Learning is essentially an interaction between individuals and environment. The environment provides stimulus to individual and vice versa. The interaction process can changes individual, in the form of behavior change. The integrated thematic learning based on local culture by using discovery learning with ICT media is expected to increase the values of character for elementary school students. ICT focused transformation is regarded positively in terms making information access easier, increasing visual learning, increasing educational quality, and more efficient (Coklar, 2013) . The culture of acculturation is a combination of two or more cultures that influence by other cultures, which occur when the proponents of both cultures relate long. The second possibility of the process of interaction or communication will result in an intercultural interaction which is then shared as a collective culture. While the culture of assimilation is a blend of two or more culture, then become a new culture without any element of coercion. This process is common when two or more groups are willing to interact, open up, and feel comfortable with each other.

ICT focused transformation is regarded positively in terms making information access easier, increasing visual learning, increasing educational quality, and more efficient.


A meaningful, thematic lesson that facilitates students actively solves the problems that he gets according to the concept of the material being studied. One concept that is familiar with the environment is the concept of human activity that can affect the balance of nature. This concept becomes more meaningful if in the lessons students are invited directly to the field to investigate the problems they face " (Badeni et al., 2014) . Through this learning, students' learning outcomes will be maximized if students are taught in contextual nuances in which the student does not passively receive knowledge and skills but he or she has experienced actively involved by using as many elements of his senses (listening, seeing, feeling, feeling and doing) about what is learned or the social environment both individually and in groups.

This concept becomes more meaningful if in the lessons students are invited directly to the field to investigate the problems they face ".


Contraceptives diminish the levels of FSH and LH, which results in the metabolic suppression of ovarian function and increased SHBG production in the liver [38, 39] . The reported changes in FSH, LH and SHBG reflect maintenance of this contraceptive action. Similarly, the pharmacokinetic data of the two Lovelle components were obviously not affected, since they behaved as reported under control conditions, i.e. the AUC was elevated to some extent on day 21 [40, 41] .

Contraceptives diminish the levels of FSH and LH, which results in the metabolic suppression of ovarian function and increased SHBG production in the liver.

Similarly, the pharmacokinetic data of the two Lovelle components were obviously not affected, since they behaved as reported under control conditions, i.e. the AUC was elevated to some extent on day 21.


One of the widely used sensors for autonomous applications is the GPS and IMU sensors, [2, 3, 4] . In this paper, the problem of detecting interference or jamming on the GPS pseudorange measurements is addressed. Interference is modeled by a medium increase in the GPS measurements-noise covariance matrix. Similarly, GPS measurements jamming is modeled by a large increase in the measurements-noise covariance matrix. Therefore, the problem of detecting signal interference/jamming and correcting for it is addressed through estimating the GPS measurements-noise covariance matrix and using the estimate in the GPS/IMU fusion algorithm. An adaptive algorithm will be presented to estimate the GPS measurements-noise covariance matrix. The algorithm is based on the autocovariance least squares technique [5, 6] . This algorithm will take account for the time varying system dynamics and measurement matrices. The intrinsic feature of this algorithm is that it accounts for the time correlation between measurement residuals. This correlation exists because of the initial use of incorrect measurements-noise covariance matrix, which is not known a priori.

One of the widely used sensors for autonomous applications is the GPS and IMU sensors.

The algorithm is based on the autocovariance least squares technique.


With the increase in the number of integrated sensors used in current engineering applications, sensor fusion research is ongoing to increase the accuracy of obtaining highaccuracy estimates from sensors' measurements. Systems that are expected to work autonomously need to be designed carefully to ensure accurate operation under changing operational environments. Also, sensors might degrade in performance over time. Sensors' quality becomes an important issue for such systems. The designer has the option of selecting sophisticated and accurate sensors on the expense of cost. Alternatively, he can adapt less expensive sensors and design his fusion algorithm to account for the less-accurate measurements [1] .

Alternatively, he can adapt less expensive sensors and design his fusion algorithm to account for the less-accurate measurements.


The issue of farm viability is particularly acute in light of the threat to farmland on the urban fringe, which contributes the majority of dairy and produce production in the US; these foods are associated with healthful diets and are often lacking in American diets [2, 3] . For these and other reasons, a sustainable food and agriculture system requires economically viable farms and productive farmland to provide quality food. Numerous other studies have linked community economic and social well-being with the presence of farms of diverse scales [4] [5] [6] . In particular, medium-sized, owner-operated, entrepreneurial farms have been found to be important in sustaining community well-being, yet this type of farm is the most imperiled [7] .

The issue of farm viability is particularly acute in light of the threat to farmland on the urban fringe, which contributes the majority of dairy and produce production in the US; these foods are associated with healthful diets and are often lacking in American diets.

Numerous other studies have linked community economic and social well-being with the presence of farms of diverse scales.

In particular, medium-sized, owner-operated, entrepreneurial farms have been found to be important in sustaining community well-being, yet this type of farm is the most imperiled.


Numerous studies have documented the demographic characteristics, as well as motivations, behaviors and preferences of farmers market and local food shoppers. Previous research has identified several demographic variables associated with farmers market patronage: farmers market shoppers tend to be older, female, married, employed, live in urban areas and have higher levels of education and income [21] [22] [23] [24] . One study with a nationwide sample found that those who frequently buy fresh produce directly from farmers place high value on product quality, freshness and safety, as well as organic and locally grown products [14] . Direct market customers in Washington State valued food quality and freshness most highly [25] . Farmers market shoppers in North Carolina and New Jersey placed high value on fresh, high quality, local farm products and a positive atmosphere [8, 9] . A nationwide survey on local food consumption found that knowledge and attitudes about food and shopping behavior, rather than demographics or health and environmental attitudes, influenced local food purchases [26] . Most Ohio consumers had purchased locally grown food and expressed support for efforts to strengthen local food systems [27] . We know of no similar study on local food or farmers market shopping in Michigan, nor any study which measures how demographic variables influence attitudes and preferences for local food and farmers markets.

Previous research has identified several demographic variables associated with farmers market patronage: farmers market shoppers tend to be older, female, married, employed, live in urban areas and have higher levels of education and income.

One study with a nationwide sample found that those who frequently buy fresh produce directly from farmers place high value on product quality, freshness and safety, as well as organic and locally grown products.

Direct market customers in Washington State valued food quality and freshness most highly.

Farmers market shoppers in North Carolina and New Jersey placed high value on fresh, high quality, local farm products and a positive atmosphere.

A nationwide survey on local food consumption found that knowledge and attitudes about food and shopping behavior, rather than demographics or health and environmental attitudes, influenced local food purchases.

Most Ohio consumers had purchased locally grown food and expressed support for efforts to strengthen local food systems.


