forest types were recognized: Pandanus/Guettarda littoral forest (with several subtypes), Hernandia nymphaeifolia littoral forest, Barringtonia littoral forest, and makatea forest (dominated by Elaeocarpus tonganus and Hernandia moeren-houtiana). These types were related, using canonical correspondence analysis, to geographical attributes (wind-wardness, elevation, and proximity to the coast or roads) that served as surrogates for environmental variables (maritime influence, soil variation, and degree of human disturbance). The eigenvalues for this direct ordination were much lower than for indirect ordination (0.32 vs. 0.71 for the first axis), indicating that the measured geographical attributes could explain only a modest portion of the compositional variation.


Predicting default probabilities is important for firms and banks to operate successfully and to estimate their specific risks. There are many reasons to use nonlinear techniques for predicting bankruptcy from financial ratios. Here we propose the so called Support Vector Machine (SVM) to estimate default probabilities of German firms. Our analysis is based on the Creditreform database. The results reveal that the most important eight predictors related to bankruptcy for these German firms belong to the ratios of activity, profitability, liquidity, leverage and the percentage of incremental inventories. Based on the performance measures, the SVM tool can predict a firms default risk and identify the insolvent firm more accurately than the benchmark logit model. The sensitivity investigation and a corresponding visualization tool reveal that the classifying ability of SVM appears to be superior over a wide range of the SVM parameters. Based on the nonparametric Nadaraya-Watson estimator, the expected returns predicted by the SVM for regression have a significant positive linear relationship with the risk scores obtained for classification. This evidence is stronger than empirical results for the CAPM based on a linear regression and confirms that higher risks need to be compensated by higher potential returns.


Abstract. In the coming era of big data, the high resolution satellite image plays an important role in providing a rich source of information for a variety of applications. Land cover classification is a major field of remote sensing application. The main task of land cover classification is to divide the pixels or regions in remote sensing imagery into several categories according to application requirements. Recently, machine interpretation methods including artificial neural network and decision tree are developing rapidly with certain fruits achieved. Compared with traditional methods, deep learning is completely data-driven, which can automatically find the best ways to extract land cover features through high resolution satellite image. This study presents a detailed investigation of convolutional neural networks for the classification of complex land cover classes using high resolution satellite image. The main contributions of this paper are as follows: (1) Aiming at the uneven spatial distribution of surface coverage, we study the training errors caused by this uneven distribution. An improved SMOTE algorithm is designed for automatic processing the task of sample augmentation. Through experimental verification, the improver algorithm can increase 2–5% classification accuracy by the same network structure. (2) The main representations of the network are also shared between the edge loss reinforced structures and semantic segmentation, which means that the CNN simultaneously achieves semantic segmentation by edge detection. (3) We use Beijing-2 satellite (BJ-2) remote sensing data for training and evaluation with Integrated Model, and the total accuracy reaches 89.6%.


A novel method for independent and simultaneous monitoring of chromatic dispersion (CD), first-order PMD and OSNR in 40Gbit/s systems is proposed and demonstrated. This is performed using in-band tone monitoring of 5GHz, optically down-converted to a low intermediate-frequency (IF) of 10kHz. The measurement provides a large monitoring range with good accuracies for CD (4742+/-100ps/nm), differential group delay (DGD) (200+/-4ps) and OSNR (23+/-1dB), independently of the bit-rate. In addition, the use of electro-absorption modulators (EAM) for the simultaneous down-conversion of all channels and the use of low-speed detectors makes it cost effective for multi-channel operation.


: Human immunodeficiency virus-1 infection of the central nervous system is an early event after primary infection, resulting in motor and cognitive defects in a significant number of individuals despite successful antiretroviral therapy. The pathology of the infected brain is characterized by enhanced leukocyte infiltration, microglial activation and nodules, aberrant expression of inflammatory factors, neuronal dysregulation and loss, and blood–brain barrier disruption. Months to years following the primary infection, these central nervous system insults result in a spectrum of motor and cognitive dysfunction, ranging from mild impairment to frank dementia. The mechanisms that mediate impairment are still not fully defined. In this review we discuss the cellular and molecular mechanisms that facilitate impairment and new data that implicate intercellular communication systems, gap junctions and tunneling nanotubes, as mediators of human immunodeficiency virus-1 toxicity and infection within the central nervous system. These data suggest potential targets for novel therapeutics. conditions, connexin 43 (Cx43) expression can be induced. Our data indicate that lipopolysaccharide (LPS) or TNF- α and interferon- γ (IFN- γ ) treatment induce Cx43 expression in monocytes. 112 These cells migrate across an in vitro model of the blood–brain barrier in response to CCL2 and we observed Cx43 staining in monocytes, astrocytes, and endothelial cells that localized to the sites of heterocellular contact. 112 Gap junctions were important for the transmigration of treated monocytes because the gap junction blockers octanol and 18- α -glycerrhetinic acid significantly decreased transmigration. 112 Based on our findings, we propose that gap junctions


In this thesis we consider two portfolio optimization models under fixed and proportional transaction costs and investigate their asymptotic behavior.

In the Black-Scholes framework of one bond and d ≥ 1 stocks the problem treated is to maximize the expected asymptotic growth rate with logarithmic utility of wealth, when transaction costs, consisting of a fixed part (proportional to the current portfolio value) and a proportional part (proportional to the trading volume) have to be paid.
The first model, where the transaction costs are paid from the bond, was introduced and treated by Irle and Sass 2005 and 2006. An optimal strategy for the one-dimensional case was found in the class of constant boundary strategies given by four boundary constants a < α ≤ β < b ∈ ]0,1[, where ]a,b[ is the continuation region for the risky fraction process and α, β denote the states it is traded back to at each transaction. For the second model, where the fixed part of the costs is paid proportionally from each asset, the existence of a general optimal strategy was shown by Tamura 2006 and 2008 via a weak solution to a quasi-variational inequality.

By establishing a maximum principle for this solution and additional information on the corresponding continuation region in the general case d ≥ 1, we first obtain the existence of an optimal constant boundary strategy for the second model in the one-dimensional case. The difference of the two models in terms of optimal boundaries and optimal asymptotic growth rates is then analyzed numerically.

In the second part we investigate in the one-dimensional case the asymptotic behavior of these two models when the proportional part of the transaction costs tends to zero. The convergence to the model with only fixed costs, introduced by Morton and Pliska 1995, is established with regard to the optimal boundaries and asymptotic growth rates. Moreover the uniqueness of the optimal boundaries for the limit model is obtained.

Finally, the convergence of the models, when the fixed costs tend to zero, is treated. A suitable model with purely proportional costs similar to that of Taksar, Klaas, and Assaf 1988 is introduced and an optimal strategy is shown to consist of keeping the risky fraction process in a unique interval [A, B] ⊆ ]0, 1[ with minimal effort. Furthermore, it is proved to be the limit model in terms of optimal boundaries, asymptotic growth rates and optimal risky fraction processes.


