Purpose To develop an interactive, probabilistic decision support system for the decision to treat or observe cerebral cavernomas and arteriovenous malformations. To allow users of the system to adapt decision analysis methods to individual patients. Methodology A computer program was designed to model the outcomes of (1) surgery (2) radiosurgery, and (3) observation. The user supplies information relating to specific patients and elects discount and quality of life adjustment rates. The program uses Bayesian methods to derive probability estimates of key parameters such as the estimated outcomes of treatment and natural history of the conditions. Monte Carlo simulation is used to model a range of possible outcomes that are expressed as discounted quality adjusted life years (dQALYs) and change in dQALYs with treatment. Results include summary statistics and graphs to display the wide range of possible outcomes. The program uses Microsoft Excel as the interface. The model incorporates user interaction with factors such as delays in the effects of radiosurgery, QALY adjustment for presenting symptoms, and repeated adverse events such as haemorrhages. Conclusion The system is available for clinical use. The system enables probabilistic sensivity analysis for any of the parameters. This can be used for an evidence-based approach to setting research agenda. The current program is accessible on the internet. 73 Suppl.May 2003 NS.doc ANZ J. Surg. 2003; 73 (Suppl.): AXX–AXX. RACS Annual Scientific Congress , 2003 bstracts BEES SGML NS02 SURGICAL DECOMPRESSION FOR MERALGIA PARAESTHETICA: A REVIEW OF 43 CASES


On behalf of the EDAC 90 Organising and Technical Programme Committee, it is our pleasure to welcome the participants of the first European Conference on Design Automation, and to present to you this Digest of Technical Papers.We are particularly pleased that this new European venture has generated great excitement and interest world-wide and has gained full support from the IEEE Computer Society. The research programme of the European Community had undoubtedly a substantial part in the stimulation of this activity. Ever since Esprit was launched, the European workers in DA from both industry and university have begun to experience a feeling of achievement, strength, mutual respect and community throughout the 12 member countries and beyond. Following the highly successful series of CAVE workshops, the time is now ripe for a major European-based international forum and publications base for VLSI design technology. The EDAC association has been formed and will be consolidated at the conference to promote a series of high quality technical DA conferences across Europe. We have already booked Amsterdam for EDAC 91.The response to the call for papers was overwhelming. 303 papers were received from 31 countries world-wide with nearly 70 per cent from Europe in its widest sense. The technical Programme Committee of 45 included Japanese and US members and has done an excellent job in selecting the best papers to be presented. The average quality was very high and easily matched the highest international standards. The Programme Committee was divided into 6 topic areas and every member reviewed all papers in that subject. At the first programme review meeting in Schipol it was unanimously agreed to accept 120 verbal presentations organised into 3 parallel sessions and a number of poster presentations.In addition to the technical presentations, the Committee has organised a panel session, a number of fringe meetings and 'birds of a feather' sessions for special interest groups, a day of tutorials and some vendor presence. All lunches, two evening receptions and the conference banquet are included in the fee. Members of IEEE/DATC, ACM/SlGDA and all European professional societies are especially encouraged to attend.We feel that you can be assured of a highly worthwhile technical forum during your visit to Glasgow in March. Thank you for participating in EDAC 90.


Looked-after Children (LAC) are considerably more likely than non-LAC to achieve poor outcomes across the life course. Although a substantial amount of attention has been given to this population in recent years, these findings remain consistent. Given that LAC are often accommodated in a variety of settings, it follows that the EP individually, and the educational psychology service (EPS) more widely, must adapt practice to work effectively in each context.
The current research paper illustrates this point by investigating one distinct method of supporting this population: psychological consultation and practitioner empowerment within a residential care context. In the host LA, psychologists, on a fortnightly basis, visit residential care settings, and, using a model known as 'POP', facilitate consultation sessions with the aim of co-constructing strategies with care home staff for supporting LAC residing in the home. The model is also designed to empower staff adopting a 'corporate parent' role.
Anecdotal findings suggest that both the process, and the model itself, are valuable; however no robust evidence is available which supports this assertion. Using 'Realistic Evaluation' as a methodological orientation, an exploration of the POP consultative process was undertaken in which questions of 'what works, for whom, and why?' permeate throughout.


The author, a former director of the Hiroshima Peace Culture Foundation and director of the Hiroshima Peace Memorial Museum, denounces the extreme danger of atomic weapons, having as his context of the city of Hiroshima, the story of the bomb dropped there and his personal role as an activist for peace and for the abolition of nuclear weapons. He demonstrates that any conflict in which they are used can exterminate life on Earth. Such an event would be devastating both directly by its destructive power as well as because of its capacity of generating the so-called nuclear darkness that may limit the penetration of the sunlight and prevent the cultivation of food causing widespread hunger. Nuclear weapons are born out of fear and hatred, and their political, social and economic influence needs to be urgently reduced. The war culture must be replaced by a peace culture. Therefore, education and action for peace need to be taken seriously for human survival itself. The most urgent of all measures is the abolition of nuclear weapons worldwide.


In 1939 attention was called by Nichols to the failure of earlier workers to apply the Reynolds number criterion and distinguish between laminar and turbulent flow in estimating the viscosity of lava from observed flow velocities. The present writers follow Nichols in his primary contention but take exception to some of his argument and much of his application of field observations in estimating viscosity of la\ a. It is the conclusion of the paper that even with the use of the Reynolds number and the Stan ton diagram in outlining flow conditions, according to the best available data, the complexities and uncertainties of the flow of lava under field conditions preclude definitions of condition or statements of results with sufficient precision to justify presentation as numerical coefficients of viscosity in the ordinary sense.


AbstractIn July 1972, a book dealer from the well-known Shanghai bookstore Gujidian came to the Shanghai museum with an assortment of Ming Dynasty texts which, he explained, had been found in a graveyard in Jiading County, one of the ten suburban counties of greater Shanghai. Members of the Museum staff immediately went to Jiading County to find out as much as possible about the discovery of the texts. The report of their findings was published in the article "Shanghai faxian yipi Ming Chenghua nianjian keyinde changben, chuanqi" in WENWU, no. 11 (1972), p. 67. Following repair and restoration, the texts were issued in 1973 by the Shanghai Museum as a photolithographic reproduction collection titled MING CHENGHUA SHUOCHANG CIHUA CONGKAN SHILIUZHONG FU BAITU JI CHUANQI YIZHONG (Collection of sixteen prosimetric stories from the Chenghua reign period of the Ming Dynasty and one chuanqi drama THE TALE OF THE WHITE RABBIT). The texts which make up the collection were all hitherto unknown; the prosimetric stor...


Type 1 Diabetes Mellitus (T1DM) is a chronic disease characterized by the immune-mediated destruction of β cells of pancreatic islets. Despite the increase of its incidence observed in last decades, it has not been fully elucidated the immunogenetic and environmental factors associated with the initiation and perpetuation of the pancreatic injury(1,2). The pathogenic process in T1DM begins with insulitis, which progresses and expands so as to be accompanied by cell necrosis. The rate of progression of the lesion is variable and may be related to age at onset of the disease, being faster in cases diagnosed in children (3). When approximately 80-90% of insulin-secreting cells have been destroyed, T1DM is clinically overt (4). T1DM patients may have some residual insulin secretion at diagnosis (5-8). Several studies indicate that the loss of functional capacity usually occurs within three to five years. Most patients with long duration of disease do not present clinical evidence of preservation of β cells (9-11). However, the conservation of some residual secretion, even insufficient to cure or prevent T1DM from using insulin, has been associated with a better prognosis regarding glycemic control, lower rates of hypoglycemia, diabetic retinopathy and nephropathy (12). One of the most frequently used method to assess β cell function in patients with T1DM is the determination of C-peptide (CP), a molecule secreted by β cells in equimolar concentrations with insulin and without significant liver metabolism (13-15). Taking into consideration the potential benefits of preserving a residual insulin secretion in patients with T1DM, experimental treatments have been proposed in order to maintain detectable levels of CP in these individuals. Developments in research aiming for the prevention and cure of T1DM, increased the need to elucidate the contributing factors for the maintenance of residual insulin secretion in patients affected by the disease. This is because individuals who still exhibit residual insulin secretion could be ideal candidates for new curative treatments. Furthermore, most studies of pancreatic function in T1DM have been performed in Caucasians and Asians. We do not know whether the results obtained so far can be extrapolated to other ethnic populations (16).


Objective To observe the progression of renal tubulointerstitial fibrosis in rat unilateral ureteral obstruction(UUO) models,and investigate the changes in expression of renal fibrosis-related proteins during the pathological course.Methods Thirty-two SD rats were randomly divided into sham-operation group(n = 16) and UUO model group(model group,n = 16).Rats were sacrificed 2,5,9 and 14d after operation(after model establishment for model group)(n = 4 for each day),and the renal tissues of the operated side(obstructed side for model group) were obtained.HE staining,Masson staining,immunohistochemical staining and Western blotting were used to evaluate the degree of renal tubulointerstitial fibrosis and detect the expression of α-smooth muscle actin(α-SMA),fibronectin(FN),vitamin D receptor(VDR) and transforming growth factor-β1(TGF-β1) in renal tissues.Results Histological observations of renal tissues revealed that the degree of renal tubulointerstitial fibrosis gradually increased with time of ureteral obstruction.It was indicated by immunohistochemical staining that the percentages of area with positive α-SMA and FN in renal interstitium of model group,which gradually increased with time of ureteral obstruction and reached the peak 14d after model establishment,were significantly higher than those of sham-operation group at each time point after model establishment(P 0.05).Western blotting analysis demonstrated that the relative expression of α-SMA and TGF-β1 at each time point after model establishment in model group was significantly higher than that in sham-operation group(P 0.05),while the relative expression of VDR was significantly lower than that in sham-operation group(P 0.05).The relative expression of α-SMA in renal tissues of rats in model group significantly increased on the second day after model establishment,and the relative expression of αSMA and TGF-β1 in model group was 12.7 times and 8.8 times respectively of that in sham-operation group on the fourteenth day after model establishment,while the relative expression of VDR decreased to 3% of sham-operation group.Conclusion Significant interstitial fibrosis may emerge at 14d after model establishment in rat UUO models.The expression of α-SMA in renal interstitium increases in the early stage of model establishment,indicating the activation of renal interstitial fibroblasts.The progression of decrease in expression of VDR indicates VDR may relate to renal interstitial fibrosis.