Viable farms are an indispensible piece of sustainable food systems. Two related marketing strategies, (i) locally grown foods and (ii) distribution at farmers markets, can enhance farm profitability and keep land in productive agricultural uses, as well as foster a host of community economic benefits. A random telephone survey of Michigan residents finds high current participation in farmers markets, driven in part by demand for high quality locally grown foods, and constrained by lack of convenience. Most Michigan residents have bought locally grown foods in the past year, with the ability to identify local foods a significant constraint to greater sales. These results further emphasize the difficult tradeoffs between attributes associated with all purchases (e.g., price, convenience) versus those more closely associated with local food and farmers markets (e.g., locally grown and relationships with local farmers), as highlighted by Hinrichs' discussion of embeddedness and marketness-instrumentalism [20] . Furthermore, relative importance of these attributes varies widely among different demographic groups and appears to affect consumer participation in these markets.

These results further emphasize the difficult tradeoffs between attributes associated with all purchases (e.g., price, convenience) versus those more closely associated with local food and farmers markets (e.g., locally grown and relationships with local farmers), as highlighted by Hinrichs' discussion of embeddedness and marketness-instrumentalism.


Farm profitability continues to be of grave concern for many US and Michigan farmers. According to the Census of Agriculture, more than half of all farms in both the US and Michigan experienced negative net income in 2002 and 2007 [1] . Coinciding with this finding, acreage dedicated to farming has also continued to decline during this period. Both trends are occurring in a time of renewed interest in the sustainability of agriculture and food systems. Sustainability has classically been described as having three legs or pillars (social, environmental and economic), yet meeting these three categories of goals can require tradeoffs. For example, more environmentally friendly production methods may cost more, limiting farmer profits or low income people's access to food products. Maintaining relationships with customers presents an opportunity cost on farmers' time. In these cases, some sort of economic compensation is needed if sustainable practices are to be adopted and maintained.

According to the Census of Agriculture, more than half of all farms in both the US and Michigan experienced negative net income in 2002 and 2007.


The twelve factors driving farmers market patronage and the seven potential local food opportunities and barriers were regressed on the demographic variables using an ordered Probit model. The objective was to discover variations in responses according to demographic factors. In our analysis, the farmers market drivers were divided into two groups: those variables representing factors generally associated with all shopping behavior like convenience and value (roughly corresponding to Hinrichs' -marketness and instrumentalism‖ concepts), and those particularly associated with reasons to shop at farmers markets like finding local food and the congenial atmosphere (Hinrichs' -embeddedness‖) [20] .

In our analysis, the farmers market drivers were divided into two groups: those variables representing factors generally associated with all shopping behavior like convenience and value (roughly corresponding to Hinrichs' -marketness and instrumentalism‖ concepts), and those particularly associated with reasons to shop at farmers markets like finding local food and the congenial atmosphere (Hinrichs' -embeddedness‖).


Locally grown foods and farmers markets also contribute to the sustainability of the food system in ways beyond fostering farm viability. Research from Michigan and Iowa finds significant job and income impacts resulting from increased consumption of locally grown produce [3, 15] . Locally grown foods play a central role in community-based food systems, which can contribute to a wide array of related economic, social, land use and public health benefits [16] . Farmers markets can bring a host of ancillary benefits as well, serving as business incubators, drawing customers to downtown areas and increasing access to healthy foods [17, 18] . Given the importance of locally grown product differentiation and direct market sales to small and medium-sized farm viability, it is crucial to understand consumer perspectives on these market attributes and venues [8] .

Research from Michigan and Iowa finds significant job and income impacts resulting from increased consumption of locally grown produce.

Locally grown foods play a central role in community-based food systems, which can contribute to a wide array of related economic, social, land use and public health benefits.

Farmers markets can bring a host of ancillary benefits as well, serving as business incubators, drawing customers to downtown areas and increasing access to healthy foods.

Given the importance of locally grown product differentiation and direct market sales to small and medium-sized farm viability, it is crucial to understand consumer perspectives on these market attributes and venues.


In order to protect hardware IP from these threats, the design needs to be unintelligible, even in decrypted form. Hardware obfuscation provides the option to effectively hide and disable the design, but still facilitate structural testing and static/dynamic parameter analysis [29, 34] . This convenience makes obfuscation a desirable method for security and an active field of research. In recent years, a large number of obfuscation techniques and attacks on obfuscation have been proposed. In most cases, researchers evaluate their techniques and attacks on circuits generated in an ad hoc fashion. Unfortunately, this makes it difficult to objectively evaluate their merits and compare their effectiveness against various metrics. Lack of welldesigned benchmarks, which can facilitate objective and accurate evaluation of important properties of obfuscation and manifest the merits and limitations of an approach, has become a major barrier for the research community. To address this limitation, for the first time, we introduce a suite of new obfuscation benchmarks that provides the option to evaluate obfuscation methods and attacks accurately and establish a baseline for comparison. In this paper, we also present our experimental results on comparative analysis of popular methods in the field based on resiliency against noteworthy attacks. We also introduce a set of metrics to quantify characteristics of the circuit and obfuscation technique applied to it.

Hardware obfuscation provides the option to effectively hide and disable the design, but still facilitate structural testing and static/dynamic parameter analysis.


The overall acceptability (Table 3) of loin samples tended to decrease with increasing levels of litter inclusion in the diets, with overall acceptability of the 85% litter treatment being lower (p < 0.05) than acceptability of the other treatments. A higher proportion of carcass fat and an increased thickness of subcutaneous fat were found to be associated with a decline in overall acceptability of loin samples (Webb et al., 1997) . In the present study the thickness of the subcutaneous fat tended to increase with increasing level of litter inclusion and an increase in the number of days to slaughter, but these differences were not statistically significant (p > 0.05). The lower overall acceptability score recorded for the 85% litter treatment appears to be due mainly to the "atypical taint" (p < 0.05) and slight reduction in fat firmness scores (p < 0.065).

A higher proportion of carcass fat and an increased thickness of subcutaneous fat were found to be associated with a decline in overall acceptability of loin samples.


In recent years climate change and other urban growth considerations have put sustainable urban development at the forefront of strategic policy discussions in Australian cities (Commonwealth of Australia, 2011) . The environmental agenda has engendered the need for employing sustainability assessment and modelling of urban systems to assist urban planning and policy development. Urban systems emerge from the complex interactions of three interconnecting and overlapping primary systems: the environment, the economy and society.

In recent years climate change and other urban growth considerations have put sustainable urban development at the forefront of strategic policy discussions in Australian cities.


Viscous fingering in a porous medium is a fundamental process occurring within a wide range of flow processes, including for CO2 storage, enhanced oil recovery, and geothermal energy systems. The porous rocks that are relevant for these applications have often undergone fracturing processes, and fractures do in general span the entire reservoir [6] . The fractures enforce a structural constraint on fluid flow and transport through the domain, and this paper targets the interplay between unstable miscible fingering and channeling through fractures that are more permeable than the surrounding rock matrix.

The porous rocks that are relevant for these applications have often undergone fracturing processes, and fractures do in general span the entire reservoir.


In the following subsection, we present the simplest geometrical case of flow parallel to the fractures. We will vary each of the dimensionless numbers independently and study how this affect the viscous flow. This will reveal important insight on the interplay between the viscous instabilities and the preferential flow paths through the fractures. In subsections 4.2 and 4.3, we change the fracture geometry and consider the the brick fractures, the hexagon fractures and the rotated hexagon fractures [36] . The last subsection 4.4, is dedicated to comparing the mixing length of the different fracture geometries.