Gene expression-based scores used to predict risk in cancer frequently include genes coding for DNA replication, repair or recombination. Using two independent cohorts of 206 and 345 previously-untreated patients with Multiple Myeloma (MM), we identified 50 cell cycle-unrelated genes overexpressed in multiple myeloma cells (MMCs) compared to normal human proliferating plasmablasts and non-proliferating bone marrow plasma cells and which have prognostic value for overall survival. Thirty-seven of these 50 myeloma genes (74%) were enriched in genes overexpressed in one of 3 normal human stem cell populations – pluripotent (18), hematopoietic (10) or mesenchymal stem cells (9) - and only three genes were enriched in one of 5 populations of differentiated cells (memory B lymphocytes, T lymphocytes, polymorphonuclear cells, monocytes, osteoclasts). These 37 genes shared by MMCs and adult or pluripotent stem cells were used to build a stem cell score (SCscore), which proved to be strongly prognostic in the 2 independent cohorts of patients compared to other gene expression-based risk scores or usual clinical scores using multivariate Cox analysis. This finding highlights cell cycle-unrelated prognostic genes shared by myeloma cells and normal stem cells, whose products might be important for normal and malignant stem cell biology.


This paper presents an analysis of the silicon film thickness (6 nm and 14 nm), the gate dielectric material (SiO2 and Highκ material) and the Ground Plane influence on the analog parameters of Ultra Thin Body and Buried Oxide (UTBB) SOl nMOSFET devices, based on experimental and simulation results. Two channel lengths (70 nm and 1μm) have been considered and the analog performance has been analyzed as a function of the back gate bias. It is shown that at zero back gate bias , the presence of a Ground Plane improves the transconductance in the saturation region due to the strong coupling between front and back gates in devices with a long channel (1 μm), thin silicon film (6 nm) and SiO2 as gate dielectric material. However, for the intrinsic voltage gain, output conductance and Early Voltage, the devices without Ground Plane present better results due to the higher drain electrical field penetration. Short-channel transistors (70 nm) with Ground Plane show an improvement of the analog parameters also due to the high drain electrical field penetration. Similar behavior is noticed in devices with a thicker silicon film (14nm). UTBB nMOSFETs with Highκ material present less influence of a Ground Plane on the parameters analyzed. Varying the back gate bias in devices with long channel (1 μm) and SiO2 as gate dielectric material, the analog parameters present better results in devices without Ground Plane, except for the transconductance in long channel transistors with a thin silicon film, for the reason explained before (strong coupling between front and back gates). Devices with High-κ material as gate dielectric show a minor improvement of the analog performance with a Ground Plane.


The neuroscience of decision making is laying the puzzle of how the brain computes decisions. It tries to sort out which factors are responsible for causing us to choose one way or the other. This thesis reviews to what extent emotional brain processes and their neural circuits impact decision making. The somatic marker hypothesis (SMH) provides a solid dual-system framework for decision making. Dissociating an impulsive system, in which the amygdala is central, and a reflective system mediated by the ventromedial prefrontal cortex (VMPFC). The SMH emphasizes the function of the VMPFC as necessary and crucial for making favorable long-term decisions. Research on moral decision making also shows that similar systems as used by the SMH has a key role in how we think about moral dilemmas as well. Damage or maldevelopment of these neural circuits can cause myopia for the future and deeply immoral behavior. Abnormalities in emotional neuronal circuits can also be linked to addictive behavior and psychopathy. The findings on decision making and its neural substrates dismantle the common sense notion of free will and moral responsibility. An explanation of how the feeling of free will arises is given using the Interpreter system theory of consciousness. Moral responsibility without the need for a free will is defended by an alternative approach with a framework of a brain in-control versus out-of-control.


Abstract It is widely believed that the development of the general theory of relativity coincided with a shift in Einstein's philosophy of science from a kind of Machian positivism to a form of scientific realism. This article criticizes that view, arguing that a kind of realism was present from the start but that Einstein was skeptical all along about some of the bolder metaphysical and epistemological claims made on behalf of what we now would call scientific realism. If we read Einstein's philosophy of science in its proper late nineteenth-and early twentieth-century philosophical context, we find that a kind of Duhemian under determinationist holism and conventionalism was more important to Einstein than either positivism or realism. And, reading his philosophy of science in its proper scientific


Successful language comprehension involves complex higher-order processing that must function fluidly in real time. While progress has been made in understanding the foundations of language processing, the mechanisms underlying the dynamic higher-order aspects of comprehension remain somewhat of a mystery. This review proposes that these higher-order aspects of language comprehension depend on cognitive control mechanisms. Specifically, the two components of cognitive control, conflict monitoring and intentional control, contribute distinctly to language comprehension. Conflict monitoring is necessary for recognizing linguistic ambiguities and attending to errors in interpretation; control works to suppress irrelevant information and engage correct interpretations. By examining the effect of cognitive control on language processing in light of these two components, this review provides a perspective that can offer novel insights into interventions for linguistic difficulties.


Problem statement: The organization culture should be organized in the form of network as a means of giving contribution to the organization office members. This study aims to investigate (1) The historical background of the organization culture of the revenue department (2) The present condition of the network formation of the etiquette-based organization culture development and (3) The network formation and the etiquette-based development of the revenue department, the ministry of Finance. Approach: The research area was focally conducted in the certain area of Bangkok Metropolitan. The population used included 98 subjects. The instrument used for data gathering consisted of the interview forms, the observation form, the focus group discussions and the participatory workshops. The obtained data were then discretely discriminated into classified group. The data were also examined by means of the triangulation technique which was then discreetly analyzed in accordance with the previously set purposes. To be concise, the analytical results were further presented in descriptive analysis. Results: (1) On account of the historical background of the organization culture of the revenue department actually started from the early age, that was, in the reign of King Rama V. The early age was the time when the leaders entirely applied the leadership of the organization. They, thus, totally assumed ultimate responsibility and also paid much respect to the seniority authorities. The middle age was the time when the organization culture was regarded as the most outstanding performance in the aspects of assuming ultimate responsibility and paying respect to the seniors. However, the organization culture became increasingly reliant on technology especially for the data collection. The present age was the period of time when a greater extent of emphasis had shifted from human reliance to technological reliance and also in terms of providing services from conventionally ways of practices to becoming more professional. However, high value was conventionally placed on humanitarian and righteous values. (2) The present condition according to the findings, the present time has also been apparent that the organization personnel are becoming more responsible for the tasks entrusted by the authorities and they also submitted to the discipline imposed by their leaders. Best of all, they have now submitted to the discipline or regulations imposed by their superior authorities. With their senses of belonging and self-adjustment, they have tried to maintain such qualifications as honesty, integrity and loyally to their organization. In addition, they have tried by all means to build up and stake the organization's reputation and images. (3) The network formation and etiquette-based development. With their strong impulse of reforming their organization to attain prosperity and improvement, the solid achievement could be constituted through the following 6 aspects: the ultimate responsibility, punctuality, holding the possession of righteous values, humanity; the deep understanding the religious principles of teaching. And has an acute sense of the respective order of seniority. As a matter of fact, the organization personnel have been classified into three different groups: Group 1. Those who have been work enthusiasts; all they need is to be given only tacitly emotional support; Group 2. Also the work enthusiasts, but have got some indirect marginal impact of a poor circumstance; Group 3. Consists of inert workers; the sole solution is providing them with the process of etiquette-based personnel development. Conclusion/Recommendations: To conclude, this study's results and implications provided made it possible to be applied in the formation of the network with greater contribution to raising the level of organization culture. Which, could result in the proficiency of working in groups, the services provided for recipients could be considered as culturally reciprocal interaction which is fully consistent with current conditions.