Objective To observe the efficacy and safety of Moxifloxacin in the treatment of community-acquired pneumonia(CAP) in the adults patients.Methods 60 patients with CAP were randomly divided into treatment group and control group(n=30 in each).The treatment group was treated with Moxifloxacin,and the control group was treated with Levofloxacin,both groups were treated for 1 to 2 weeks.The clinical effect,bacterial clearance rate and adverse events were observed.Results The effective rate of the treatment group and control group were 86.7% and 70.0%.The bacterial clearance rate in the two groups were 96.2% and 88.9% respectively,and the difference was statistically significant(P0.05).There were no severe drug-related adverse events in the two groups.Conclusion Moxifloxacin in the treatment of CAP in the adults patients is safe and effective,and worthy in clinical application.


Novel poly(methacryloylaminocarboxylate) ligands were synthesized as models for an acidic peptide in CaCO3 biominerals. Syndiotactic poly[3-methyl-2-(methacryloylamino)butyrate], isotactic-rich poly[3-(methacryloylamino)propionate], and syndiotactic poly[4-(methacryloylamino)butyrate] form 5-, 6-, and 7-membered-ring intra-side-chain NH⋯O hydrogen bonds, respectively, between a carboxylate oxyanion and the neighboring amide NH proton, while syndiotactic poly[3-(methacryloylamino)propionate] forms intermolecular NH⋯O hydrogen bonds. These polymer ligands strongly bind to CaCO3 crystals because of the NH⋯O hydrogen bonds. In polymer ligand–CaCO3 composites, the strength and/or mode of hydrogen bonding in the polymer ligands affects the CaCO3 polymorphs. Five-membered-ring intra-side-chain and intermolecular hydrogen-bonded polymers have weak hydrogen bonds and produce calcite crystals, whereas other ligands with 6- and 7-membered-ring intra-side-chain hydrogen bonds have strong hydrogen bonds and yield vaterite crystals. Polymorph change of CaCO3 crystal is induced by differences of strength and/or mode of the NH⋯O hydrogen bond.


Past research has indicated the importance of disputant voice in determining the fairness of conflict resolution procedures, but some conflicting data have called the role of voice into question. The authors review the role of voice in procedural fairness and conclude that some of those negative results were due to a confounded research design. In three studies, this problem was corrected, and additional data were collected. Contrary to the earlier findings, results show that when other factors are equated, participants prefer the conflict resolution procedures that offer the most voice. The authors further note, however, that factors such as the role of the decision maker are also important in determining fairness.


T devastating effects of Hurricane Katrina on communities, in general, and on the medical infrastructure, in particular, have been well documented. In 2006, The American Journal of the Medical Sciences (AJMS) dedicated a symposium issue to the impact of Hurricane Katrina on New Orleans and other areas of the Gulf Coast. Physicians, administrators, medical educators, residents, and students eloquently described their experiences, personal losses, challenges, courageous acts, and lessons learned in an effort to capture this historical event and to provide constructive commentary for future disaster preparedness and response (AJMS 2006;332). Three years after our nation's largest natural disaster, this symposium issue, Moving Beyond Katrina: From Crisis to Opportunity, reflects on the unexpected post-disaster—the opportunities and successes. Individuals and institutions were forced out of their comfort zones to forge unchartered territory, foster new collaborations, explore fresh approaches to scientific investigation, redesign facilities, curricula, and community healthcare, and better prepare for future disasters. We address 4 facets of healthcare recovery and the opportunities realized after this disaster: patientfocused disaster-preparedness, medical education (undergraduate and graduate), healthcare infrastructure, and healthcare providers. As in the previous issue, the perspectives from physicians, physician-administrators, medical educators, residents, and students looking back at the last 3 years are incorporated. Results of quantitative research including patients with chronic diseases and pregnant women, and of qualitative research with key informants and institutional leaders are also presented. Although most disaster planning efforts focused on possible injuries and infections occurring poststorm, chronic disease management post-Katrina was a major issue for displaced residents and healthcare facilities. No one expected a prolonged evacuation; thus, many patients and medical institutions were inadequately prepared to manage chronic medical conditions long term. For many insured and underserved patients, access to regular healthcare and medications was limited for extended periods of time. In the first section, patient-focused disaster preparedness, Drs. Hyre and Krousel-Wood report the results of 2 different studies of patients with renal disease and hypertension, respectively, and identify opportunities for improving disaster management in the immediate aftermath of the storm for patients with chronic diseases. In separate studies looking at the extended effects of the hurricane on medication adherence and pregnancy outcomes, Drs. Islam and Xiong, respectively, reported limited health effects after the disaster. Dr. Bailey identified the needs of the chronically-ill and highlighted the role and challenges of academic medical centers in Mississippi in filling the medical care void in the weeks after the disaster when the medical infrastructure was in complete disarray. Dr. Geraci and colleagues describe the successes and opportunities for improvement in disaster preparedness and response from the Jackson Veterans Affairs Medical Center experience. Among other findings, they report opportunities to improve communication systems, gas and water supplies, chronic care management, and redefining "essential personnel" to include housekeeping personnel, social workers, and case managers. Dr. Arieta reports the findings of a study of key informants to determine better approaches to chronic care management. She and her colleagues promote collaboration with state and federal relief agencies with local institutions to improve communication systems, volunteer coordination, and medical supplies/medications donations management. For the New Orleans medical schools severely damaged by the storm, the immediate affect on medical education was substantial. Teaching facilities were moved to new locations out of town, curricula were modified, faculties were reduced, and stress levels were at an all time high. Even those institutions minimally damaged in New Orleans were greatly affected as they worked tirelessly to accommodate students, residents, faculties, and researchers seeking to continue their training and scholarly endeavors. Three years later, many aspects of medical education have improved with record numbers of applicants to both New Orleans medical schools, revived facilities, enhanced curricula, expanded collaborations resulting in more diverse learning opportunities, and a new attitude toward learning. In the medical education From the Research Division, Ochsner Clinic Foundation and the Schools of Medicine and Public Health and Tropical Medicine, Tulane University, New Orleans, Louisiana. Submitted May 22, 2008; accepted in revised form May 28, 2008. Correspondence: Marie A. Krousel-Wood, MD, MSPH, Research Division, Ochsner Clinic Foundation, New Orleans, LA (E-mail: firstname.lastname@example.com).


This paper describes the impact that thermally induced fracturing (TIF) has had on the North Sea Ula field injection wells, allowing higher than anticipated water injection rates to be achieved. This work also discusses how thermal stress reduced fracture propagation pressures by 2,000 psi and how a 3D simulation code developed to model TIF was used. Injection-water-quality specifications and techniques to optimize TIF are presented.


This paper summarizes the result of exploring into the thoughts of Rene Descartes, at his youth age, included in the work Rules for the direction of the Mind. It has the aim of finding elements that prove the origin of the Cartesian idea related to the fusion of two mathematical areas: Algebra and Geometry, as the now known Analytic Geometry. This investigation represents an epistemological approach to a mathematical topic. The same way, this article defines the real legacy of Descartes to Analytic Geometry.


On the one hand, Pb isotope data on 18–13 Myr volcanic rocks from the eastern part of the Tunka Valley yield age estimate of garnet-bearing source region in the viscous mantle of ca. 2.2 Byr that might correspond to the age of the Siberian craton mantle. On the other hand, inclusions from basanites show the pressure range that overlaps the pressure estimates for rocks of the Slyudyanka Ordovician collision zone. The lithospheric material corresponds to the transition from spinel-pyroxene to olivine-plagioclase facies of peridotites in the uppermost part of the mantle and lower-middle crust. VS-data show a low-speed zone dipping from the central Tunka valley eastwards under Southern Baikal to a depth of 70 km. This zone ends at the South Baikal – Tunka Valley junction. We suggest that the eastern parts of the Tunka Valley has inherited the Early Paleozoic collision zone between the Hamar-Daban Terrane and Siberian Paleo-Continent and that the lithosphere of the collision zone overlays the viscous mantle related to the Siberian craton.

This work is supported by the RSF grant 18-77-10027.


OBJECTIVE To study the distribution of gBgenotypes by investigating the prevalent human cytomegalovirus(HCMV)cauisng infections in the infants of Wenzhou area.METHODS A total of 187cases of infants infected with HCMV were enrolled.The HCMV IgM/IgG antibodies in serum,HCMV DNA load of urine and HCMV pp65antigen in peripheral blood were determined.The HCMV gB genotypes with PCR-RFLP were determined,and the genotypes were verified by gene sequencing.RESULTS The HCMV gB genotypes in Wenzhou included gB1,gB2and gB3.Among 187infants with CMV diseases,the prevalence of gBtypes was as follows:97(51.87%)cases with gB1,39(20.86%)cases with gB2,34(18.18%)cases with gB3,whereas there were 17(9.09%)cases with mixed types of gBincluding 16cases with gB1+3and 1case with gB1+2.The HCMV-DNA viral loads in the urine were signifi cantly higher in the infants with mixed gBgenotyes than in the infants with single gBgenotype,the difference was signifcant(t=2.018,P=0.045),the difference in the HCMV-DNA viral loads in the urine between the infants with single gB genotype was not significant.CONCLUSION Among the infants infected with HCMV in Wenzhou,there exists the prevalent HCMV gB genotypes of gB1~3,the gB1is dominated,yet the gB4has not been detected.The HCMV-DNA viral loads in the urine are higher in the infants with mixed gB genotypes than in the infancts with sinble gB genotype,indicating that the mixed gBgenotypes are more prone to viral replication.