In subsections 4.2 and 4.3, we change the fracture geometry and consider the the brick fractures, the hexagon fractures and the rotated hexagon fractures.


Since the appearance of the Internet-of-Things (IoT) idea some years ago, a growing number of objects are continuously being made "smart" and interconnected through the Internet. New applications in areas such as manufacturing, healthcare and education are being developed both in academia and industry [1] . At the current rate of progress, it is expected that the number of deployed wireless sensor nodes in the world will approximately be 50 billion by the year 2025. However, to reach that vision there are still many practical problems that must be solved. One of them is how to embed everywhere that massive number of devices in a sustainable manner [2] .

New applications in areas such as manufacturing, healthcare and education are being developed both in academia and industry.

One of them is how to embed everywhere that massive number of devices in a sustainable manner.


Participants described negative health effects due to the high demands placed on them. Not seeing daylight, working with few breaks, and being forced to work both night and day shift caused sleep deprivation and visits to an intensive care unit. These findings are confirmed in other studies [8, 9, 11, [14] [15] [16] . Factors such as high demands with a lack of control, and imbalance in effortreward could cause staff to leave their jobs [23] [24] [25] . Conversely, participation in vocational rehabilitation is a predictor for returning to work. Well-planned breaks and increased feeling of having control may increase the feeling of freedom and provide an opportunity for recuperation. Therefore, small breaks should be planned between two patients and after being locked in the operating room for hours, so the specialist nurses are able to change focus and start afresh. Specialist nurses have an important responsibility for patients' lives and safety and their physical and mental recovery should be regulated and secured with reasonable brakes [34] .

These findings are confirmed in other studies.

Factors such as high demands with a lack of control, and imbalance in effortreward could cause staff to leave their jobs.

Specialist nurses have an important responsibility for patients' lives and safety and their physical and mental recovery should be regulated and secured with reasonable brakes.


One approach to solve for the limitation of the dilatational motion of sandwich panels involves the use of higher-order theory. A recent report described the use of consistent higher-order sandwich plate theory (HSAPT), which considers both the antisymmetric and symmetric motions [20] . HSAPT was both accurate and efficient when used to describe and predict dynamical motions of sandwich panels. In the present paper, this approach will be briefly reviewed, and then combined with SEA to predict the sound transmission loss of sandwich panels. The major difference between the present approach and previous SEA of sandwich panels is the incorporation of the dilatational modes in the study.

A recent report described the use of consistent higher-order sandwich plate theory (HSAPT), which considers both the antisymmetric and symmetric motions.


Comparing with the theoretical methods, numerical approaches have more practical importance, i.e., when the sandwich panel is part of a large structure and the interactions between structures are important. Conventional numerical methods include the finite element method (FEM) and boundary element method (BEM). However, the utility of FEM at high frequency is generally limited because of the vast number of vibration modes [11] . For the same reason, efforts to simulate vibration modes using BEM have encountered similar limitations at high frequencies [12] .

However, the utility of FEM at high frequency is generally limited because of the vast number of vibration modes.

For the same reason, efforts to simulate vibration modes using BEM have encountered similar limitations at high frequencies.


Structural members such as beams, columns and slabs may be subjected to dynamic loads besides compressive, shear, tensile and flexural loads. The dynamic loads on buildings are in general due to extreme wind and seismic vibrations [8] . To determine the effect of such impact loads on a structural member, various types of impact and impulsive tests are conducted such as: 1) falling mass, 2) air ballast, 3) spring loads, 4) deformation controlled impact and 5) pendulum loading [9] .

The dynamic loads on buildings are in general due to extreme wind and seismic vibrations.

To determine the effect of such impact loads on a structural member, various types of impact and impulsive tests are conducted such as: 1) falling mass, 2) air ballast, 3) spring loads, 4) deformation controlled impact and 5) pendulum loading.


The intermittent nature of wind power generation creates new challenges compared to a system operating solely on traditional generation sources such as nuclear and fossil fuel. In particular, the addition of wind power capacity impacts on power system components that are not themselves directly weather sensitive (e.g. the volume of power produced and prices received by traditional power stations; [4] [5] [6] [7] ). The focus of this paper is the impact of increasing wind power capacity on GB Total Annual Energy Requirement (TAER, i.e. the total energy (in GWh) required from generators other than wind power), peak residual load (i.e. the maximum load demanded from generators other than wind power) and wind power curtailment. For convenience we refer to these as compound system impacts.

In particular, the addition of wind power capacity impacts on power system components that are not themselves directly weather sensitive (e.g. the volume of power produced and prices received by traditional power stations;).


We have seen that the solar system was too special to have revealed key aspects of gravity. These only become evident when Newtonian gravity is re-formulated in terms of a velocity in-flow field. A generalisation of that formalism leads to an explanation of the so-called 'Dark Matter' effect. The most significant aspect of this work is the discovery that the magnitude of the 'dark matter' spatial self-interaction dynamics is determined by the fine structure constant α, while Newton's gravitational constant G only determines the interaction of space with matter. It has been shown how the values of α and G together may be determined in Cavendish-type laboratory experiments. Also significant is the discovery that this new theory of gravity leads to gravitational attractors -a new form of black hole, and whose properties are determined by the value of α and not G. As a consequence we saw how these attractors explain the observed globular cluster black hole masses, and similarly the necessity for black holes in galaxies. We also saw that primordial non-minimal black holes explain both the origin and nature of spiral galaxies, particularly their rotational behaviour. This new theory of gravity has its origins in the information-theoretic Process Physics, which offers as well an explanation and unification of the quantum nature of space and matter, and their classicalisation [8] . That work implies that the occurrence of α in the new classical description of gravity is indicative of the underlying quantum processes of space, that space is a complex quantum-information theoretic system, and at that level it is not geometric. The results herein imply that we have the first evidence of quantum aspects of gravity.

This new theory of gravity has its origins in the information-theoretic Process Physics, which offers as well an explanation and unification of the quantum nature of space and matter, and their classicalisation.


Herein the connection of the new theory of gravity to both the Newtonian theory and to General Relativity is analysed, but the most significant results relate to an analysis of the various phenomena that only this new theory now explains, including the borehole g anomaly effect, the difficulties over the last 60 years in ongoing attempts to increase the accuracy with which G could be measured in Cavendish-type experiments, which are all manifestations of the 'dark matter' effect, but which is, as explained here, most evident in the rotation velocity curves of spiral galaxies [7] . This new theory introduces a new form of quantum-foam black hole, the properties of which are determined by the fine structure constant, and which have either 'minimal' of 'non-minimal' forms. The 'minimal' black holes are mandated by the in-flow into matter, and occur in all forms of matter. In the case of the globular clusters the effective mass of the 'minimal' central black holes are computable and found to be in agreement with recent observations. The 'non-minimal' black holes are not caused by matter and appear to be primordial, namely residual effects of the big bang. They have a non-inverse square law acceleration field, and are the cause of both the rapid formation of galaxies and of the non-Keplerian rotation dynamics of spiral galaxies. They have an effective 'dark matter' density that falls off as almost the inverse of the square of the distance form the black hole, as is indeed observed. The presence of the minimal black holes in stars affects their internal central dy-namics, but the effect of this upon the solar neutrino flux problem has yet to be studied.