Populism, particularly in its radical right-wing variants, is often posited as antithetical to the principles of liberalism. Yet a number of contemporary cases of populist radical right parties from Northern Europe complicate this characterisation of populism: rather than being directly opposed to liberalism, these parties selectively reconfigure traditionally liberal defences of discriminated-against groups—such as homosexuals or women—in their own image, positing these groups as part of 'the people' who must be protected, and presenting themselves as defenders of liberty, free speech and 'Enlightenment values'. This article examines this situation, and argues that that while populist radical right parties in Northern Europe may only invoke such liberal values to opportunistically attack their enemies—in many of these cases, Muslims and 'the elite' who allegedly are abetting the 'Islamisation' of Europe'—this discursive shift represents a move towards a 'liberal illiberalism'. Drawing on party manifestoes and press materials, it outlines the ways in which these actors articulate liberal illiberalism, the reasons they do so, and the ramifications of this shift.


The purpose of this study was to determine the actual behaviors or problems which college students are experiencing, as opposed to their general attitudes concerning sexuality. The study surveys sexual behavior in college students, including usage of sexual enhancements (such as pornography, provocative dress, and sadomasochism), "safe sex" practices, HIV awareness, and reported experience of sexual dysfunction. A confidential questionnaire composed of author-devised questions and questions adapted from previous surveys by Hernandez & Smith (1990) and Spencer and Zeiss (1987) was administered to 127 randomly selected subjects. The Marlowe-Crowne Social Desirability Scale (MC-SDS, 1960) was administered concurrently, in order to assess the extent of social desirability contamination of the sexual behavior measures. The surveys were individually administered using procedures to safeguard confidentiality. Reported HIV awareness (80%) made respondents cautious about sex, females being more concerned than males. 757. of respondents said they were likely to use a condom during intercourse. High scoring individuals on the Marlowe-Crowne were more likely to encourage partners to wear provocative lingerie or costumes, suggesting possible contamination. Almost twice as many males as females view x-rated films or engage in sadomasochistic practices, and more males than females report feeling comfortable viewing such films with their partners. (MSF) *********************************************************************** * Reproductions supplied by EDRS are the best that can be made * * from the original document. * ***********************************************************************


Purpose - This paper aims to examine production linkage and technology spillovers due to the presence of foreign firms in the Indian pharmaceutical industry. Design/methodology/approach - This study employs the semi-parametric estimation method suggested by Olley and Pakes to control for unobserved firm heterogeneity that accounts for the endogeneity of input selection with respect to productivity. Findings - The results suggest that R&D activities of foreign firms lead to positive technology spillover to local firms. However, we also found negative linkage from the activities of foreign firms. The negative linkage could be explained by the large reverse engineering activities that occur on existing drugs in the Indian pharmaceutical industry, where the enclave activities of foreign firms might be a preemptive strategy to reduce the flow of technologies to downstream local firms and to protect their firm-specific (product) technology. Originality/value - The results provide support for strong institutional arrangements such as giving protection for Intellectual Property Rights, which might be important for attracting and creating linkages with activities of foreign firms in the host country.


IMPORTANCE
The benefits of rehabilitation after immobilization for ankle fracture are unclear.

OBJECTIVES
To determine the effectiveness of a supervised exercise program and advice (rehabilitation) compared with advice alone and to determine if effects are moderated by fracture severity or age and sex.

DESIGN, SETTING, AND PARTICIPANTS
The EXACT trial was a pragmatic, randomized clinical trial conducted from December 2010 to June 2014. Patients with isolated ankle fracture presenting to fracture clinics in 7 Australian hospitals were randomized on the day of removal of immobilization. Of 571 eligible patients, 357 chose not to participate and 214 were allocated to rehabilitation (n = 106) or advice alone (n = 108), with 194 (91%) followed up at 1 month, 173 (81%) at 3 months, and 170 (79%) at 6 months. There were no withdrawals attributed to adverse effects. Recruitment terminated early on December 31, 2013 (planned enrollment, 342; actual, 214), because funding was exhausted.

INTERVENTIONS
Supervised exercise program and advice about self-management (rehabilitation) (individually tailored, prescribed, monitored, and progressed) or advice alone, both delivered by a physical therapist.

MAIN OUTCOMES AND MEASURES
Primary outcomes were activity limitation assessed using the Lower Extremity Functional Scale (score range, 0-80; higher scores indicate better activity), and quality of life assessed using the Assessment of Quality of Life (score range, 0-1; higher scores indicate better quality of life), measured at baseline and at 1, 3 (primary time point), and 6 months.

RESULTS
Mean activity limitation and quality of life at baseline were 30.1 (SD, 12.5) and 0.51 (SD, 0.24), respectively, for advice and 30.2 (SD, 13.2) and 0.54 (SD, 0.24) for rehabilitation, increasing to 64.3 (SD, 13.5) and 0.85 (SD, 0.17) for advice vs 64.3 (SD, 15.1) and 0.85 (SD, 0.20) for rehabilitation at 3 months. Rehabilitation was not more effective than advice for activity limitation (mean effect at 3 months, 0.4 [95% CI, -3.3 to 4.1]) or quality of life (-0.01 [95% CI, -0.06 to 0.04]). Treatment effects were not moderated by fracture severity or age and sex.

CONCLUSIONS AND RELEVANCE
A supervised exercise program and advice did not confer additional benefits in activity limitation or quality of life compared with advice alone for patients with isolated and uncomplicated ankle fracture. These findings do not support the routine use of supervised exercise programs after removal of immobilization for patients with isolated and uncomplicated ankle fracture.

TRIAL REGISTRATION
anzctr.org.au Identifier: ACTRN12610000979055.


Renal artery stenosis is responsible for approximately 75% of secondary hypertensive cases. A 63-year-old female patient with uncontrolled hypertension and other comorbidities including type 2 diabetes mellitus and knee osteoarthritis presented with drastically raised systolic blood pressure in this case report (220 mmHg). Bilateral abdominal bruits were detected upon of physical examination. Imaging investigation showed significant bilateral atherosclerotic renal artery stenosis. An optimal combination of antihypertensive agents mainly with an angiotensin converting enzyme inhibitor, other than interventional revascularization, was applied and resulted in controlled blood pressure.