After analyzing present situation of forestry resources and existing problems during forestry resource management in Min county,Countermeasures to realize sustainable development of forestry resources have been put forward,that including clarify forest property right by further reform forestry management constitution,restoration of forest coverage by strengthening artificial afforestation,propagandizing ethics management of the forestry and changing production mode and lifestyle.


In this paper we establish the radio number for Flower Wheel graph (F W k n), k-Wheel graph (kW ) and


More than 40 years after the Black Report, evidence about the dynamics and determinants of socioeconomic inequalities in mortality is quite inconclusive. Although some recent studies reported signs of positive changes, such as reductions in absolute inequalities in a few countries, internationalspecific and countryspecific findings remain very sensitive to data specifics and measuring approaches. Surprisingly, even some Nordic countries having long histories of registers cannot provide complete data covering entire populations. For example, the official Danish and Swedish registerbased data on mortality differences by education often exclude advanced ages (eg, those born before 1922 in Denmark or born before 1915 in Sweden) and cover only the nativeborn populations. Despite some specific limitations, Nordic studies still provide the most systematic and reliable evidence about temporal changes in socioeconomic inequalities in mortality. The study by Jensen and colleagues focusing on educational inequalities in mortality in the Danish population aged 30–74 years warns about a notable increase in absolute inequalities between 1995 and 2019. Another key finding of this study concerns the profound role of smokingrelated and alcoholrelated deaths explaining about 60% of the total educational gap in mortality and about 50% of the increase in inequality during the study period. The fact that a country with a highly developed and generous social welfare system cannot prevent the widening of absolute inequalities in mortality is unexpected. It should be considered a warning about obstacles to sustainable national longevity improvements in the future. The new evidence comes in the context of the Danish female longevity disadvantage against Sweden and Norway, which is attributable to excess mortality of the 1915–1945 cohorts. In order to close this gap, Denmark needs to ensure faster, systematic and more equitable health progress. The controversy between the Nordic social democratic welfare state model and notable mortality inequalities has been called as 'Nordic paradox'. Although the original definition considers Sweden an exception from the paradox, evidence suggests that all Nordic countries show persisting or increasing mortality and longevity inequalities. 6 These findings might be considered worrying, taking into account other unfavourable signs. For example, Sweden has been gradually losing the highest international longevity rankings to other vanguard countries due to too slow progress at old age. Keeping longevity leadership at the most advanced stage of epidemiological development requires expanding systematic mortality reductions towards increasingly advanced ages. After entering a new stage of health transition, the steady leap forward is only possible in case of success in further reducing and postponing the burden of chronic diseases and combatting ageingrelated diseases such as Alzheimer's disease, other mental diseases and disability. Equitable progress across population groups is another important precondition for sustainable longevity improvements. Meanwhile, the most recent evidence from Denmark, Finland, Sweden (men only), and Norway warns about the opposite trends—slower progress in lower education groups and widening longevity gaps after the age of 65 years. At first glance, welfare state regime typologies provide practical conceptual frameworks to classify countries according to social contexts connected with population health outcomes, including inequalities in health. Therefore, it might be very tempting to associate the reported evidence about widening mortality and longevity inequalities with the 'failing' equitable Nordic socialdemocratic model. However, the literature points to numerous deficiencies in concepts of ideal/ classical types of welfare state regimes. Instead, it has been suggested to look at specific institutional mechanisms and policies combatting various types of inequalities rather than rely on abstract ideal types of welfare state. Despite many commonalities in social policies, the four Nordic countries show striking diversity in many other aspects, including health policies. A very illustrative example concerns differences in alcohol and smoking control policies and the subsequent impact of smoking and alcoholrelated mortality on the persisting longevity disadvantage of Danish and Finnish males against their Swedish counterparts. Welfare state regimes have also been changing due to the rapid expansion of modern highskills and advanced technologybased economies. These fast developments occurred together with significant changes in population composition—shrinkage and increasing selection (also in terms of health) of lower socioeconomic classes. Although improvements in education and occupational structures had a positive impact on average national longevity, smaller and selective lower socioeconomic classes tend to display increasingly higher excess mortality. Nevertheless, this compositional change and health selection argument cannot be used as an excuse for inaction. Despite rapidly growing ageing and socioeconomic challenges, it has been claimed that the shrinking Nordic social model is performing at least not worse than other forms of welfare state. Regarding population health, Nordic nations remain in the group of countries with the highest life expectancy. However, keeping the leadership in social and health domains will require much more effort than before due to newly emerging global challenges— threats of returning pandemics, consequences of climate change and growing economic and geopolitical instabilities. Unexpected declines in fertility observed in all Nordic countries may also indicate uncertainties in societal and demographic development. Emerging evidence from equitable Sweden about the disproportional effects of the COVID19 pandemic on vulnerable groups such as those lower educated, having lower income or being born in a lowincome country is a Laboratory of Demographic Data, MaxPlanckInstitute for Demographic Research, Rostock, MecklenburgVorpommern, Germany Max Planck – University of Helsinki Center for Social Inequalities in Population Health, Helsinki, Finland Vytautas Kavolis Interdisciplinary Research Institute, Vytautas Magnus University, Kaunas, Lithuania


Work patterns and the nature of regional agriculture defined the world of antebellum slave families in the American South. This article examines the effects that work had on the collective experiences of slave families living in Fairfax County in northern Virginia. Specifically, this study explores the consequences of work for child rearing, family time, and the development of internal family economies among slave families. A region often overlooked by historians of the antebellum South, northern Virginia was a difficult place for slave families by any standard. As this study will show, a weak agricultural sector and small slaveholdings, combined with long workdays, forced slaves to resort to shared child rearing and offered families few opportunities to be together or to develop extensive family economies.


The exponential increase in uniprocessor performance has begun to slow. Designers have been unable to scale performance while managing thermal, power, and electrical effects. Furthermore, design complexity limits the size of monolithic processors that can be designed while keeping costs reasonable. Industry has responded by moving toward chip multi-processor architectures (CMP). These architectures are composed from replicated processors utilizing the die area afforded by newer design processes. While this approach mitigates the issues with design complexity, power, and electrical effects, it does nothing to directly improve the performance of contemporary or future single-threaded applications.This paper examines the scalability potential for exploiting the parallelism in single-threaded applications on these CMP platforms. The paper explores the total available parallelism in unmodified sequential applications and then examines the viability of exploiting this parallelism on CMP machines. Using the results from this analysis, the paper forecasts that CMPs, using the "intrinsic" parallelism in a program, can sustain the performance improvement users have come to expect from new processors for only 6-8 years provided many successful parallelization efforts emerge. Given this outlook, the paper advocates exploring methodologies which achieve parallelism beyond this "intrinsic" limit of programs.


Sir: W have read the article by Tourani et al. with great interest.1 Following a cadaveric study, the authors' findings indicated that sparing the Scarpa fascia does not preserve the majority of lymphatics in the lower abdomen. Preserving a thin layer of fat above the rectus sheath reduces rates of seroma formation by preserving the deep lymphatics that run on top of the aponeurosis.2 Quoted rates of abdominal seroma formation following deep inferior epigastric perforator (DIEP) flap breast reconstruction range from 5.6 to 8 percent.3 Various methods have been described aiming to reduce seroma rates, including quilting sutures,4 the use of abdominal binders, and postoperative drains. Even with newer techniques, a rate of 2.4 percent (42 patients) was reported.5 In our practice, we note a very low rate of seroma formation after DIEP flap breast reconstruction. We analyzed data from January of 2000 to December of 2014 that were collected prospectively for all consecutive patients undergoing DIEP flap breast reconstruction at Norfolk and Norwich University Hospital. Four of the 726 patients had seromas, a rate of 0.55 percent. Donor-site closure was performed in a standardized fashion in all cases. The superior abdominal flap is undermined in the central portion only (Fig. 1). We avoid lateral dissection unless a rectus divarication is corrected. A thin layer of fat overlying the rectus sheath and the external oblique muscle is left intact, except for where the DIEP perforators have been dissected. We use cutting diathermy, paying close attention to the cutting technique, using the arc rather than contact, thus minimizing thermal injury to the fat and deep lymphatics. The rectus sheath is closed with a double continuous suture with looped 0 nylon. The abdomen is closed in three layers using 2-0 polydioxanone interrupted sutures to the Scarpa fascia, followed by deep dermal and subcuticular sutures using 3-0 Monocryl (Ethicon, Inc., Somerville, N.J.). We use two 15-French Blake drains that are removed once the drainage is less than 30 ml in 24 hours. This ranged from 3 to 8 days (average, 5.3 days). We also adhere to a strict postoperative physiotherapy regimen, avoiding active movements of the abdomen for the first 10 days to minimize shearing forces over the abdominal wall. According to the authors' findings, lymphatics are located close to fascial planes rather than Fig. 1. The superior abdominal flap is undermined only in the central portion, leaving it intact laterally and thus reducing the potential dead space. A thin layer of fat overlying the rectus sheath under the superior abdominal flap is left intact. GUIDELINES Letters to the Editor, discussing material recently published in the Journal, are welcome. They will have the best chance of acceptance if they are received within 8 weeks of an article's publication. Letters to the Editor may be published with a response from the authors of the article being discussed. Discussions beyond the initial letter and response will not be published. Letters submitted pertaining to published Discussions of articles will not be printed. Letters to the Editor are not usually peer reviewed, but the Journal may invite replies from the authors of the original publication. All Letters are published at the discretion of the Editor. Letters submitted should pose a specific question that clarifies a point that either was not made in the article or was unclear, and therefore a response from the corresponding author of the article is requested. Authors will be listed in the order in which they appear in the submission. Letters should be submitted electronically via PRS' enkwell, at www.editorialmanager.com/prs/. We reserve the right to edit Letters to meet requirements of space and format. Any financial interests relevant to the content of the correspondence must be disclosed. Submission of a Letter constitutes permission for the American Society of Plastic Surgeons and its licensees and assignees to publish it in the Journal and in any other form or medium. The views, opinions, and conclusions expressed in the Letters to the Editor represent the personal opinions of the individual writers and not those of the publisher, the Editorial Board, or the sponsors of the Journal. Any stated views, opinions, and conclusions do not reflect the policy of any of the sponsoring organizations or of the institutions with which the writer is affiliated, and the publisher, the Editorial Board, and the sponsoring organizations assume no responsibility for the content of such correspondence. The Journal requests that individuals submit no more than five (5) letters to Plastic and Reconstructive Surgery in a calendar year.