Herein the connection of the new theory of gravity to both the Newtonian theory and to General Relativity is analysed, but the most significant results relate to an analysis of the various phenomena that only this new theory now explains, including the borehole g anomaly effect, the difficulties over the last 60 years in ongoing attempts to increase the accuracy with which G could be measured in Cavendish-type experiments, which are all manifestations of the 'dark matter' effect, but which is, as explained here, most evident in the rotation velocity curves of spiral galaxies.


For the treated segment of the population, euthanasia will affect population parameters by an increase in mortality above the natural rate, whereas implementation of a TNR program will decrease fecundity rates. Implementation of euthanasia or TNR would realistically include treatment of male and female cats. The effects of each control scenario on male and female vital rates and the subsequent effects on population growth have not been considered in prior modelling attempts (Andersen et al. 2004) .

The effects of each control scenario on male and female vital rates and the subsequent effects on population growth have not been considered in prior modelling attempts.


In the latter species, duplication of one of the telomeric heterochromatin blocks on chromosome pair 1 was observed when the chromosomes showed a greater degree of decondensation. This pattern may have resulted from a small inversion, with break points in a subterminal heterochromatic region and an internal euchromatic region. However, the absence of longitudinal differentiation in the chromosomes impairs the detection of chromosome rearrangements, which might have occurred in different heteropteran groups. Duplicate heterochromatin blocks observed in individuals from different Triatoma infestans populations are associated with extensive polymorphisms involving these regions. Mechanisms such as addition and transposition of C-positive material are suggested as a probable origin of these blocks (Panzera et al., 1992) .

Mechanisms such as addition and transposition of C-positive material are suggested as a probable origin of these blocks.


Ellis has differentiated between (rational beliefs) and (irrational beliefs) arguing that rational-thinking persons tend to be relative in their judgments and evaluations using mostly such words as maybe, possible, probably.., etc. This way of perception and visualization creates in them self-consistency and adaptability to reality which will lead to feelings of consent, efficacy, comfort, and stability. Irrational-thinking persons tend mostly to make absolute and resolved judgments and most often use such words as must, should be, ought to be, supposed to be.., etc. Such judgments and perceptions in most cases contradict with the self and life realities, which add another form of emotional stress like anxiety, depression, and sadness (Dryden, 1999) .

Such judgments and perceptions in most cases contradict with the self and life realities, which add another form of emotional stress like anxiety, depression, and sadness.


NFEs are more stable and more likely to operate continuously during the whole year, especially in urban areas (Nagler and Naudé, 2017) . However, low profitability, lack of finance, idiosyncratic labor shocks and unreliable supplies cause NFEs to stop operating. For women, it has been extensively documented that marital status and fertility reduce the likelihood to continue employment (de Jong et al., 2017) .

NFEs are more stable and more likely to operate continuously during the whole year, especially in urban areas.

For women, it has been extensively documented that marital status and fertility reduce the likelihood to continue employment.


Push factors entail different forms of shocks, lack of agricultural productive assets and social factors. Both idiosyncratic shocks (e.g. death or illness of a household member) and covariate shocks (e.g. extreme weather events, sudden price increases) might push people into off-farm employment to mitigate farm income losses (Kijima et al., 2006) . Households who are constrained 5 in terms of landholdings and livestock may move out of agriculture to be able to earn an income. This is especially the case for young people, who are often underemployed on the own householdfarm (Bezu and Holden, 2014) .

Both idiosyncratic shocks (e.g. death or illness of a household member) and covariate shocks (e.g. extreme weather events, sudden price increases) might push people into off-farm employment to mitigate farm income losses.

This is especially the case for young people, who are often underemployed on the own householdfarm.


Once men and women enter the off-farm labor market, job characteristics and demographic factors determine whether they will remain employed. Insecure and unstable jobs in the informal sector are particularly a concern for women and youth . Casual wage jobs are typically short-term, seasonal activities, which are not likely to lead to continued employment (Oya, 2013) .

Casual wage jobs are typically short-term, seasonal activities, which are not likely to lead to continued employment.


Research on poverty in developing countries has been pursued extensively across the social sciences, and interest in this topic is not dwindling; despite what appear to be significant reductions in monetary poverty over recent decades, many still live in precarious material conditions. A recent estimate places a lower bound on the prevalence of global poverty at nearly 800 million people, of whom more than half are located in sub-Saharan Africa (Ravallion and Chen 2017) . At the same time, approaches to poverty analysis from different disciplines within the social sciences are often at odds or speak past one another. As a result, policy-makers (and non-academics) face the complicated task of trying to make sense of highly diverse perspectives on the same issue in a particular context.

A recent estimate places a lower bound on the prevalence of global poverty at nearly 800 million people, of whom more than half are located in sub-Saharan Africa.


The gold-standard for the diagnosis of HS is liver biopsy, but this is a costly procedure that is not exempt of possible severe complications. This is why, in the last decade many other non-invasive diagnostic methods have been used instead. Some imaging modalities include ultrasound, computed tomography or magnetic resonance imaging, have been used with excellent results [5] . The hepatic ultrasound has reported a 100% sensitivity in detecting more than 33% liver fat and a positive predictive value of 62%. Other authors have used different serum markers and biochemical scales to diagnosis HS, such as the SteatoTest and fatty liver index [6] .

Some imaging modalities include ultrasound, computed tomography or magnetic resonance imaging, have been used with excellent results.

Other authors have used different serum markers and biochemical scales to diagnosis HS, such as the SteatoTest and fatty liver index.


Iron de®ciency, and in particular iron de®ciency anaemia, remains a nutritional disorder of major importance. So much so that the Montreal meeting on micronutrients of October 1991 and the international conference on nutrition held in Rome in 1992, called for more efforts to control vitamin A de®ciency and reduce iron de®ciency before the end of the decade. It is estimated that more than 2 billion people suffer from iron de®ciency. Women in particular are affected and, although the prevalence¯uctuates widely between countries, it is estimated that 40 ± 50% of adult women in developing countries suffer from iron de®ciency anaemia (WHOaFAO, 1992) .

Women in particular are affected and, although the prevalence¯uctuates widely between countries, it is estimated that 40 ± 50% of adult women in developing countries suffer from iron de®ciency anaemia.


Following completion of trials using intact spiders, we induced each individual to autotomize a haphazardly-selected leg by grasping the femur of the leg with fine forceps; the leg then autotomized at the coxa-trochanter joint as the spider pulled away (Foelix 1996) . This caused a small loss of hemolymph, but the break rapidly sealed and the spider was otherwise unaffected. We then repeated the terrestrial and aquatic running trials two days after legs were autotomized, using the same order of substrate use for each spider as used in the intact trials. Using this experimental procedure, we assume that any physical or psychological stress from autotomy had abated after two days, so that any differences observed in locomotion were due to autotomy alone rather than the stress of the procedure; however, we recognize that this is an untested assumption in our design. After completion of all running trials, spiders were returned to Cave Creek.