Using a previously established model for nutritional acceleration of puberty, beef heifers ( = 48; 1/2 Angus × 1/4 Hereford × 1/4 Brahman) were used in a replicated 2 × 2 factorial design to examine the effects of diet type (high forage [HF] vs. high concentrate [HC]) and rate of BW gain (low gain [LG], 0.45 kg/d, vs. high gain [HG], 0.91 kg/d) on key metabolic hormones and age at puberty. After weaning at 14 ± 1 wk of age, heifers were assigned randomly to be fed HC-HG, HC-LG, HF-HG, or HF-LG ( = 12/group) beginning at 4 mo of age for 14 wk. Heifers were then switched to a common growth diet until puberty. Average daily gain was greater ( < 0.04) during the dietary treatment phase in HG heifers (0.81 ± 0.06 kg/d) than in LG heifers (0.43 ± 0.06 kg/d), and there was no diet type × rate of gain interaction. Puberty was achieved at a younger age (54.5 ± 1.8 wk) in both HG groups than in LG groups (60.2 ± 1.9 wk; < 0.04), but dietary energy source (HC vs. HF) did not influence this variable. Moreover, mean BW at puberty did not differ by diet type or rate of gain during the dietary treatment phase. Nonetheless, heifers fed HC-HG exhibited a striking increase ( < 0.0001) in serum leptin beginning at 26 ± 1 wk of age and remained elevated ( < 0.01) throughout the remainder of the experimental feeding phase compared to all other treatments. However, serum leptin in HC-HG dropped precipitously when heifers were switched to the common growth diet and did not differ from that of other groups thereafter. Overall mean concentrations of serum glucose were greater ( < 0.006) in HG heifers than in LG during the dietary treatment phase, with serum insulin also greater ( < 0.04) in HG than in LG only during weeks 20, 22, and 30. Mean serum IGF-1 was not affected by dietary type or rate of BW gain. We speculate that failure of the marked increase in serum leptin observed in HC-HG heifers during the dietary treatment phase to further accelerate puberty compared to HF-HG occurred because of its abrupt decline at the onset of the common growth phase, thus attenuating the temporal cue for activation of the reproductive neuroendocrine system.


Medicine, as a profession, is quite a hard commitment, with the main aim of giving care to patients. Physicians assume professional accountability not only to their patients and relatives but also to legal authorities. In case of insufficiency in exercising this multi-dimensional accountability, they may confront legal and ethical issues. A high index of awareness of responsibility and accountability may help them avoid getting involved in unwilling situations. This article revisits physicians' and, in particular, surgeons' legal liability to medical legislation and jurisprudence in Turkey, with emphasis on medico-legal consequences.


Stonehenge has been the site of lengthy, and at times violent, disputes concerning the refusal of access to the site. In particular, this has concerned the wishes of various groups of people to celebrate there (whether in religious or secular form) at Midsummer. This paper examines the events at the site from the violent end to the era of free festivals at the site in the mid-1980s to the current moves to extend free access to the stones at the Solstice. It suggests that these events cannot be viewed in isolation. Denying access to a national monument held in public ownership raises questions of the nature of national monuments themselves, and of the society for which they have symbolic importance. The recent moves towards open access to the site at the Solstice are part of a process of renegotiation of boundaries, which itself reflects a changed social climate. However, this has not provided a final resolution to the problem of reconciling diverse interests in the site.


Abstract The systematics of sitticine jumping spiders is reviewed, with a focus on the Palearctic and Nearctic regions, in order to revise their generic classification, clarify the species of one region (Canada), and study their chromosomes. A genome-wide molecular phylogeny of 23 sitticine species, using more than 700 loci from the arachnid Ultra-Conserved Element (UCE) probeset, confirms the Neotropical origins of sitticines, whose basal divergence separates the new subtribeAillutticina (a group of five Neotropical genera) from the subtribe Sitticina (five genera of Eurasia and the Americas). The phylogeny shows that most Eurasian sitticines form a relatively recent and rapid radiation, which we unite into the genus Attulus Simon, 1868, consisting of the subgenera Sitticus Simon, 1901 (seven described species), Attulus (41 described species), and Sittilong Prószyński, 2017 (one species). Five species of Attulus occur natively in North America, presumably through dispersals back from the Eurasian radiation, but an additional three species were more recently introduced from Eurasia. Attus palustris Peckham & Peckham, 1883 is considered to be a full synonym of Euophrys floricola C. L. Koch, 1837 (not a distinct subspecies). Attus sylvestris Emerton, 1891 is removed from synonymy and recognized as a senior synonym of Sitticus magnus Chamberlin & Ivie, 1944. Thus, the five native Attulus in North America are Attulus floricola, A. sylvestris, A. cutleri, A. striatus, and A. finschi. The other sitticines of Canada and the U.S.A. are placed in separate genera, all of which arose from a Neotropical radiation including Jollas Simon, 1901 and Tomis F.O.Pickard-Cambridge, 1901: (1) Attinella Banks, 1905 (A. dorsata, A. concolor, A. juniperi), (2) Tomis (T. welchi), and (3) Sittisax Prószyński, 2017 (S. ranieri). All Neotropical and Caribbean "Sitticus" are transferred to either Jollas (12 species total) or Tomis (14 species). Attinella (three species) and Tomis are both removed from synonymy with Sitticus; the synonymy of Sitticus cabellensis Prószyński, 1971 with Pseudattulus kratochvili Caporiacco, 1947 is restored; Pseudattulus Caporiacco, 1947 is synonymized with Tomis. Six generic names are newly synonymized with Attulus and one with Attinella. Two Neotropical species are described as new, Jollas cupreussp. nov. and Tomis manabitasp. nov. Forty-six new combinations are established and three are restored. Three species synonymies are restored, one is new, and two are rejected. Across this diversity of species is a striking diversification of chromosome complements, with X-autosome fusions occurring at least four times to produce neo-Y sex chromosome systems (X1X2Y and X1X2X3Y), some of which (Sittisax ranieri and S. saxicola) are sufficiently derived as to no longer preserve the simple traces of ancestral X material. The correlated distribution of neo-Y and a base autosome number of 28 suggests that neo-Y origins occurred preferentially in lineages with the presence of an extra pair of autosomes.


ABSTRACT In a recent interview with the British newspaper, The Daily Mail, celebrity chef Jamie Oliver stated that 'Food is the most basic issue […] it's about health […] someone has to take responsibility for this. Someone has to keep shouting'. Oliver's statement reflects his position as a chef, a public pedagogue and, importantly for the purposes of this article, a celebrity. Oliver's is one of many voices that have entered the public realm to educate the public about the dangers of unhealthy eating. In this article we discuss the work of three celebrities: Jamie Oliver. Sesame Street Workshop's character Cookie Monster and Australian food celebrity Stephanie Alexander's Kitchen Garden Foundation for schools. Whilst acknowledging that these three food pedagogues represent only a few of the voices that seek to intervene in the food consumption habits of citizens in contemporary times, they can be understood as a public pedagogical response fuelled by the obesity epidemic. We argue that whilst on the surface it appears that our three food pedagogues offer benevolently inspired propositions, we understand such posturing as deeply political. Specifically we are interested in examining the educative effects of these messages and their troubling implications for how individuals understand and experience food-related imperatives. We ask readers to consider who is metaphorically 'shouting' whilst drawing on various pedagogical forms and devices and we ask who is being 'shouted' at, and to what effects. We suggest that these celebrities function as powerful pedagogues who seemingly attempt to offer particular visions of health, consumption and citizenship, and, above all, attempt to cultivate a moral duty to eat well.


We developed a murine monoclonal antibody (5B10 MAb) that reacted in vitro specifically to lipopolysaccharide (LPS) obtained from Escherichia coli 0111:B4. Enzyme-linked immunosorbent assay (ELISA) titers to a variety of gram-negative bacterial whole cell and LPS antigens demonstrated that this antibody may react with the O antigen portion of 0111:B4 LPS. We then examined the ability of this antibody to protect mice in vivo against a challenge of either viable bacteria or purified LPS. One milligram of 5B10 MAb was administered intraperitoneally (IP) and protected against a lethal challenge of either viable E coli 0111:B4 or 0111:B4 LPS, but no other type of bacterial or LPS challenge. Protection occurred in an antibody dose-dependent manner, and as little as 0.01 mg of 5B10 MAb enhanced survival. We concluded that IP pretreatment with a single MAb would protect against lethal sepsis or endotoxemia in this animal model and that anti-LPS specificity was a sufficient condition for an antibody to protect during bacteremia, confirming the importance of LPS in the pathogenesis of gram-negative bacterial sepsis.