This paper gives a general algorithm for computing the character table of any Renner monoid Hecke algebra, by adapting and generalizing techniques of Solomon used to study the rook monoid. The character table of the Hecke algebra of the rook monoid (i.e., the Cartan type $A$ Renner monoid) was computed earlier by Dieng, Halverson, and Poladian using different methods. Our approach uses analogues of so-called A- and B-matrices of Solomon. In addition to the algorithm, we give explicit combinatorial formulas for the A- and B-matrices in Cartan type $C$ and use them to obtain an explicit description of the character table for the type $C$ Renner monoid Hecke algebra.


Tax fraud and tax evasion limit the ability of countries to generate income and to carry out their economic policies. In a period of significant budgetary constraints, combating tax fraud and tax evasion is more than a matter of tax equity - it becomes an essential element for the social and political acceptability of fiscal consolidation. The European Council agreed to accelerate the work in terms of combating tax fraud, tax evasion and aggressive tax planning. In particular, progress will be made with priority in the promotion and widening of the scope of the automatic exchange of information at all levels.


This paper deals with the problem of fault (or disturbance) decoupling in nonlinear systems. A new method is proposed to increase dimension of state subspace which is insensitive to fault (or disturbance). This method is based on a nonlinear filter defined by means of the generalized output injection. An example is presented which illustrates results.


We performed myocardial scan using 201TlCl and 99mTc-methoxy isobutyl isonitrile (99mTc-MIBI) in 16 patients of myocardial infarction and compared their diagnostic value. In view of image quality, 99mTc-MIBI scan was superior to 201Tl scan in 11 cases, and 201T1scan was superior in no case. There was no statistically significant difference between 99mTc-MIBI scan and201T1 scan in sensitivity (88.9% and 83.3%, respectively) and specificity (83.9% and 80.6%, respectively) . It is concluded that 99mTc-MIBI enables us to perform high quality myocardial scan and is clinically useful.


Between October 1999 and June 2000 a joint government-donor working group undertook a public expenditure review in Vietnam that was supposed to use "gender issues" as a cross-cutting theme. The article discusses ways in which a gender analysis could have been incorporated into a review of public expenditure, and examines why this did not happen in the end. Flaws in the process reduced the scope of gender analysis. Institutional constraints on the part of both the government and the World Bank weakened the commitment to a gender analysis. More fundamentally, however, it is argued that the methodological approach of the World Bank rendered it incapable of investigating possibly unquantifiable macrostructural and mesoinstitutional determinants of individual behavior. It is further argued that the conceptualization of social institutions offered by the World Bank with regard to gender relations fails to adequately express the extent to which social institutions are gendered.


4130 Background: Recent international guidelines have included stereotactic body radiotherapy (SBRT) which outstanding tumor control as a treatment option for hepatocellular carcinoma (HCC) in several settings. However, data evaluating surgery and SBRT are limited, and results published were controversial. The retrospective study aims to compare the efficacy of hepatectomy and SBRT for HCC. Methods: The study population started with patients in databases of primary HCC, treated with curative hepatectomy or SBRT, regardless of tumor number, tumor size, cirrhosis and portal vein thrombosis. Patients with prior cancer treatment other than transarterial chemoembolization were excluded. In order to reduce the potential confounding effect of treatment and selection bias, 3-to-1 propensity score models were constructed based on each patient's estimated propensity score. The variables significant for overall survival were considered for the match, including age, sex, Child-Pugh score, ECOG performance status score, maximum diameter, BCLC stage, prothrombin time, total bilirubin, albumin, and white blood cell. Overall survival and progression-free survival were compared. Results: A total of 174 patients, 154 in hepatectomy group and 20 in SBRT group, were analyzed. 125 men and 29 women, mean 56.2 years of age, in hepatectomy group. 12 men and 8 women, mean 70.5 years of age, in SBRT group. ECOG was a significant favorable factor for overall survival. Maximum diameter, portal vein embolization, aspartate transferase and albumin was significant favorable factors for disease-free survival of patients with primary hepatocellular carcinomas. Before PSM, patients in the hepatectomy group tended to be younger, had better performance status, less cirrhosis, less tumor number and had better hepatic function than those in the SBRT group ( P < .05). The 3-year overall survival rate and median progression-free survival time for the surgical resection and SBRT groups were 77.9% vs 35.4 (P = .003) and 30 vs 20 month (P = .486), respectively. After PSM, 80 patients, 60 in hepatectomy group and 20 in SBRT group, were analyzed. The 3-year overall survival rate and median progression-free survival time for the surgical resection and SBRT groups were 71.9% vs 56.6 (P = .92) and 17 vs 26 month (P = .656), respectively. The patients of hepatectomy group had less cirrhosis, better liver function and less tumor number than those in 20 with SBRT. Conclusions: For primary HCC, regardless of tumor size and tumor number, stereotactic body radiotherapy can provide similar result on overall survival and tumor control compared to hepatectomy. Stereotactic body radiotherapy can also be less invasive and provide less inpatient time. So stereotactic body radiotherapy can be a effective treatment for patients with primary HCC.


We present results of spectroscopic observations of selected stars in the southern open cluster NGC 6134. We have determined the rotational velocities of the six known Scuti stars in NGC 6134 as well as several other non-variable stars with similar colour temperature in order to investigate ifv sini and variability is somehow connected: we find no such correlation. We also compare the distribution ofv sini of Scuti stars and non-variable stars with four other well-studied open clusters to look for any systematic behaviour, but we find no conclusive evidence forv sini and variability to be connected. We have also used the spectra to carry out an abundance analysis of the Scuti stars in NGC 6134 to confirm the high metal content of the cluster. We find (Fe=H)=+0:38 0:05 which is in agreement with the result obtained from Stromgren photometry. We also presenta photometry of the cluster, but we find no chemical peculiar stars based on this index.


EW Lac has shown remarkable V/R variations in 1976 - 1986, and a similar V/R variation has started again in around 2007, after some quasi-periodic V/R variation. For the first V/R variation event, we analyze the spectroscopic behaviors of emission lines and shell absorption lines of the Balmer series. The V/R variations of the H_alpha through H_delta lines are characterized by the different manner of variations of the individual emission lines in time lag and in duration of the V/R phases. Weak correlation is also notable between the V/R variations and other variations of the line-profile parameter such as the peak velocities, emission line intensities and peak separations. We analyze shell absorption lines for higher members of the Balmer series for their central depths and radial velocities. The optical depth of the H_alpha line is in a range of 2000 to 6000, and its long-term variation discloses different behaviors as compared to the V/R variations. Combining the analyses of emission and shell absorption lines, and regarding the V/R variation as wave propagation phenomena, we find for the 1976 - 1986 event that the V/R variation is of retrograde structure and a spiral structure is likely formed inside the disk in the latter half of this event. The weak correlations among physical parameters are suggestive of the disk truncated at some radius. It is noticed that remarkable stellar brightening has occurred in the latter half of the event, accompanying marked decrease of emission line intensities. As for the V/R variation appeared in around 2007, which looks like a recurrence of the previous event, we found less developed state of the disk without appreciable time lag.


Traditional long short-term memory (LSTM) neural networks generally face the challenge of low training efficiency and poor prediction accuracy for the remaining useful life (RUL) prediction due to their structure. In this study, a novel model called self-attention ConvLSTM (SA-ConvLSTM) neural network is proposed derived from ConvLSTM and a SA mechanism. First, convolution operators replace the fully connected layers inside the network structure to reduce the redundancy of the network and enhance its nonlinear modeling capability. Subsequently, a SA module is designed and embedded into the interior of the model by adaptively employing the corresponding important information to improve the prediction performance. Extensive experiments on the test rig and the actual wind farm confirmed that the developed SA-ConvLSTM has advantages over other conventional prediction methods in terms of convergence speed and prediction precision.


We show that a properly immersed minimal hypersurface in M x R_+ equals some M x {c} when M is a complete, recurrent n-dimensional Riemannian manifold with bounded curvature. If on the other hand, M has nonnegative Ricci curvature with curvature bounded below, the same result holds for any positive entire minimal graph over M.


To study the relationship between neonatal hypoglycemia and obstetricrisk factors. Metbods 73 cases with neonatal hypoglycemia (the hypoglycemia group) during Jan1996 to June 1998 were analyzed and compared with 73 cases without hypoglycemia newborns (thecontrol group) at the same time. Result The incidences of pregnancy with PIH, diabetes, primaryhypertension, IUGR, preterm labor, twin pregnancy in the hypoglycemia group were higher thanthose in the control group. The early nenatal hypoglycemia increased significantly in newborns withcomplications (including neonatal hyperbilirubinemia, asphyxia, pneumonia et al. ). Couclusion Itis essential to monitor neonatal blood sugar carefully in the newborn witha high risk on hypoglycemia. It is also suggested that we should observe the blood glucose change in newborns with complications in order to discover and to treat neonatal hypoglycemia timely.