Following completion of trials using intact spiders, we induced each individual to autotomize a haphazardly-selected leg by grasping the femur of the leg with fine forceps; the leg then autotomized at the coxa-trochanter joint as the spider pulled away.


Hydatid disease is a zoonotic parasitic disease most frequently caused by echinococcus granulosus or echinococcus multilocularis. Echinococcus granulosus can reach any organ or tissue of the body where it develops into a small hydatid cyst [1] . The characteristic imaging findings have been described as calcification of the cyst wall, the presence of daughter cysts, or membrane detachment [2] . However the radiologic signs are often nonspecific. Serological tests may be helpful in the diagnosis, but even their reliability is not 100% [3] . Unusual sites of this disease can frequently cause diagnostic problems and lead to diagnostic delays and many potentially serious complications.

Echinococcus granulosus can reach any organ or tissue of the body where it develops into a small hydatid cyst.

The characteristic imaging findings have been described as calcification of the cyst wall, the presence of daughter cysts, or membrane detachment.

Serological tests may be helpful in the diagnosis, but even their reliability is not 100%.


Hydatid disease or echinococcosis is a parasitic disease caused by infection with larva (metacestode) of the cestode echinococcus. Four species of the genus echinococcus are known to cause infection in humans: echinococcus granulosus (cystic hydatid disease), echinococcus multilocularis (alveolar hydatid disease), echinococcus vogeli, and echinococcus oligarthus (both causing polycystic hydatid disease) [5] . Echinococcus granulosus requires two hosts. Humans become accidental intermediate hosts. The most common site involved is the liver (59-75%), followed in frequency by lung (27%), kidney (3%), bone (1-4%), and brain (1-2%). Other sites such as the heart, spleen, pancreas, omentum, ovaries, parametrium, pelvis, thyroid, orbit, or retroperitoneum, and muscles are very rarely affected [6] .

Four species of the genus echinococcus are known to cause infection in humans: echinococcus granulosus (cystic hydatid disease), echinococcus multilocularis (alveolar hydatid disease), echinococcus vogeli, and echinococcus oligarthus (both causing polycystic hydatid disease).

Other sites such as the heart, spleen, pancreas, omentum, ovaries, parametrium, pelvis, thyroid, orbit, or retroperitoneum, and muscles are very rarely affected.


In Japan, a study of burnout among physicians engaged in end of-life care for cancer patients found that 22% of the respondents had a high level of emotional exhaustion, 11% had a high level of depersonalization and 62% had a low level of personal accomplishment [20] . The European General Practice Research Network Burnout Study Group (EGPRN) conducted research among family doctors in 12 European countries in 2006. The study showed that 43% of respondents had high scores for emotional exhaustion burnout, 35% high scores for depersonalization and 32% low scores for personal accomplishment, while 12% of physicians scored high burnout in all 3 dimensions [21] . In the current study, the proportion of physicians scoring high on individual and all 3 subscales were lower than that reported by the EGPRN study. In other studies of burnout in general physicians, high levels of emotional exhaustion (19%-53%), high levels of depersonalization (22%-64%) and low scores on personal accomplishment (13%-31%) were observed [22] [23] [24] [25] [26] [27] [28] [29] [30] [31] [32] . Again, our rates of burnout were relatively lower compared with those studies [21, 32, 33] . Most studies emphasize the interaction between personality and environmental factors as the most important cause of the development of burnout in medical practitioners [34] .

In Japan, a study of burnout among physicians engaged in end of-life care for cancer patients found that 22% of the respondents had a high level of emotional exhaustion, 11% had a high level of depersonalization and 62% had a low level of personal accomplishment.

The study showed that 43% of respondents had high scores for emotional exhaustion burnout, 35% high scores for depersonalization and 32% low scores for personal accomplishment, while 12% of physicians scored high burnout in all 3 dimensions.

In other studies of burnout in general physicians, high levels of emotional exhaustion (19%-53%), high levels of depersonalization (22%-64%) and low scores on personal accomplishment (13%-31%) were observed.

Again, our rates of burnout were relatively lower compared with those studies.

Most studies emphasize the interaction between personality and environmental factors as the most important cause of the development of burnout in medical practitioners.


There is a relative lack of literature regarding the integration of primary care within the Irish healthcare system but a UK study has examined the benefits of such a service for older patients, suggesting that integrating services could reduce fragmentation and incoherence, thus positively influencing patient satisfaction and outcomes [6] . A national survey report conducted by the NHS in the UK revealed that older people were less likely to: have potential side effects of treatments explained to them, or be given written information about these side effects; be given a named Clinical Nurse Specialist in charge of their care; be given information on self-help or patient support groups; and be given more information on benefits for which they may be eligible [7] . Another aspect of care that warrants attention is the transport of elderly patients to radiotherapy departments on a daily basis. Musselwhite and Haddad found that driving cessation is associated with a reduced quality of life, with older patients feeling isolated and excluded from society [8] . Thus, for such a cohort of patients, travelling to care can be a source of anxiety and worry, which could influence one's attitude towards treatment.

There is a relative lack of literature regarding the integration of primary care within the Irish healthcare system but a UK study has examined the benefits of such a service for older patients, suggesting that integrating services could reduce fragmentation and incoherence, thus positively influencing patient satisfaction and outcomes.

A national survey report conducted by the NHS in the UK revealed that older people were less likely to: have potential side effects of treatments explained to them, or be given written information about these side effects; be given a named Clinical Nurse Specialist in charge of their care; be given information on self-help or patient support groups; and be given more information on benefits for which they may be eligible.

Musselwhite and Haddad found that driving cessation is associated with a reduced quality of life, with older patients feeling isolated and excluded from society.


IOP fluctuates rhythmically with a 24-hour period (diurnal variation), but it also shows rhythmical fluctuations with other phase lengths and sporadic fluctuation [4] . Diurnal variation of IOP has been examined in clinical studies for a long time, because it was felt that "it concerns itself with one of the most fundamental aspects of the disease" [5] . In eyes with glaucoma, timing of IOP variation was believed to be generally more erratic [6] . Newer studies support this notion, and it has been demonstrated that the responsible circadian timing system can be altered in glaucoma [7] . Furthermore, a larger magnitude of IOP fluctuations is generally considered characteristic of glaucoma [5] .

IOP fluctuates rhythmically with a 24-hour period (diurnal variation), but it also shows rhythmical fluctuations with other phase lengths and sporadic fluctuation.

Diurnal variation of IOP has been examined in clinical studies for a long time, because it was felt that "it concerns itself with one of the most fundamental aspects of the disease".

In eyes with glaucoma, timing of IOP variation was believed to be generally more erratic.

Newer studies support this notion, and it has been demonstrated that the responsible circadian timing system can be altered in glaucoma.

Furthermore, a larger magnitude of IOP fluctuations is generally considered characteristic of glaucoma.