The increasing risk of coastal flooding and water shortage in Pacific Island Countries is usually attributed to climate change hazards. This ignores other risk components, exposure and vulnerability, of which a major contributor is urbanization. We develop simplified analyses that can be applied to other PICs. By dividing climate risks into hazard and exposure components we determine how urbanization contributed to present-day risks and then predict how growing climate change hazards may increase future risk, using the Republic of Palau as a case study. Results show that urbanization was responsible for 94% of the buildings exposed to coastal flooding today. Projected sea level rise, 30.2 cm by 2050, only increased exposure of today's buildings by 0.5%. In both present and future scenarios exposure resultant from urbanization was more significant than sea level rise. Our water scarcity index showed urbanization caused 3 of the 7 recorded water shortages from 1980–2018. From 2041–2079, analysis of projected rainfall showed mean reductions between 1.6–16.6% and increased variance between 0.3–3.4%. This led to three times as many water shortages under present population levels. In historical and future scenarios exposure from increased population was just as significant in causing water shortages as rainfall variation. These findings suggest that urban management is an important tool to lower exposure to coastal flooding and water shortage and we recommend that decision makers prioritize urbanization within climate risk policy in Pacific Island Countries.


A response to tissue transplantation was elicited in germ-free neonatally thymectomized CFW and C3H mice by challenge with homotransplantations of methylcholanthrene-inducecl tumor cells and neoplastic lymph node cells. Germ-free thymectomized mice of both CFW and C3H strains accepted all isologous trans plants and rejected all homologous transplants with only 1 excep tion. When these thymectomized mice were irradiated, their immune resjxjnse seemed to be effectively depressed and homol ogous transplants made 3 days after irradiation were accepted by both strains. In CFW thymectomized and irradiated mice the tumor enlarged and eventually killed the mouse, but in C3H thymectomized and irradiated mice the tumor did not enlarge, but persisted until 6 weeks, when the experiment was terminated and the animals were sacrificed and autopsied. However, when transplantation of C3H tumors to CFW mice was delayed until 2 months after irradiation to permit recovery of immunologically active tissues, most of the tumors were rejected after a brief period of acceptance. Results of transplantation of neoplastic lymph node cells from C3H mice infected with leukemia were comparable to those from the tumor transplants. Both germ-free and germ-free thymec tomized CFW mice were able to reject homologous lymph node cells from C3H mice; all but 1 of the C3H control mice developed leukemia. Neonatal thymectomy alone does not deprive CFW and C3H mice of the ability to reject tumor homotransplants, nor does exposure to 300 R of X-radiation abolish this response in these thymectomized mice. The assault by microorganisms on the conventional mouse at a time when it has been deprived of most of its lymphoid tissue appears to overtax its immunologie defense and to induce a debilitated state in which it cannot successfully respond to a homotransplant.


This paper describes the design and implementation of a framework that integrates deployment, execution, and notification mechanisms for running surveillance monitoring applications on multi-purpose grids. The proposed framework employs statistical analysis over historical data along with self-adaptive mechanisms to allocate efficiently task to resources. This framework has been deployed on a set of computational resources pertaining to the Pacific Rim Applications and Grid Middleware Assembly (PRAGMA) infrastructure.


The authors have previously shown that bilirubin-oxidation products (BOXes) are present in CSF of subarachnoid hemorrhage patients with vasospasm, and that BOXes cause vasoconstriction in vitro. This study determined whether BOXes cause vasospasm in vivo. Identical volumes of either lysed blood or standardized amounts of BOXes were injected into the cisterna magna of adult rats. BOX injections caused 6 of 10 rats to die within 10 minutes, whereas 12 of 12 rats survived for 24 hours after blood injections. The mechanism for this significant (P ⩽ 0.01) increase in mortality was unclear. To directly test whether BOXes produced vasospasm, a cranial window technique was used. Application of 20 μL of 10-μmol/L bilirubin had little effect on the vessels. However, application of BOXes produced marked, dose-dependent small artery and arteriole vasospasm that approached a 90% decrease in diameter by 40 minutes after application in some vessels, and persisted for at least 24 hours. To determine if BOX-mediated vasospasm led to cortical injury, histology and immunocytochemistry were performed on animals that survived for 24 hours. There was a BOX-related stress protein response for HSP25 and HSP32 (HO-1) without evidence of infarction. The finding that the BOXes produce vasospasm of cerebral vessels in vivo, in conjunction with BOXes being found in CSF of vasospasm patients, supports our hypothesis that BOXes contribute to or cause cerebral vasospasm after subarachnoid hemorrhage.


Race as a variable in research ethics is investigated: to what extent is it morally appropriate to regard the race of research subjects as pivotal for research outcomes? The challenges it poses to deliberation in research ethics committees are considered, and it is concluded that race sometimes must be considered, subject to clearly stated qualifications.


The transversal lower rectus abdominis myocutaneous flap is presented as a new method in reconstruction surgery of the female breast. Attention is drawn to the problems associated with breast reconstruction, as seen against the background of this new method. Anatomy, indications, and surgical technique are presented. From the experiences collected so far with 10 cases, it can be concluded that the rectus flap is a valuable alternative to the latissimus dorsi flap and to reconstruction with silicone protheses. If the conditions for performing the rectus flap graft are fulfilled, this method may deserve preference in our opinion. The occurrence of four necroses of the tips, which may be considered as a typical complication, may in all probability be reduced by a more sophisticated surgical technique.


Most catecholaminergic cells derived from the sympathoadrenal lineage of the neural crest contain one or more neuropeptides. Although a great deal is known about the development and regulation of catecholaminergic properties in these cells, relatively little is known about the developmental control of their neuropeptidergic properties. We have investigated the possible role of glucocorticoids and preganglionic innervation in the regulation of leucine-enkephalin (L-Enk) expression in cultures of embryonic and neonatal adrenal chromaffin cells and in mature chromaffin cells in vivo. Exposure of embryonic and neonatal chromaffin cells to the synthetic glucocorticoid dexamethasone increases L-Enk content. Neonatal chromaffin cells grown in medium containing elevated levels of potassium to mimic depolarization also exhibited increased L-Enk levels. The depolarization-induced increase in L-Enk was selectively inhibited by treatment with the enkephalin analog [D-Ala, d-Leu]-enkephalin to mimic the enkephalinergic component of the preganglionic innervation. Denervation of the adrenal gland in vivo resulted in a dramatic increase in L-enk expression that could be partially mimicked by selectively blocking enkephalinergic transmission with administration of the opiate receptor antagonist naloxone. Taken together with the developmental time course and pattern of L-Enk expression in vivo, our results suggest that glucocorticoids and the preganglionic innervation regulate the developmental expression of this peptide in adrenal chromaffin cells and therefore participate in the generation of the mature neurochemical phenotypes present in the adrenal medulla. Further, in adult chromaffin cells similar factors appear to regulate the expression of L-Enk, which could in turn participate in physiological responses to stress.