Methylmalonic acidemia was first described in 1967 and represents an autosomal recessive disease originating from a disorder of propionate metabolism. Although rare, it is one of the most frequent inborn errors of organic acid metabolism. The disease can manifest itself in the first days of life or have late onset in childhood. The therapy is based on protein restriction and carnitine supplementation. The present study reports a case of an infant who was seen at the hospitals emergency room with vomiting, dehydration, fever, adynamia, hyporexia, hypotonia and hyporesponsiveness, and developmental delay. Started research for methylmalonic acidemia and confirmed diagnosis through laboratory tests. Therefore, it is important to have studies and research on rare genetic diseases so that medical professionals can update, diagnose and seek early treatment for such patients.


Thermomechanical analysis was used to compare cure conditions of a bisphenol A epoxy resin composition and the same composition prepared with a rigid rod biphenol epoxy resin. The rigid rod system exhibited a lower curing rate and lower thermal expansion than did the bisphenol A system. The glass transition and thermal expansion of the rigid rod system can be varied by manipulation of the ratio of curing agent to epoxy. © 1998 John Wiley & Sons, Inc. J Appl Polym Sci 70: 2163–2167, 1998


ABSTRACT The paper analyzes long-term effects of changes in external conditions on the support for populist parties in the Czech Republic. The results confirmed importance of political dissatisfaction for the rise of populist parties but are limited by the presence of other protest parties. While the evidence of the effects of the economic context is mixed, results of our analysis indicate the importance of time and of election campaigns in particular. All in all, our results point to the importance of the campaign dynamics, the party system setting, and incumbency in assessing support for populist parties in Central Europe and elsewhere.


The efficiency of nurses in detecting arrhythmias was studied in a coronary care unit (CCU) with 6 beds, equipped with a system for decentralised electrocardiographic display and with well-defined routines for arrhythmia documentation. Arrhythmias were classified and reported at half-hour intervals. Fifty patients were included in the study. A continuous electrocardiographic recording was subsequently analysed beat by beat and used as reference. The arrhythmias were classified into: (i) 'benign' arrhythmias, (ii) 'warning' arrhythmias, (iii) 'malignant' arrhythmias, and (iv) ventricular tachycardia. The detection rate for different arrhythmias variedfrom 96 per centfor patients with 'benign' arrhythmias occurring in at least three 1-minute periods per half-hour and 86 per cent for patients with 'warning' arrhythmias, to 42 per cent for patients with ventricular tachycardia. Special attention was paid to infrequently occurring arrhythmias which were analysed in relation to half-hour periods. Of 'warning' arrhythmias occurring during only one 1-minute period per half-hour, 48 per cent were detected, but the detection rate increased to 71 per cent when the same type of arrhythmia occurred during two or more 1-minute periods per half-hour. The mean delay time for detection of 'warning' and 'malignant' arrhythmias was less than half an hour. The exact delay time could not be evaluated as the study was based on the half-hourly reports of the nurses. The fact that the most infrequent 'warning' arrhythmias were detected in 48 per cent during the first possible minute indicates, however, that the true delay time is


urine. For it has been shown that substances other than bile salts, which also have the power of reducing surface tension, may occur in vomit and faeces, and might under special circumstances be resent in sufficient quantity to introduce a serious fallacy. The most important of such substances are alcohol, ether, chloroform, acetic acid, acetone, turpentine, phenol, skatol, and soaps. In the majority of these the power of reducing surface tension is small as compared with that of bile salts. With urine the case is different, for none of the normal constituents give the reaction. None of the substances other than bile salts, which do give the reaction, have ever been found to occur in urine in sufficient quantity to introduce a fallacy, and there is no drug at present known which, when taken, invalidates this test. The simplest method of carrying out the test is to place the urine in a test tube with a diameter of about I in., and to throw some sublimed or finely powdered sulphur upon it. If any begins at once to fall in the urine there is at least I part of bile salts per xo,ooo. If none falls at once, then, after waiting one minute, the test tube is given a very gentle shake; if sulphur now begins to fall, there is at least I part of bile salts per 40,000, and so on for further dilutions. Few precautions are necessary. The urine must be free from air bubbles, it must be clear, and, if it is necessary to clear it, this must be done by filtration and not by heat. For all specimens of urine at the temperature of the1body give the reaction at the end of one minute, owing to the effect that heat has in lowering the surface tension of a fluid; therefore in every case before the test is applied the urine must be cooled to about 170 C. The reaction of the urine and its specific gravity do not:in any way affect ,the accuracy or delicacy of the test. The delicacy of Hay's reaction as compared with that of Pettenkofer is very great; for, apart from the fact that in applying Pettenkofer's test to urine there are so many fallacies as to render it almost useless; i part of bile salts per I,OOO gives only a doubtful :Pettenkofer's reaction. Many urines in various pathological conditions have been tested, but no case giving the reaction has yet been found in which the clinical condition was not such as to make the presence of bile salts in the urine possible. Thus it has been found that Hay's reaction is frequently given by the urine from cases of backward pressure in cardiac and pulmonary disease, and in cases of suspected cirrhosis of the liver; even when bile pigments were shown by the iodine test3 to be absent. In two cases of suspected cirrhosis of the liver the reaction was given only intermittently, being present on one day and absent on the next. In a case of gall stones with jaundice which was operated upon and the obstruction removed bile salts were found present in the urine for a fortnight after the bile pigments had disappeared, and when the patient in appearance was quite free from jaundice. It has further been noticed that jaundiced patients differ greatly in the relative amounts of bile salts and bile pigments which their urine contains. For instance, the urine from a case of cirrhosis of the liver, which was scarcely darker in colour than the normal, was found to contain large quantities of bile salts; on the other hand, in two cases of secondary growths in the liver and in one case of gall stones, in all of which the jaundice was very intense and of some months' duration, the urine, although almost black with bile pigment, was found to contain but little bile salts. Hay's test is so simple that it certainly deserves more extended use in clinical work, especially in investigations upon the relative excretion of bile salts and bile pigments.


Lake States pulpwood production climbed to a record 8.54 million cords in 1989. Pulpwood production is shown by county and species group in Michigan, Minnesota, and Wisconsin.


When closely examining data of technology users, there is an apparent and interesting shift in two specific groups—the elderly and disabled. This paper investigates the potential reasons for the data trends found in these two groups. Technology greatly impacts people with disabilities and how they navigate the world. Technological developments increasingly work to address the isolation that people with disabilities experience, and how they are often unable to engage with their communities. This research paper outlines the way technology has shaped social communication, information distribution, and day-to-day living among people with disabilities.The internet has transformed social communication and interaction. Previously, socially isolated people with disabilities have gained exposure to social environments through the internet and social media. The broad range of information available on the internet increases access to resources such as government services, health services, and social support. Assistive devices help people overcome their motor, sensory, or cognitive difficulties that may hinder them from performing daily functions. Although technology has proven to be effectively integrated in the lives of people with disabilities, many individuals with disabilities lack the access to technology such as a computer with internet connection. This paper examines how technology has benefited communication, information distribution, and day-to-day living in the disabled and aging community.


This paper introduced the transmission links behind the turbine governor controller output link, and elaborated the interaction between these transmission links. Based on the example, the paper considered the universality of controlled object's self-regulating and self-balancing from a new perspective, and cited how to use these common and convergence regular pattern 'intentionally or unintentionally' in turbine governor control. At last, the paper proposed some ideas of turbine governor control system design, and suggested how to deeply understand and use self-balancing ability of control object.


Experimental study and finite element modeling on the structural behavior of high-strength Q460 steel columns after being exposed to ISO-834 standard fire are presented. Two section shapes were considered, namely welded H-shaped section and welded box-section. The experiment composes of two stages: heating and cooling stage of the specimens and compressive test on the specimen after fire exposure. The temperatures experienced in the specimens were recorded during both the heating and cooling phases, as well as the load–deflection curves, load–axial displacement curves, load–rotation curves, load–strain curves, and failure modes in the steel columns were measured during the compressive tests. Three-dimensional finite element models were also established by employing the program ANSYS to study the post-fire behavior of high-strength Q460 steel columns. The finite element models were used to investigate the effects of key parameters on the residual load-bearing capacity of high-strength Q460 steel columns, following exposure to the ISO-834 standard fire. The investigated parameters included heating time, cooling methods, and slenderness ratio. Finally, a simplified design approach was proposed for predicting the residual load-bearing capacity of high-strength Q460 steel columns after being exposed to ISO-834 standard fire.


Five different types of glandular micro-hair, namely panicoid form chloris form balano and arundoform specific form and sporobolus form were present in the abaxial epidermis of the lamina in 11 different strains of citronella. The density of essential-oil producing micro-hairs of the leaf lamina showed differences among the 11 strains of citronella (strains HI1 and HI11) studied. Micro hair density also showed differences between the micro-hair types and citronella strains. All the strains except HI9 and HI11 has a higher density of panicoid form micro-hair than balanoform, arundoform and specific micro-hair densities and most of the chemical components of the essential oil of citronella


The rapid urbanization and growing population aging have become salient features in China. Understanding their impacts on household emissions is crucial for designing mitigation policies for household carbon emissions. By integrating Chinese older household survey data with an unconditional quantile regression model, this paper examines the heterogeneous impacts of household characteristics on indirect carbon emissions of older Chinese households. There are three main findings: (1) The effects of urbanization on emissions at different quantiles of carbon emissions appear to be inverted U-shaped, which means that the rise of urbanization level increases carbon emissions more at the middle than at the bottom or the top, and helps to alleviate carbon emission inequality, (2) though carbon emissions rise with the increase of income, there is a clear urban-rural divide in the effects of income on carbon emissions, and (3) the rise in the share of well-educated people contributes to the increase in carbon emissions. The higher the degree of education is, the larger the impact is. These findings contribute to understanding the determinants of carbon emissions and are helpful for policymakers to design targeted policies in reducing carbon emissions from the consumption-side.