The sub-scale which focused on enjoyment of playing, lessons, making music with others and practice not being boring was not enhanced by the inclusion of the statement 'I like practising'. This suggests that there is a subtle perceived difference between enjoying practice and practice being interesting (not boring). This reflects research findings on the importance of finding a balance between challenge and competence when setting work to be completed, which in turn contributes to achieving a state of flow (Csikszentmihalyi, 1991) .

This reflects research findings on the importance of finding a balance between challenge and competence when setting work to be completed, which in turn contributes to achieving a state of flow.


The present study adopted a self-report questionnaire as a means of collecting data from a large sample of learners. The questionnaire was devised based on the research evidence outlined above and a smaller scale prior study (Hallam, 2013) . The questionnaire sought information about the level of expertise attained as assessed by the highest examination grade achieved in independent graded instrumental examinations from preliminary to Grade 8. Typically, graded examinations assess candidates' performance on pieces, scales, sightreading, and aural tests. Examinations are taken when the teacher believes that the student is ready. They are not age related and can be taken by adults. As such they provide a convenient, widely recognised and impartial means of assessing level of expertise. The questionnaire included a range of statements relating to various elements of motivation including support of family and friends; the respondents' enjoyment of participating in performance; enjoying playing an instrument and having lessons; listening to music; music as a social activity; enjoyment of practice; self-beliefs about musical ability and potential; beliefs about self-efficacy and the relationship between effort and musical ability; and social affirmation. Respondents were requested to respond to the statements on a 7 point Likert scale with 7 indicating the strongest agreement, 1 the strongest disagreement. There were 3 statements relating to musical aspirations: to always want to engage with music; wanting to be a musician; and perceiving that playing an instrument would be useful to any future career. The questionnaire was piloted on a small group of young musicians to ensure that the statements were easy to understand. Their feedback indicated that no changes were required.

The questionnaire was devised based on the research evidence outlined above and a smaller scale prior study.


It is well-known that primary Kodaira surfaces have the structure of nilmanifolds; this is the quotient of a connected, simply connected, nilpotent Lie group G by a lattice Γ (i.e. a discrete and cocompact subgroup; see Section 6 for the relevant details). Now note that a left-invariant complex symplectic structure on G induces a natural "invariant" complex symplectic structure on the nilmanifold Γ\G and that any Kähler nilmanifold is diffeomorphic to a torus [23] . Thus, complex symplectic nilmanifolds never carry hyperkähler metrics provided that G is non-abelian. Moreover, left-invariant complex symplectic structures on G are in one-to-one correspondence with complex symplectic structures on the associated Lie algebra g and G admits a lattice if and only if g admits a rational structure [32] .

Now note that a left-invariant complex symplectic structure on G induces a natural "invariant" complex symplectic structure on the nilmanifold Γ\G and that any Kähler nilmanifold is diffeomorphic to a torus.

Moreover, left-invariant complex symplectic structures on G are in one-to-one correspondence with complex symplectic structures on the associated Lie algebra g and G admits a lattice if and only if g admits a rational structure.


This inequality can be regarded as the applicability condition for the approximate theory of EAS [37] . The factor |E 00 /max(|E 1 (x)|)| appears in inequality (9) because in the case of EAS the scattered wave amplitude is much larger than the amplitude of the incident wave: |E 1 | ≪ |E 00 |. As indicated in Section 2, this may result in unusually strong boundary scattering, oscillations of the incident wave amplitude inside the grating, and large amplitude of the 2 harmonic (all these effects are proportional to |E 1 |).

This inequality can be regarded as the applicability condition for the approximate theory of EAS.


Conceptual modeling in software engineering is employed to facilitate, systemize, and aid the process of information engineering. Conceptual models describe entities of some domains in semantic terms [3] . The model serves as a tool for communicating between developers and users, thus helping analysts to understand a domain, providing input to the design process, and documenting purposes [3] . This paper adopts a conceptual model, called a thinging (abstract) machine (TM) that views all components of the domain in terms of a single notion: flow machine [4] [5] [6] [7] [8] [9] [10] [11] [12] . As our objective is to discuss the TM in terms of existential ontology, the TM is reviewed, and a full sample of the TM model is applied to a real system of ordering items.

Conceptual models describe entities of some domains in semantic terms.

The model serves as a tool for communicating between developers and users, thus helping analysts to understand a domain, providing input to the design process, and documenting purposes.

This paper adopts a conceptual model, called a thinging (abstract) machine (TM) that views all components of the domain in terms of a single notion: flow machine.


The paper is organized in five sections. Section 1 offers the basic motivation and the literature behind the problem including the definition of the problem considered. In section 2 structure of solution set of the problem (1) is introduced then consistency conditions are explained. Section 3 discusses the procedure used to determine the solution set of fuzzy relational system considered as the feasible domain of the problem (1). Section 4 describes the design of the evolutionary procedure applied. Section 5 presents a numerical example for describing the overall procedure to solve the problem (1) . A concluding remark is given at the end.

Section 5 presents a numerical example for describing the overall procedure to solve the problem.


The achievements of market reforms in the third world countries rely to a large extent on the strength of price signals transmitted within various levels of market. With this regard the coordination between producers, wholesalers and retail prices keep up to be of a widely regarded economic interest. The relationship between farm and retail prices provides insights into marketing efficiency as well as consumer and producer welfare. Regarding to price theory, flexible prices are responsible for efficient resource allocation and price transmission integrates markets spatially [1] .

Regarding to price theory, flexible prices are responsible for efficient resource allocation and price transmission integrates markets spatially.


According to a study done by USAID, in Ethiopia, most dairy products are distributed through supermarkets. Currently in Addis Ababa there are 25 bigger supermarkets owned by 15 companies and out of which 12 are owned by Ethiopian and the other 3 by foreigners. Moreover other supermarkets also exist in major towns of the country which distribute milk and milk products processed by milk processing companies based in Addis Ababa [2] . Retailers are the primary outlets for dairy products to the consumer. This indicates that, market domination of retailers and processors intends to reduce earnings and profitability of the farmers/producers from milk.

Moreover other supermarkets also exist in major towns of the country which distribute milk and milk products processed by milk processing companies based in Addis Ababa.


Data words appear in other areas as well, in particular verification, and querying databases. In several applications, one would like to deal with concise and easy-tounderstand representations of languages of data words. These can be used, for example, in extending languages for XML navigation that take into account data values. Another possible example is in the field of verification, in particular from modeling infinite-state systems with finite control [9, 12] . Here having a concise representation of system properties is much preferred to long and unintuitive specifications given by e.g. automata.

Another possible example is in the field of verification, in particular from modeling infinite-state systems with finite control.


The location of the HEMS team members influenced the length of activation time. HEMS bases where all team members were located together close to the helicopter had the shortest activation and approach times. The distance between team members and helicopter within the HEMS base could be important, but in our study the absolute distance waried between 20 and 100 metres and would have had a minimal effect on activation time. Team members in different locations, even in the same HEMS base, increased the pre-take off phase, as did the distance from the helicopter. A 'Rendezvous' system (team members in different locations away from the HEMS base) is not recommended from a safety and timing perspective [16, 31] .