Abstract Deposition of the Abenaki Formation carbonate complex began during the Middle Jurassic, shortly after the interpreted onset of western Atlantic sea-floor spreading, and continued through Late Jurassic time, resulting in thick carbonate deposits along the Jurassic shelf edge. This carbonate complex was the exploration target of 16 wells drilled from 1970 to 1989. Although there were no discoveries in the carbonate objectives, oil was discovered in Cretaceous siliciclastics in structural drape closures overlying the carbonate margin. The Province of Nova Scotia decided to undertake a technical study to further the interest in the carbonate bank objective while the shallow oil play was being developed. Subsequently, in 1989, two studies were undertaken to investigate a porosity play in the Jurassic Baccaro Member of the Abenaki Formation because significant porosity had been encountered in a number of the dry holes that targeted the carbonate margin, particularly the Demascota G-32 well. The first study modelled porosity in several wells utilizing one-dimensional (1D) and wedge models, and amplitude v. offset (AVO) models. The Demascota G-32 well was used to seismically identify and model several types of potential hydrocarbon-bearing prospects along the bank. Modelling indicated that zones of 11–14% porosity with a minimum thickness of 10 m could be detected. However, a thickness of 50 m was required to resolve the top and base of the porosity. The AVO model for the Demascota well demonstrated that an increase in amplitude with offset (AVO effect) in the presence of gas and fracturing (which dramatically decreases Poisson's ratio) should be detectable and may be useful in identifying prospects in this type of play. The assumption of a fractured reservoir was reasonable due to the number of seismically identified faults at the front of the carbonate bank and the description of fractures in conventional cores taken in the Baccaro Member. The second study involved acquiring a pair of dip and strike seismic lines adjacent to the Demascota well and reprocessing them to preserve relative amplitudes while providing a high-resolution, stacked section, especially at the Baccaro Member level. Interpretation of these lines was undertaken in the AVO domain. An increase in amplitude with offset was observed up-dip of the Demascota G-32 well that indicated a fractured, gas-filled porous zone could exist up-dip of this well. Following these studies, 3D seismic data was acquired over the shallower Panuke Oil Field and similar studies were conducted on that dataset in 1997. As a result, Encana drilled a structural high containing bright amplitude reflectors and encountered over 100 m of net gas pay in vuggy and cavernous limestones and dolomites in 1999. This validated the earlier studies, confirming that these reservoirs could be seen on seismic data and proved that economic gas reservoirs exist in the carbonate bank. These results should encourage exploration along the extensive, sparsely drilled Late Jurassic carbonate margins bounding offshore eastern North America and its conjugates in the Central Atlantic Region.


: Introduction: Misdiagnosing ovarian torsion is now suggested as an important issue in clinical setting that is suggested to be related to the variety of its clinical manifestations. Objectives: The main objective of the study is to find the accuracy of pelvic ultrasound in diagnosing adnexal torsion in females of reproductive age group presenting with lower abdominal pain. Material and methods: This descriptive study was conducted in Jinnah Hospital, Lahore during March 2019 to November 2019. All women aged between 14 and 45 years with acute lower abdominal pain suggestive of ovarian or adnexal were identified. Among the selected subjects, only those with positive ultrasound findings suggestive of ovarian/adnexal torsion and underwent laparoscopic surgery were included in this study. Results: The data was collected from 100 patients. 43 (13.3%) were confirmed as cases of ovarian torsion by surgery and other surgical diagnoses were appendicitis (24.8%), hemorrhagic cyst (22.9%), ectopic pregnancy (21.1%), and others (18.0%). The highest and the lowest mean age was specified to women suffering from ovarian torsion (24.9 ± 8.0 years) and hemorrhagic cyst (26.9 ± 7.8 years). Twenty eight women (8.7%) were pregnant who suffered the most from ovarian torsion compared with non-pregnant women (35.7% versus 11.1%, p < 0.001). Conclusion: It is concluded that increment in the number of cases of adnexal torsion demands specific, quick, and accurate diagnostic measure. Ultrasound has been the most successful technique in this scenario.


Background: Transient left ventricular (LV) apical ballooning is characterized by acute onset of chest pain with reversible balloon-like LV motion abnormality, hypercontractile basal segments, ST segment elevation or T-wave inversion in anterior chest leads and mild cardiac enzyme rise in the absence of significant coronary disease. Methods: We describe 5 patients (4 females) with anteroapical ballooning who were hospitalized with acute myocardial infarction and showed ST segment elevation in anterior chest leads. Results: Echocardiogram demonstrated apical ballooning with normal or hypercontractile contraction of the basal segments. Four patients had severe mitral incompetence and one had mild incompetence. All patients had also systolic anterior motion and 4 had a significant LV outflow (LVOT) gradient. All patients underwent cardiac catheterization soon after admission showing non-significant narrowing of the coronary arteries. At discharge 4 patients had normal LV function and 1 was mildly impaired. Conclusions: LV apical ballooning is relatively rare. It should be suspected in older patients, mainly women, with severe mitral incompetence and LVOT gradient.


Abstract. Earthquakes are the most destructive natural disasters, which result in massive loss of life, infrastructure damages and financial losses. Earthquake-induced building damage detection is a very important step after earthquakes since earthquake-induced building damage is one of the most critical threats to cities and countries in terms of the area of damage, rate of collapsed buildings, the damage grade near the epicenters and also building damage types for all constructions. Van-Ercis (Turkey) earthquake (Mw= 7.1) was occurred on October 23th, 2011; at 10:41 UTC (13:41 local time) centered at 38.75 N 43.36 E that places the epicenter about 30 kilometers northern part of the city of Van. It is recorded that, 604 people died and approximately 4000 buildings collapsed or seriously damaged by the earthquake. In this study, high-resolution satellite images of Van-Ercis, acquired by Quickbird-2 (© Digital Globe Inc.) after the earthquake, were used to detect the debris areas using an object-based image classification. Two different land surfaces, having homogeneous and heterogeneous land covers, were selected as case study areas. As a first step of the object-based image processing, segmentation was applied with a convenient scale parameter and homogeneity criterion parameters. As a next step, condition based classification was used. In the final step of this preliminary study, outputs were compared with streetview/ortophotos for the verification and evaluation of the classification accuracy.


ABSTRACT Governments across the world outsource service delivery to external agents, but does ownership matter for service delivery value? Though theory points to clear ownership differences on effectiveness, there remains limited empirical evidence of the impact of ownership on citizens' satisfaction. Focusing on local authorities in England, we draw on secondary data (2007 and 2009) to examine if ownership type matters. The findings indicate that ownership – public, non-profit, private – confers no direct benefits for citizens' satisfaction suggesting that the outsourcing decision should not rely on unfounded assumptions about performance differentials between ownership types. The implications for public management are explored.