The EU transport policy regarding financial provision of public passenger transport is considered. Place the separate provisions of EC Regulation 1370/2007 of the European Parliament and of the Council of 23 October 2007 on public passenger transport services on rail and road transport, which repeals Regulation (EEC) № 1191/69 and (EEC) № 1107/70 of the Council, which must be over 8 years implemented in Ukraine.
Keywords: social services, Regulation 1370/2009, benefits in cash, compensation for public services, contracts, publicity.


Objective:To refine the value of baseline and adrenocorticotropin hormone (ACTH)-stimulated cortisol levels in relation to mortality from severe sepsis or septic shock. Design:Retrospective multicenter cohort study. Setting:Twenty European intensive care units. Patients:Patients included 477 patients with severe sepsis and septic shock who had undergone an ACTH stimulation test on the day of the onset of severe sepsis. Interventions:None. Measurements and Main Results:Compared with survivors, nonsurvivors had higher baseline cortisol levels (29.5 ± 33.5 vs. 24.3 ± 16.5 &mgr;g/dL, p = .03) but similar peak cortisol values (37.6 ± 40.2 vs. 35.2 ± 22.9 &mgr;g/dL, p = .42). Thus, nonsurvivors had lower &Dgr;max (i.e., peak cortisol minus baseline cortisol) (6.4 ± 22.6 vs. 10.9 ± 12.9 &mgr;g/dL, p = .006). Patients with either baseline cortisol levels <15 &mgr;g/dL or a &Dgr;max ≤9 &mgr;g/dL had a likelihood ratio of dying of 1.26 (95% confidence interval, 1.11–1.44), a longer duration of shock, and a shorter survival time. Patients with a &Dgr;max ≤9 &mgr;g/dL but any baseline cortisol value had a likelihood ratio of dying of 1.38 (95% confidence interval, 1.18–1.61). Conclusions:Although delta cortisol and not basal cortisol level was associated with clinical outcome, further studies are still needed to optimize the diagnosis of adrenal insufficiency in critical illness. Etomidate influenced ACTH test results and was associated with a worse outcome.


In an attempt to examine different social appropriations, we formulate a periodizationthat comprehends the continuities and ruptures in Brazilian national populism. Thefocus is especially on the final phase, at the beginning of the 1960s, marked by anintense appropriation of national populism by the popular classes. This appropriationwould contribute to the deepening of the political crisis, whose end result was the coupof 1964, the starting point for 21 years of military dictatorship.


A vast discussion is underway regarding European structural funds, an instrument the European Union created in order to reduce the economic differentials among its regions. During the 2000-2006 CSF they represented 1/ 3 of EU budget. Despite these efforts, part of the literature finds small effects and persistence in those differences in GDP which these funds should reduce.
In this work the issue will be addressed by looking at regions within EU-15, in the period 2000-2007. Proof of the positive effect of funds was first searched using models of absolute beta convergence and addressing issues like spatial autocorrelation and heterogeneity between regions. The attention moved then to the task of constructing a dataset which could provide detailed figures on funding paid to each region each year, by combining information available from official sources and through the estimation of those figures for which information was missing. On the base of this dataset new models were estimated, taking into account the spill-over effects and the possibility of cluster convergence.
The result was that structural funds have, overall, a positive impact. Once we move to more complex and realistic models, convergence becomes weaker, casting some doubts on the effectiveness of these funds.


The paper proposes one power grid partition method for black start based on complex network theory. The method is composed of splitting algorithm and agglomerative algorithm. The former algorithm divided grid to some temp zone according to the number of black-start unit, which determines the basic structure of the partition and reduces the number of iterations in agglomerative process. The latter algorithm redefines the line weight and weighted modularity based on flow distribution and network topology, then merges neighbouring temp zone to maximum weighted modularity. The method can reflect the close degree of the partition, accurately assess the partition quality and determine the optimal number of partitions. The simulation results on IEEE 39-bus test system illustrate the validity of this methodology.


1 I plastic surgery is among the most competitive specialties in medicine. In 2015, there were 67 integrated plastic surgery residency programs, offering 148 training positions, with 206 applicants for these positions.1 Geography plays a significant role in applicants' decision as to where to apply. An association between residents' matriculated medical school and residency program has been identified in several surgical specialties, including ophthalmology, general surgery, and otorhinology.2–4 Although many factors contribute to the success of an applicant in matching into a plastic surgery program, the role of geography in the match has not been explored. American Medical Association's interactive database was accessed for the list of integrated plastic surgery programs in June 2015. Sixty-seven plastic surgery program Web sites were accessed and data were collected. Programs were categorized based on US census bureau-designated regions, namely Northeast, Midwest, South, and West, and number of residency positions available. One-way Analysis of Variance (ANOVA) and Student's t test were used for comparison with P value of <0.05 considered as statistically significant. Four hundred seventy-three residents belonging to 43 programs, which had complete listing of residents available on their Web sites, were identified. Ninety-three (19.6%) residents attended the medical school affiliated with their residency program. This is similar to the trends seen with otolaryngology residency match where 20% of the residents attended the program affiliated with their medical school.3 Larger programs, with 11 or more residents, were found to have a higher proportion of residents attending the program affiliated with their medical school compared with smaller programs, with less than 11 residents (24.2% versus 14.8%) (Table 1) (P value = 0.03). Interestingly, geographic bias also differed with regions. Northeast had the highest proportion of residents from the same region (57.7%), whereas the West had the lowest proportion (13.2%; P value < 0.0003) (Table 2). It is important to note that residents who matched at programs in the West versus those that matched in the Northeast had no statistically significant difference in availability of plastic surgery residency program affiliated with their medical school of graduation. In conclusion, in integrated plastic surgery residency programs, one fifth of residents attend the same program as their matriculated medical school. Geographic association between residency program and medical school is strongest for the residents in the Northeast and weakest for those in the West. We believe this geographic bias has implications for applicants in the match as it appears that medical students in the Northeast and those from large programs are more likely to match at a program affiliated with their medical school of graduation compared with other regions. These data may also be relevant to the few undergraduate students who have an interest in plastic surgery. Whether our findings are secondary to program or applicant preference is unclear, but our analysis sheds light on some biases that may be exceedingly relevant to aspirants of plastic surgery.


AbstractThe continuously deteriorating water quality situation in Pakistan is posing serious health threats to the population. The study aimed to assess the physicochemical and bacteriological quality of drinking water in different institutions of Abbottabad city and its potential health effects on staff and students. About 63 samples from 60 institutions across different locations of Abbottabad city were analysed for physicochemical (temperature, pH, total dissolved solids (TDS) and electrical conductivity (EC)) and bacteriological (total coliforms and Escherichia coli) analysis using standard methods. Water quality (n = 60) and health related (n = 300) information was obtained through pre-designed survey questionnaires. Results showed that all water samples were aesthetically acceptable. In physicochemical analysis, the mean temperature and pH values were found at 27.12 ± 2.47°C and 7.98 ± 0.24, respectively. The mean TDS and EC values were found at 335.42 ± 86.3 ppm and 647.38 ± 174.82 μS, respectively...


A magnetosonic wave propagating perpendicular to a magnetic field in a two-ion-species plasma has two branches, high-frequency and low-frequency modes. The finite beta effects on these modes are analyzed theoretically on the basis of the three-fluid model with finite ion and electron pressures. First, it is shown that the Korteweg-de Vries (KdV) equation for the low-frequency mode is valid for amplitudes e<emax, where the upper limit of the amplitude emax is given as a function of β (β is the ratio of the kinetic and magnetic energy densities), the density ratio, and the cyclotron frequency ratio of two ion species. Next, the linear dispersion relation and KdV equation for the high-frequency mode are derived, including β as a factor. In addition, the theory for heavy ion acceleration by the high-frequency mode pulse and the pulse damping due to this energy transfer in a finite beta plasma are presented.


Multireservoir system consists of several reservoirs which are connected serially or parallel in the same basin. To optimize such a complex multireservoir system, the dynamic programming (DP), linear programming (LP) and non-linear programming (NLP) have been widely applied to real problems. However, when DP is applied to multireservoir system it has a major problem, so called `the curse of dimensionality' and LP and NLP have essential approximation problems dealing with discontinuous, nondifferentiable, non-convex, or multi-modal objective functions. Recently, there has been an increasing interest in a biologically motivated adaptive system for solving optimization problems. The genetic algorithms (GAs) are one of the most promising techniques in natural adaptive system field and receiving many attentions because of their flexibility and effectiveness for optimizing complex systems. Optimization of multireservoir system is to solve multi-dimensional and multi-objective problems and GAs are appropriate optimization methods to multireservoir system. GAs are not restricted by a number of dimensions because computer memory increases by dimensions linearly, not exponentially. Thus, there is no `curse of dimensionality'. Especially classical optimization methods such as DP, LP, and NLP are not proper to multi-objective optimization because these methods use a point-by-point approach, in which the outcome of classical optimization methods is a single optimal solution. However, GAs use a population of solutions in each iteration instead of a single solution, so they are called as population-based approaches. This is one of the most striking differences between classical optimization methods and GAs.