A 'Rendezvous' system (team members in different locations away from the HEMS base) is not recommended from a safety and timing perspective.


In conclusion, certification, as a strategy for harnessing market forces in support of sustainably managing commodity production, is an important and timely innovation. Thus far, though, certification has grown through capture of the low-hanging fruit represented by those fisheries that are already well managed and able to make the adjustments needed to meet standards of sustainability. The artisanal fisheries of the developing world represent a far greater challenge. While the potential impacts on the global trade in fisheries products are less impressive, the impacts in terms Market Formalization and Amazon Fisheries 525 of numbers of people and human well-being and of the conservation of critical aquatic and marine habitat are enormous (Béné et al. 2007; Dugan et al. 2010) . However, achieving these impacts requires a response that goes beyond recognizing winners. It requires a long-term commitment to working with governments, local fisher organizations, and fisheries industries to develop co-management systems that enable local stakeholders to rebuild stocks, improve livelihoods, increase food security, and conserve the ecosystems they depend on.

While the potential impacts on the global trade in fisheries products are less impressive, the impacts in terms Market Formalization and Amazon Fisheries 525 of numbers of people and human well-being and of the conservation of critical aquatic and marine habitat are enormous.


Fisheries certification grew out of a concern that governments had proven to be largely ineffective in halting the depletion of the world's major marine fisheries (Gale and Haward 2011) . Private-sector, third-party certification was seen as a strategy through which market forces could be used to promote the sustainable management of commercial fisheries and by their example stimulate governments to make greater efforts to improve fisheries management. The view that emerges from the literature, however, is that certification generally relies on the conditions created by government management agencies (Pomeroy and Berkes 1997; Grafton et al. 2006) . Without the investment made by government fisheries agencies, few fisheries would qualify for certification. Certification is formal recognition for sustainably managing a fishery, but it does not provide the means for achieving that goal. The case study presented here highlights the critical role of federal and state governments in creating the conditions that make sustainable fisheries management possible. Where governments have not implemented effective regulatory systems for managing fisheries, as has been the case in Pará, the basic governance conditions required for certification are not likely to exist. This is the situation found in much of the Brazilian Amazon. The main exceptions are in those states, such as Amazonas and Acre, where government agencies have the interest and the political support to invest in the sustainable management of the state's fisheries. Both of the states discussed here have long and important traditions of grass-roots mobilization in support of community-based fisheries management and both passed similar legislation for the co-management of floodplain fisheries. However, only Amazonas implemented a comprehensive management system for state fisheries and consequently only in Amazonas is this grass-roots effort succeeding.

Fisheries certification grew out of a concern that governments had proven to be largely ineffective in halting the depletion of the world's major marine fisheries.

The view that emerges from the literature, however, is that certification generally relies on the conditions created by government management agencies.


The community management system for pirarucu is a case in point. The state of Amazonas has implemented regulations and precarious arrangements for monitoring and enforcement that may have reduced the market for illegal pirarucu and have enabled pirarucu populations to recover in reserves where they are being managed (Bessa and Lima 2010) . In contrast, the state of Pará has made no such effort, so pirarucu products from sustainably managed fisheries must compete in local markets with products from illegal and unmanaged fisheries. Not surprisingly, two of the three artisanal fisheries that have undergoing preassessment for MSC certification are community-managed pirarucu fisheries in government reserves in Amazonas (Dias and Viguié 2013) .

The state of Amazonas has implemented regulations and precarious arrangements for monitoring and enforcement that may have reduced the market for illegal pirarucu and have enabled pirarucu populations to recover in reserves where they are being managed.

Not surprisingly, two of the three artisanal fisheries that have undergoing preassessment for MSC certification are community-managed pirarucu fisheries in government reserves in Amazonas.


Aetiology of CKD and co-morbid risk factors Figure 1 shows that the 3 commonest diagnoses encountered were: hypertension in 227 (75.2%), diabetes in 90 (29.8%) and HIV in 86 (28.5%) with similar gender distribution. Self-reported history was verified in all patients using medical records. Renal diagnoses in 21 patients referred for renal biopsy were: primary glomerulonephritis (16), hepatitis B virus-associated (4) and lupus nephritis (1) . Tubulointerstitial diseases were observed in 17 (5.6%) with autosomal dominant polycystic kidney disease (11), obstructive uropathy (5) and presumed analgesic nephropathy (1) . Hypertension and diabetes increased with age while HIV was prevalent in young patients ( Figure 2 ). Multiple concomitant CKD risk factors were common (51.1%); dual co-morbidities in 136 (47.9%) patients and triple co-morbidities in 9 (3.2%). CKD was attributed to a single cause in 139 (48.9%) patients; 87/302 (28.8%) had hypertension alone, 32/302 (10.6%) had HIV alone while glomerulonephritis alone and tubulointerstitial disease were uncommon; 9/ 302 (3.0%) and 5/302 (1.7%), respectively ( Figure 3 ). Only 6/90 (6.7%) diabetic patients had diabetes alone with concurrent hypertension in 76 (84.4%) and concurrent HIV in 8 (8.9%). Hypertension was a co-morbid diagnosis in >50% of patients with HIV, glomerulonephritis and tubulointerstitial disease as well ( Figure 3 ).

Renal diagnoses in 21 patients referred for renal biopsy were: primary glomerulonephritis (16), hepatitis B virus-associated (4) and lupus nephritis.

Tubulointerstitial diseases were observed in 17 (5.6%) with autosomal dominant polycystic kidney disease (11), obstructive uropathy (5) and presumed analgesic nephropathy.


Dedicated CKD clinics typically conducted at tertiary level by nephrologists were inaccessible to most patients in this study due to various healthcare resource constraints hence the establishment of this CKD outreach clinic. Published South African experience of nephrology outreach is limited to a study in Soweto primary healthcare clinics in Gauteng province that found eGFR <60 ml/min/1.73 m 2 in 26% and nephrotic-range proteinuria in 9% of patients evaluated [12] . The high proportion of patients with advanced disease (50.6% with eGFR <30 ml/min/1.73 m 2 ) in our clinic highlights an important reality in resource-poor settings that CKD patients remain at district and regional level healthcare unable to access tertiary care, thus primary healthcare practitioners are managing increasingly complex patients.

Published South African experience of nephrology outreach is limited to a study in Soweto primary healthcare clinics in Gauteng province that found eGFR <60 ml/min/1.73 m 2 in 26% and nephrotic-range proteinuria in 9% of patients evaluated.


As a postoperative adjuvant chemotherapy, docetaxel/S-1 was superior to S-1 alone for pathological Stage III gastric cancer in the JACCRO GC-07 trial [21] . JACCRO GC-07 trial included patients undergoing R0 resection. Meanwhile, the present study included patients with tumors that were unclear whether R0 resection was possible or not. The subjects were different between the studies. It was reported that large type 3 and type 4 gastric cancers accounted for only about 10% of stage II/III gastric cancer and large type 3 or type 4 gastric cancer was a poor prognostic factor independent of pathological stage [11] . Even if docetaxel/S-1 is superior to S-1 alone for pathological stage III gastric cancer, the same would not necessarily be true for the present research subject.