Abstract The literature shows that when a society believes that wealth is determined by random "luck" rather than by merit, it demands more redistribution. Adverse shocks, like earthquakes, strengthen the belief that random "bad luck" can frustrate the outcomes achieved with merit. We theoretically illustrate that individuals react to such shocks by raising support for redistribution. We then present evidence of this behavior by exploiting a natural experiment provided by one of the strongest seismic events that occurred in Italy in the last three decades, the L'Aquila earthquake in 2009. We assemble a novel dataset by matching information on the ground acceleration registered throughout the National Strong Motion Network during the earthquake with survey data about individual opinions on redistribution collected a few months later. The empirical analysis illustrates that the intensity of the shakes is associated with subsequent stronger beliefs that, for a society to be fair, income inequalities should be levelled by redistribution.


This study estimates the trade effects of economic sanctions used by the European Union 1990-2000. The EU has used economic sanctions frequently since the early nineties. These sanctions are compiled into a comprehensive list for the period 1990-2000, and classified as limited or extensive. Then, a gravity model is used to estimate how sanctions have affected trade between the EU and target countries. The regressions are run on both cross-sectional data and panel data, with a sample of 163 developing countries. The main result is that economic sanctions have had ambiguous effects on trade. The magnitude of the trade effect is greater on EU imports than on EU exports, which is consistent with theoretical predictions. Limited sanctions have become more trade-suppressing during the latter half of the nineties, while extensive sanctions have become less trade-suppressing.


This guide is designed to assist students in the Pre-Service Firefighter program to find library and Internet resources to help them with their studies


The distribution and mobility of GABA/benzodiazepine receptors has been examined on living nerve cells by fluorescence digital imaging and fluorescence photobleach recovery with 2 novel fluorescent derivatives of the benzodiazepines Ro7–1986 and 1012S. These fluorescent derivatives retain their high affinity for the GABA/benzodiazepine receptor complex with Ks of 79 and 85 nM, respectively. Digital fluorescence imaging of GABA/benzodiazepine receptors on rat spinal cord neurons maintained in culture reveal that, even in the absence of observable synaptic contact, GABA/benzodiazepine receptors are localized on the cell body in clusters of very high density. Receptor density on processes is lower than on cell bodies, although occasional areas of intense fluorescence were observed. Fluorescence photobleach recovery measurements show that 70% of the GABA/benzodiazepine receptors on the cell body and greater than 85% on the processes of rat spinal cord neurons are immobile. In comparison, voltage-gated sodium channels are diffusely distributed and very mobile on the cell body (D = 10(-9) cm2/sec). The results suggest that even in the absence of nerve-nerve cell contact, there are specific mechanisms that segregate GABA/benzodiazepine receptors to the neuronal cell body and control their lateral mobility.


Mentoring is a well known strategy used in many different disciplines. However, while it does commonly occur in the alcohol and other drugs (AOD) field, it appears that little has been published to specifically address mentoring relating to AOD work. There is, however, a considerable amount of mentoring literature produced by disciplines that have significant potential to respond to AOD issues, including medicine, nursing, social work and education. This suggests a familiarity with the idea of mentoring and a readiness to view mentoring as a strategy for the AOD field. This paper is based on a monograph recently published by the National Centre for Education and Training on Addiction (NCETA) on mentoring in the AOD field. It is a synthesis of the mentoring literature from other disciplines, discussed in the context of AOD work. This paper addresses useful mentoring models for the AOD field and why it is an important strategy for development of the AOD workforce.


This report compiled all abstracts presented in the NKS Workshop on Radioanalytical Chemistry at Risø, Roskilde, Denmark in 2-6 Sept. 2013. Total 35 participants registered to the workshop, among them 18 from Sweden, 5 from Denmark, 3 from Finland, and 3 from Norway, there are also 6 participants from Germany, France, Slovenia, Korea, Turkey, and China. The workshop consists two part, 3 days lab practices and 2 days lectures/presentation. 3 lab practices were organized, i.e. (1) Radiochemical separation of Pu and ICP-MS measurement of Pu isotopes; (2) Radiochemical separation of Po and Ra and their alpha spectrometry measurement; and (3) Radiochemical separation of Fe, Ni, Sr and their LSC measurement. Among them, each participant can participate in 2 lab practices. 15 invited lectures are given by the experts in their specific fields, 8 oral and 6 poster presentations are given by the participants. The abstracts of all presentations are included in this report.


Investors require compensation for holding risky assets – an example is the bond liquidity premium for holding debt assets. In stress conditions, market liquidity can evaporate and lead to disorderly movements in prices. The Bank of England's recent Financial Stability Report (p.29) documents a decline in the market liquidity of some government and corporate bonds, accompanied by a reduction in dealer activity. Does market liquidity risk affect bond returns more seriously in stress times than in normal times? Does a higher cost of funding for dealers in stress times cause bond returns to be more sensitive to liquidity shocks? Focusing on Euro-dominated investment-grade corporate bonds, we conduct a quantitative analysis in a regime-switching model, and confirm a 'yes' answer to both of these questions.


Predicting and averting the spread of invasive species is a core focus of resource managers in all ecosystems. Patterns of invasion are difficult to forecast, compounded by a lack of user-friendly species distribution model (SDM) tools to help managers focus control efforts. This paper presents a web-based cellular automata hybrid modeling tool developed to study the invasion pattern of lionfish (Pterois volitans/miles) in the western Atlantic and is a natural extension our previous lionfish study. Our goal is to make publically available this hybrid SDM tool and demonstrate both a test case (P. volitans/miles) and a use case (Caulerpa taxifolia). The software derived from the model, titled Invasionsoft, is unique in its ability to examine multiple default or user-defined parameters, their relation to invasion patterns, and is presented in a rich web browser-based GUI with integrated results viewer. The beta version is not species-specific and includes a default parameter set that is tailored to the marine habitat. Invasionsoft is provided as copyright protected freeware at http://www.invasionsoft.com.


High-performance computing data centers have been rapidly growing, both in number and size. Thermal management of data centers can address dominant problems associated with cooling such as the recirculation of hot air from the equipment outlets to their inlets and the appearance of hot spots. In this paper, we show through formalization that minimizing the peak inlet temperature allows for the lowest cooling power needs. Using a low-complexity linear heat recirculation model, we define the problem of minimizing the peak inlet temperature within a data center through task assignment (MPIT-TA), consequently leading to minimal cooling-requirement. We also provide two methods to solve the formulation: Xlnt-GA, which uses a genetic algorithm, and Xlnt-SQP, which uses sequential quadratic programming. Results from small-scale data center simulations show that solving the formulation leads to an inlet temperature distribution that, compared to other approaches, is 2 degC to 5 degC lower and achieves about 20 to 30 percent cooling energy savings at common data center utilization rates. Moreover, our algorithms consistently outperform the minimize heat recirculation algorithm, a recirculation-reducing task placement algorithm in the literature.


Nowadays, it is essential that researchers operationalize their research evidence with the help of knowledge brokers in proper communication with stakeholders and make such pieces of evidence applicable. The present study aims at psychometric of the self-assessment tool of academic researchers' knowledge translation activities and explaining the role of academic librarians in this process. This study was a methodology research. A questionnaire was designed and its psychometric properties including design, face validity and content validity, and internal and external reliability of the construct were measured. During the first and second stages of the research, the initial version of the questionnaire with 52 items was designed. During the third and fourth stages, the self-assessment section of knowledge translation activities was developed as the main structure of the questionnaire in four components, namely research question, knowledge creation, knowledge transfer, and promotion of using evidence. In the following, the psychometric analysis of the final version of the questionnaire (with 46 items) was approved for all the items with the impact score of 4.48, content validity index of 0.92, content validity ratio of  0.85, Cronbach's alpha coefficient of 0.91, and correlation coefficient of 0.93. The results of this study indicated that the developed questionnaire enjoys proper psychometric properties for the self-assessment of knowledge translation activities of academic researchers by considering the role of librarians in facilitating this process.