Here, we report that intense ultra-short laser pulses produce a plasma of low energy electrons (LEEs) by the inverse Bremsstrahlung effect and multiphoton ionization process. The phenomena show five striking characteristics. First, the self-focusing of ultra-short laser pulses creates a plasma of LEEs (6.5 eV), which is concentrated in filaments through an avalanche process. Second, kinetically hot 6.5 eV electrons interact with surrounding molecules resulting in reactive radical species. Third, the dose rate reaches an enormous level of ~2.8 × 1011 Gy/s as determined by a cericcerous sulfate dosimetry and this leads to an ultra-high deposition of energy of between 4.6 × 107 to 8.16 × 107 keV/μm. Fourth, filaments of variable length are produced by femtosecond pulses depending on the pulse duration as determined by a tissue-equivalent radiation polymer gel dosimeter and imaged by magnetic resonance imaging (MRI). These results reveal that one of the very interesting novelty of filamentation is the very low entrance dose, similar to proton irradiation. Lastly, filamentary irradiation results in the decomposition of thymidine in the absence and the presence of oxygen similar to the radiolysis of water.


The development of the society has gradually attached importance to the cultivation of e-commerce professionals. Higher vocational education should actively reform the teaching mode of e-commerce specialty to meet the basic needs of the development of the contemporary society. Under the background of "Internet plus", the e-commerce majors in higher vocational colleges are facing greater challenges. Only by changing the traditional teaching concept, enhancing teachers' innovative consciousness and actively meeting various challenges in teaching can we promote the deepening reform of the teaching mode of e-commerce in higher vocational colleges.


This paper investigates the impact of load power factor on sympathetic inrush current. Sympathetic inrush current is caused by the voltage drop across the system resistance due to energizing current of the parallel adjacent transformer. It may cause the protection system to mal-trip and the transformer outage. The presented model is validated by simulation using DIgSILENT. The simulation results show that sympathetic inrush current's magnitude depends on the load power factors. This dependency is illustrated and analyzed, which gives deeper insight into sympathetic inrush current and transformer protection.


During the last years the interest in least squares finite element methods (LSFEM) has grown continuously. Least squares finite element methods offer some advantages over the widely used Galerkin variational principle. One reason is the ability to cope with first order differential operators without special treatment as required by the Galerkin FEM. The other reason comes from the numerical point of view, where the LSFEM leads to symmetric positive definite matrices which can be solved very efficiently under some conditions. This report gives an overview about the recent literature which appeared in the field of least squares finite element methods and summarises the essential results and facts about the LSFEM.


The invention relates to polyhedra GLASS THAT CAN BE USED AS PARTICULARLY TRAVIESAS that keep a space between two glass slides. According to the invention, these polyhedra POSSESS a substantially polygonal section whose dimensions are sub-millimeter, the angles are rounded with a radius of less than 10 microns curbatura. The invention also provides a manufacturing process and a device for your application.


Randomly perturbed lattice models play a vital role in the exploration of novel quasi-disordered structures such as disordered photonic crystals that combine the coherent optical effects of crystals and the broadband, isotropic power spectra of disordered media. Recent studies have shown that the Bragg scattering peaks of uniformly randomized lattices can be switch-on and -off by increasing the perturbation strength while preserving the long-range order of the underlying lattice. In this work, we investigate the pair correlation statistics of uniformly randomized lattices focusing on the impact of the perturbations on the system's short-range order. We find that locally isotropic perturbations generate disordered structures with resilient hyperuniformity and short-range order. The interplay of these two properties has been discovered to be critical in the design of disordered materials with enhanced photonic band gaps and light absorption. The present study provides an alternative approach for designing partially disordered hyperuniform structures.


In this article, a novel full-chip EM simulation tool, called EMSpice simulator is proposed. The new method starts from first principles and simultaneously considers two major interplaying physics effects in EM failure process: the hydrostatic stress and electronic current/voltage in a power grid network. The new tool starts by reading the power grid layout information from Synopsys IC Compiler. It then removes immortal interconnect wires by considering both nucleation phase immortality and incubation phase immortality for multi-segment interconnects. Thereafter, a finite difference time domain (FDTD) solver is employed for stress analysis for every mortal interconnect tree for both nucleation and post-voiding phases. At the whole power grid circuit level, the EM analysis is coupled with IR drop analysis of a whole power grid network at each time step so that we can consider the interaction among stress, void growth, resistance change and IR drop in a single simulation framework. Accuracy of EMSpice is validated by comparing with a published EM simulator, XSim, for nucleation phase, and finite element method based COMSOL for post-voiding phase. The comparison results show that EMSpice agrees well with both methods with. Experimental results on two practical processor chip designs show that the proposed coupled EM-IR drop analysis method can further reduce the overly conservative EM-aware power grid design as the number of the failed trees found by EMSpice simulator is up to 76.7% less than the Black's method and 66.7% less than a recently proposed full-chip EM analysis method respectively. Furthermore EMSpice simulator is the least conservative one for lifetime estimation of individual tree wires among the three methods.


We have studied the matrix effects in Si1−xGex structures under O2+ and Cs+ bombardments. Matrix effects are practically suppressed with Cs2Ge+ secondary ions, for Ge concentrations between 0 and 100at.%. A procedure for the accurate quantification of the Ge concentration in Si1−xGex alloys using Cs2Ge+ and CsGe+ clusters has been proposed. For structures in which the Ge content is constant over several hundreds of nanometers, both methods provide very similar results, with an excellent agreement between the Ge concentrations measured by secondary ions mass spectrometry and x-ray diffraction. However, for continuously varying Ge concentration profiles, the nonlinear response of the CsGe+ normalized intensity and the persistence of strong matrix effects for CsSi+ ions lead to differences between the Ge concentration profiles measured with the CsGe+ method compared to the Cs2Ge+ one. The latter is therefore the only reliable method for the study of Ge indiffusion into Si from a pure Ge layer grown by chemic...


In this contribution the principle of the trustworthiness and user trust is discussed. The research aim was to discuss a users trust and its issues, which are connected to the electronic voting. The electronic voting seems to be more problematic in case of system trustworthiness. Trustworthiness can be defined as user relation to the system or software solution. The four more significant factors are described. Key-Words: system engineering, system design, trustworthiness, electronic voting systems.


The problem of designing a controller to obtain simultaneous stabilization or pole-assignment for multiple systems is dealt with in this paper. The need of simultaneous stabilization or pole-assignment is due to de-signing fault-tolerant control systems. Sufficient conditions of simultaneous pole-assignment by a dynamical com- pensator for multiple systems ate derived. These conditions arc shown to be necessary in the case where the number of either input or output channels is one. Finally, the procedure of designing the compensator is presented, and an example is given.


Image analysis is the extraction of meaningful information from images; mainly from digital images by harnessing image processing techniques. Digital image processing allows the use of complex algorithms, and offers more sophisticated performance at simple tasks. We are developing a system for retrieving information from digital document images which is later stored on a database. Preprocessing of an image includes binarization and for this, we are using Maximum Entropy method. Optical Character Recognition (OCR) is a technology for converting scanned papers, digital photos and PDF files to text documents which can be edited. OCR is used to detect text from images which is then processed.


When the Earth's surface warms and emits long-wave infrared (IR) radiation, IR active gases (e.g. CO2, CH4, etc.) effectively absorb it; CO2 is therefore one of the major challenges facing the climate research community. However, in Europe recent radiation measurement over about a decade shows that rapid temperature increase is mainly (∼65%) caused by water vapor. The following points are established through the main discussion: (i) there are a number of factors causing climate change (e.g. astronomical factors), that is, CO2 is just one of various climate drivers; (ii) the coupling complexity of CO2 with climate is enhanced by the time-scale extension; and (iii) this complexity involves various climate drivers with different cycles and magnitudes. The Earth's atmosphere has evolved over the last 4.5 billion years and still continues to evolve; thus, climate variability must be inevitable and complex. Future climate change may be drawn from the newly emerging discipline of complexity science.


Police is the primary state agency to intervene in crisis situations caused by crime. In other words, the police are in a differentiated position for...


The effect on mice blood-fat metabolism of α-linolenic from male silk moth was studied.The mice with hyperlipidemia were feed on α-linolenic of different dose and were weight every week.4 weeks later,the effects of α-linolenic on weight,liver index and serum lipid were observed.Results showed that the results showed that α-linolenic from male silk moth could significantly reduce weight and liver index of the mice,and significantly reduce serum TC,TG and LDL-C lever also.α-linolenic can regulate the blood-fat metabolism of mice,and could significantly reduce the blood-fat level of mice.


Coevolution was studied in six species of rodents of the genus Ctenomys and their parasitic nematodes of the genus Paraspidodera, collected in Bolivia. Representatives of the families Octodontidae and Caviidae were used as outgroups for the mammals, and nematodes from caviids were used as outgroups of the nematodes from ctenomyids. For the nematodes, quantitative and qualitative morphological characteristics of both males and females and electrophoretic characters of both sexes were used to generate phylogenetic hypotheses of evolutionary relationships of the OTes occurring in hosts of different species. Concordance estimates of cladograms generated from biochemical-genetic and morphological data of the nematodes show a percentage incongruence (Mickevich-Farris Incongruence Statistic or 1"r) of 8.23"0 in the character sets. Parsimony mapping, testing concordance of topologies between the trees derived from both analysis of both morphological and biochemical-genetic data indicates an overall agreement of82.3° 0 . Comparisons of topologies of the host and parasite cladograms, as measured with parsimony mapping, showed 70. 8 o/" concordance, indicating substantially more cospeciation than host-switching in the Ctenomys-Paraspidodera host-parasite system. Nematodes of the genus Paraspidodera appear to have invaded the Ctenomys lineage from an origin in caviids sometime before the ctenomyids began to diversify in early Pleistocene time.


Cervical cancer is one of the major causes of death for women in Indonesia, after breast cancer. Basil herbs (Ocimum basilicum L.) are commonly used as a cancer treatment alternative. Purpose: To determine the cytotoxic effect of basil herbs on HeLa and Vero cells. Methods: Basil was extracted by maceration and then fractionated with the solvents n-hexane, ethyl acetate, and water. Extracts and fractions were tested for cytotoxic effects using the MTT method with a concentration series of 500; 250; 125; 62.5; 31.25; 15,625 µg/mL. Cisplastin was used as positive control and cell control as a negative control. Results: The cytotoxic activity of the extract, n-hexane fraction, ethyl acetate and basil herb water against HeLa cells showed IC 50 values respectively, namely (156.27; 120.55; 170.17; 186.62) µg/ml with a selectivity index of more than 3 for the extract and the three fractions. Conclusion: Extracts and fractions of Basil herbs have a chemopreventive effect on cervical cancer cells.


The increasing employment of teachers on a part-time, casual or contract basis, the ageing workforce and the low percentage of TAFE teachers with VET-level teaching qualifications are discussed. It is observed that the situation can be remedied only with increased funding for the sector, and by involving the existing workforce in identifying and fulfilling the needs of the sector, students and teachers.


Heat conduction in anisotropic materials has important applications in science and engineering. In this paper the virtual boundary element method (VBEM) is applied to solve these problems. Due to the fact of a virtual boundary outside the real boundary, the VBEM does not need to treat the singular boundary integrals, and thus, is more accurate and convenient than the traditional one. Numerical examples are presented, to demonstrate the efficiency and accuracy of this method.


thanks to the members of the medical staff for their very valuable services daring the past year, Mr. Lucas alluded to the serious loss they had sustained In the death of Dr. Hadden, Assistant Physician to this hospital and to St. Thomas's. He was one of those who might truly be called a hero in doiDg his duty, and io was, he believed, through his devotion to his work that he had contracted his last illness. Mr. Lucas went on to


Summary

Teachers generally assume that children's language expertise develops with the age of the child, and that any teacher/adult coversation with the child provides modelling on the part of the adult in the use of grammar, syntax and in vocabulary. The teachers in this study start out as a group to prove that language facility is age related and that adultlchild conversation is led and developed in the linguistic context by the adult. This article is based on the findings of a group of twelve teachers, although direct evidence is cited from only three teacher texts. After the teachers' investigations and analyses of audio tapes based on conversations with individual children, the teachers involved were surprised and in some cases shocked by their inevitable conclusions.


The mainly propose of this article was to develop theoretically a way to approach the topics of death and authenticity from the existential psychotherapy, starting off from the ontological, psychical and anthropological conditions of the human being, as well as from a theological indication, having as result the construction of a resolution as a proper way of self-care; also the foundation of an appropriate regional ontology for the approach of the authenticity and the possibility of the death in existential psychotherapy was made, through the clarification of many of the concepts used by this psychotherapeutic approach and considering some of the scientific levels contained within this ontology, mainly those referred to the psychotherapy process (psychotherapeutic strategies, approaching methods, therapist knowledges, stages of the psychotherapeutic process, characteristics of the existential psychotherapy) and to the psychopathology (defense mechanisms, constitution of the psychopathology)


The molecular map adjacency matrix,based on the distance matrix,a new definition of topological index ww,and combined with the effective alkane molecules of carbon chain length,0 x bands molecular connectivity indices,starting with the optimal subset of 40 alkanes of the physical and chemical properties of the associated results show that the structure of ww has good selectivity and the nature of relevance.reached 0.995 correlation coefficient above shows that the index is expected to QSAR/QSPR study as a new set of parameters and get promotion.


Abstract Abstract Abstract Abstract Understanding the physicochemical properties and excited-state dynamics of molecules at bulk and interfaces is of essential importance in fundamental sciences and applied fields. Advanced laser spectroscopy techniques such as, heterodyne-detected vibrational sum frequency generation (HD-VSFG) and femtosecond transient absorption spectroscopy revealed important interrelations between the physicochemical properties/excited-state dynamics of molecules and their functional groups and properties of bulk and interfacial media. probe the vibrational characteristics of molecules located at a few molecular layer thick interfaces. Our HD-VSFG investigations revealed unique organization of water at cationic, anionic, and zwitterionic lipid containing cell membrane-water interfaces.


Non-destructive techniques are essential to detect common pathologies and analyse the building behaviour. Infrared thermography is a testing technology that has been applied to buildings diagnosis for some decades. However, there are still some applications which are not yet completely explored like the detection of micro-cracks on façade coating materials.


Engine exhausts issuing from multiple engines in close proximity, such as in militarystyle aircraft, produce complex flow fields around them. Such engines are often operated under off-design conditions, generating high-amplitude screech tones in certain circumstances (Powell 1953). In this case, aeroacoustic coupling between the two jets can significantly modify their screech characteristics (Raman et al. 2012). Over the past few decades, the effects of an additional nozzle have been studied extensively for nozzles with circular exits in both experiments and numerical simulations. In contrast, whereas experiments on rectangular jets go back to 1980s, excessive amounts of required computational resources have delayed numerical simulations of twin rectangular jets (Viswanath et al. 2020; Jeun et al. 2020, 2021b,c). Recent numerical campaigns using large-eddy simulations (LES) have documented prediction of flow physics in both nearand far-fields to serve as stepping-stones to further investigation of twin-jet coupling mechanisms. The resulting LES database agreed quite well with the experimental measurements (Karnam et al. 2020; Jeun et al. 2021b) for twin rectangular jets issuing from sharp converging-diverging nozzles with an aspect ratio of 2:1. LES captured many screech tones at various inlet angles in the far-field and even matched the screech amplitudes in some cases. In the smaller dimension direction, intense flapping motions and antisymmetric coupling modes of the twin jets were reported at the fundamental screech frequency, consistent with the experiments. Nevertheless, physical mechanisms associated with screech generation or aeroacoustic coupling in the twin rectangular jets have not been elucidated. In this regard, the present paper utilizes the LES data from the authors' previous publication (Jeun et al. 2021b) to investigate screech feedback closure and reinforcement by the twin-jet coupling. Due to the twin-nozzle geometry, there are two possible screech excitation scenarios; in addition to the screech feedback closure of one jet by itself, cross-excitation by the other must be considered. Spectral proper orthogonal decomposition (SPOD) modes (Schmidt et al. 2018) at the screech fundamental frequency are used to model coherent structures relevant to screech generation. We further decompose the SPOD modes into upstream-traveling and downstream-traveling wave components to extract modes relevant to the screech feedback closure (Wu et al. 2020; EdgingtonMitchell et al. 2021). The cross-correlation analysis (Wu et al. 2020) is then applied to identify spatially distributed source locations where disturbances originating from such points satisfy a constructive phase criterion for screech resonance. This paper extends the authors' preliminary results (Jeun et al. 2021a) by relaxing the assumption of a pair of acoustic sources located at the same downstream positions in each jet. Moreover, while Powell (1953) originally described screech feedback closure by external upstream-


Women are vital human resource and play a significant role in agriculture and allied sector undertaking household, Farm and art activities. A part from the fact and assumption that women are trial and indecisive, they encounter many problems in their life. This study was conducted in Madhubani district of Bihar to study the analysis of constraints faced by women artist in Mithila painting for this purpose sixty respondents were purposively selected who were involved in Mithila painting. The findings of the study showed that the average majority (63.99%) of the respondents become Socio-psychological constraints involved in Mithila painting, among the study variables such as (Age, cast, occupation, Family type and family annual income).


This paper describes the technology development for packaging two identical CPU die on one package. Historically, processors involved packaging one die on a package, but with higher performance demands, multiple die products have become necessary. With existing single core die designs, packaging two die in one unit provides a novel way of producing a dual core CPU without designing new silicon. This paper starts with the evolution of dual core CPU from use of two die joined to each other to separate die placed next to each other to the final form of two die placed with a gap. The land grid array (LGA) package technology development was done within the boundary conditions of reuse of existing sockets and enabling solutions. It involved use of higher layer count substrates to allow routing of two die to pre-existing pin-out, modified IHS to accommodate two die in a limited space, and die side components for helping power delivery. The paper describes the details of the substrate technology, routing options and design rules to meet the dual die package requirements that include product performance, substrate manufacturing and assembly and test. The test vehicle definition and design of different structures are described that are new for the dual die scenario. Also limitations based upon compatibility requirements for test lead to creative implementations of those test vehicle structures. The IHS design modifications implemented to fit the two die and to maintain the over all package stack-up are described. Routing and power delivery methodologies in the dual die package architecture are described. Discussed also are how substrate design rules, & collaterals and design process changed and adjusted to the move from a single die to two. The paper then focuses on the multiple challenges faced by the assembly and reliability areas. Single chip package versus dual chip package mechanical stresses are compared. Assembly areas of chip attach, under-fill, and IHS attach are described. The process design rules for UF in dual die case are new compared with the single die case. The challenges of IHS attach and TIM process (including thicknesses) for the two separate die are addressed. Specific challenges encountered for multi-chip packages (MCP) include application of chip attach flux, removal of flux after chip attach as well as voids formed at the TIM to IHS interface. Finally, thermal performances of the dual die package are presented and compared with that of a single die package. The thermal definitions and measurement methods for the dual die package are shown with equivalents to single die case. The thermal benefits of a dual die package prove the advantages of a dual die package in terms of product performance with respect to power dissipation. The future directions of the dual die technology based on the new products on the roadmap are discussed along with some potential areas of focus in the next generation dual die packages


This is the slide presentation I used to illustrate my comments, as discussant of Pekkala, Polk and Ribiero's Taxes and Stock Returns, presented by Christopher Polk at the University of Pennsylvania, Wharton School, Rodney L. White Center for Financial Research's Spring 2007 Conference.