The Baikal rift system faults, having developed in the recent rift formation period, are characterized by hydrothermal and seismic activity. Especially in the northeastern part, the level of fracturing affects the localization of thermal outlets and the distribution of earthquake swarms. The specific features of the hydrothermal outputs and seismicity interposition, depending on the fracture heterogeneity and water saturation of the lithosphere layers, have not been previously evaluated. The results of the statistical analysis of the hydrothermal data, presented herein, show that most of the springs are distributed in areas of increased fault density. Multiple less hot hydrotherms are associated with zones of maximum density in the inter-block space. The spatio-temporal analysis of seismicity showed that migrations of weak and moderate seismic activity propagate from earthquake swarms through these zones. Swarms initiate the deformation front by propagating in the quasiplastic layer of the upper mantle at a speed of tens of kilometers per year, which can increase the aqueous fluid pore pressure in the lower earth's crust, facilitate the movement of the fluid upwards along the section, and cause a process of successive stress relaxation in zones of high fracturing and concentration of hydrothermal springs. Earthquake swarms occur in areas of about average fracture density, associated with deep faults framing consolidated blocks of the earth's crust. The hydrotherms with high or average temperature, and with probable deep source chemical composition components are related with such zones.


Vital Lies, Simple Truths is a penetrating analysis of the ways in which we deceive ourselves. Daniel Goleman draws on evidence of all kinds - from brain function to social dynamics - to reveal how we must distort our most intimate relationships and our day-to-day lives by burying painful insights and memories. This self-deception is our means of psychological self-preservation, the currency of survival in which society transacts. But although self-deception is sometimes benighn, it can also be dangerous and life-diminishing. This important book both illuminates and raises challenging questions about a subject central to our psychological existence.


We present five patients with alpha-L-iduronidase deficiency who do not have the typical Hurler or Scheie phenotypes; they are compared to 28 similarly atypical cases from the literature. Phenotypic differences are pointed out and intrafamilial similarities stressed. Among the various possible explanations for this situation, the existence of genetic compounds seems acceptable for some of the cases, but others seem to be caused by different mutations. The elucidation of these alternative possibilities from recent biochemical research is discussed.


The aim of this thesis is to investigate a dual gradient riser system, adapted for operations in the Gulf of Mexico and subjected to first- and second-order wave forces, current and rig/vessel motion. Deep water drilling in narrow pressure zones pose several challenges for handling well pressure. Using two separate fluid volumes, in what is known as a dual gradient drilling (DGD) solution, the hydrostatic well pressure can be reduced by managing the return flow. To separate these volumes and control the mud return, the riser must accommodate a device known as a rotating control device (RCD). The RCD and the well pressure system extends the capabilities of conventional drilling schemes allowing for operations in deeper water and narrower pressure zones. The two volumes are closed off using a sealing element in the RCD, which holds the differential pressure created by the drilling system. The seal operate in a hostile environment resulting in extensive wear originating from abrasive particles, the rotating drillpipe and dynamic forces from the sheltering riser. The abrasion related to friction contact is strongly coupled with the riser and drillpipe contact and prompt the need for a closer analysis of the forces occurring between them. The riser system and RCD is therefore modelled in SIMA/RIFLEX and a dynamic analysis is carried out to obtain the lateral drillpipe/riser contact forces, indirectly finding the forces affecting the seal element. The analysis results indicate that the lateral force is below 4% of the seal element?s clamp force. The force magnitude is modest and will most likely have no significant impact on the operation. However, local forces and vibrations associated with resonance can create undesirable effects, which over time can lead to fatigue damage of the RCD and its subcomponents. Submerged equipment will be sensitive to range of resonance phenomena originating from the rig motions, second-order wave forces, current and vortex induced vibrations. This will encourage a review of the local dynamics and the potential use of riser control. Motivated by this, a finite element model is developed in Matlab/SIMULINK to study this in more detail. In order to de- tect resonance related vibrations, a modal decomposition model is formulated based on the finite element model. Using the modal model, a weighted estimate of the eigen frequencies active in the response can be provided to evaluate the resonance properties of the riser. To obtain a better understanding of the riser system and the control potential, a dynamic analysis of the models is carried out, focusing on low frequent rig/vessel motion. Both models are throughly verified using the commercial program RIFLEX, to ensure the sufficient accuracy. Inspired by the results from the analysis, control strategies based on manipulation of the resonance properties (modal con- trol) of the riser are examined, applied to a riser management system framework. The purpose of modal control is to increase safety margins and the operational economy, e.g. by reducing the time spent suspended because of seal element exchange or the risk for well head fatigue. Four different strategies based on manipulation of tension and position are proposed. Followed by a qualitative evaluation of the practical aspects, indicating that setpoint chasing and tension control are the most effective and attainable strategies available. The main contributions in this thesis are assessment of the lateral contact force associated with a deep water pipe-in-pipe dual gradient riser in the Gulf of Mexico, the development and verification of a extensive riser model using Matlab and SIMULINK, and the formulation of modal riser control for resonance vibrations in deep water drilling risers.


Background Myofascial pain syndrome (MPS) is the most common diagnosis in patient presenting with chronic non-specific neck pain. It affects people's work performance, productivity, and quality of life. To date, there is little research evaluating the effectiveness of non-invasive techniques, such as ISBT-Bowen Therapy in managing neck MPS. Objectives To investigate the effectiveness of Bowen therapy in managing myofascial pain syndrome with symptoms lasting for more than six weeks. The study will also examine the long-term effect of ISBT-Bowen Therapy on functional enhancement, quality of life, and physical and mental well-being. Methods This is a prospective, single-blinded randomized controlled trial (RCT). A total of 90 myofascial neck pain patients were recruited and randomized to receive 8 sessions of ISBT-Bowen Therapy over a 12-week period (n = 45) or to continue their usual conventional treatment (n = 45). Pressure pain threshold (PPT), cervical range of motion (CROM), numerical rating pain scores, Neck Disability Index (NDI), SF-12 Health Survey (SF-12) Version 2, Generalized Anxiety Disorder 7-item (GAD7), and Patient Health Questionnaire (PHQ9) were measured at baseline, 12 weeks, and 24 weeks after baseline. Results When compared with the control group, PPT significantly increased after ISBT-Bowen Therapy at 12 and 24 weeks. CROM on flexion, lateral flexion, and rotation were greatly improved at 12 weeks after Bowen therapy, and maintained at 24 weeks, except left lateral flexion. NDI, GAD7, and PHQ9 were all reduced after Bowen Therapy at both 12 and 24 weeks. Both Physical and Mental Component Summary scores of SF-12 were improved after Bowen therapy at 12 and 24 weeks. Conclusions This study confirmed the efficacy of ISBT-Bowen Therapy for patients with MPS. It alleviates pain, improves functional outcomes, enhances quality of life, and relieves mood symptoms.