As a postoperative adjuvant chemotherapy, docetaxel/S-1 was superior to S-1 alone for pathological Stage III gastric cancer in the JACCRO GC-07 trial.

It was reported that large type 3 and type 4 gastric cancers accounted for only about 10% of stage II/III gastric cancer and large type 3 or type 4 gastric cancer was a poor prognostic factor independent of pathological stage.


A total of 22 studies were found using the search keywords and then met the inclusion/exclusion criteria. Of the 22 studies, 21 were published in peer-reviewed journals between the years of 1981 and 2007. One doctoral dissertation met the inclusion criteria (Jennett, 2005) . The 22 studies included an aggregate total of 65 research participants. The mean age of the research participants for the included studies was 6.2 years, with a range of 2 -13 years (see Figure 1 ).

One doctoral dissertation met the inclusion criteria.


Fluoropolymers are used extensively in the oil and gas industries due to their exceptional properties like chemical inertness and thermal stability over a wide range of temperatures. Fluoroelastomers are generally applied as seals or gasket material for high gas pressure applications. However, these fluoroelastomeric seals are susceptible to rapid gas decompression (RGD) [1] . This phenomenon is caused by the diffusion of a gas into the polymer whilst under pressure and when the pressure is released the pressure differential in the polymer causes mechanical or explosive damage of the polymer matrix [2, 3] . Polytetrafluoroethylene (PTFE) is often used as a substitute when an elastomer is unsuitable for a specific pressure or chemical application due to its lacking mechanical strength and chemical inertness. However, PTFE is known to be vulnerable to gas permeation more than the elastomeric seals due to the processing methods used to fabricate finished articles.

However, these fluoroelastomeric seals are susceptible to rapid gas decompression (RGD).

This phenomenon is caused by the diffusion of a gas into the polymer whilst under pressure and when the pressure is released the pressure differential in the polymer causes mechanical or explosive damage of the polymer matrix.


The study presented in this paper builds on the household production theory (Becker, 1965; Lancaster, 1966; Muth, 1966) . The household production model emphasizes that market goods and services are not themselves carrying utility, but are inputs to a process that yields householdproduced commodities, which, in turn, yield utility. The household production theory stresses that certain goods do not affect a household's utility directly, but rather through intermediate goods which are produced by the household using market-based goods and services and time as inputs.

The study presented in this paper builds on the household production theory.


Especially because of the interdisciplinary approach adopted, we think that this paper delivers new and more encompassing insights to better understand HEC. The theoretical HEC model and the underlying household production theory are shown to be a versatile platform to develop and test further theoretical as well as empirical advancements. The data available enables us to demonstrate the usefulness of an econometric panel estimation not just for economic modeling, but also for engineering predictions. Our estimation delivers a broad overview on a detailed separation of influences constituting HEC. Further, we show that the household production theory does not 24 just integrate interdisciplinary research, but also combines different conceptual approaches. This is because HEC research also divides between habitual and rational decision-making. Although the theoretical background chosen in this paper resides on a rational actor, the estimation shows a potential link with approaches that are based on habits or practices, as they are reportedly influential to the HEC (Maréchal 2010; Gram-Hanssen 2011) . Finally, yet importantly, we show that the price elasticity of demand of occupants' HEC behavior is time-sensitive with regard to the time resolution of the data. This aspect contributes to the general understanding of associated economic decision-making.

Although the theoretical background chosen in this paper resides on a rational actor, the estimation shows a potential link with approaches that are based on habits or practices, as they are reportedly influential to the HEC.


In the energy economics literature, the deviations from ex ante anticipated energy savings potentials to ex post realized energy consumptions, are analyzed according to the price elasticity of demand, which adopts an increased demand for energy services because of a lower price per unit of service (Berkhout et al. 2000) . This paper shows theoretically as well as empirically that the price elasticity of demand relationship to energy consumption does hold true, but in order to assess its full predictive power the price elasticity of demand needs to be incorporated into an 3 interdisciplinary framework. As the theoretical HEC model follows an interdisciplinary approach, it interprets the price elasticity of energy demand as one influence among competing others and thus prevents possible biases caused by the omission of utility-relevant components. The theoretical HEC model proposed explains interdependencies that result in HEC that are explained based on economic, engineering as well as psychological principles and reasoning. This is necessary because e.g. the physiological influences from comfort taking may overshadow the economic price influence. Based on panel estimation of monitoring data from a field experiment in South-West Germany the price elasticity of demand is shown to have no significant influence on the daily to monthly HEC and thus the habits or routines of the occupants. Yet the estimation shows a significant influence of the price elasticity of demand on a yearly (and thus likely more considered) economic decision-making process concerning HEC. Furthermore, we find that thermal comfort conditions influence HEC up to 500% more than the price elasticity of demand.

In the energy economics literature, the deviations from ex ante anticipated energy savings potentials to ex post realized energy consumptions, are analyzed according to the price elasticity of demand, which adopts an increased demand for energy services because of a lower price per unit of service.


Feature selection will be done using particle swarm optimisation (PSO) to maximise the performance of SVR. Using PSO for feature selection will reduce computational time. It is an evolutionary computation technique, which is computationally less expensive than other evolutionary computation algorithm [5, 6] .

It is an evolutionary computation technique, which is computationally less expensive than other evolutionary computation algorithm.


A stock is a sign of ownership of a company and indicates that a shareholder holds a share of the company's assets and earnings [1] . Stock is one of the most popular types of investment instruments; they are doubly beneficial since they provide both dividend and capital gain. Dividends are profits shared among shareholders based on the number of shares held by them. Further, capital gain is a benefit of the difference between the purchase and selling prices; however, it can become capital loss if the selling price is lower than the purchase price. Stock prices are determined by the marketplace, where the seller's supply meets the buyer's demand. Unfortunately, since there is no specific equation that can exactly determine how a stock price will behave, stock prices are always fluctuating.

A stock is a sign of ownership of a company and indicates that a shareholder holds a share of the company's assets and earnings.


The use of composite materials in primary aircraft structures is increasing significantly with the recent design changes in modern commercial aircraft. This increased application of composites gives rise to a heightened demand for composite repair technologies. Generally the scarf repair method is preferred over mechanical fastened repairs due to its superior structural efficiency and conformity to the external contour of the original structure [1] [2] [3] [4] .

Generally the scarf repair method is preferred over mechanical fastened repairs due to its superior structural efficiency and conformity to the external contour of the original structure.


In Grand-Duchy of Luxembourg, CVD is the primary cause of mortality and a major reason for hospital admission. This has led public health authorities to consider CVD as one of their national healthcare priorities. It is well established that early management of CVRF by lifestyle modifications and/or therapeutic interventions leads to marked reduction in mortality, morbidity, and maintaining quality of life [31, 32] . Therefore, early detection of individuals with modifiable and treatable CVRF may result in saving lives and reducing the burden on healthcare resources. In the absence of relevant national baseline statistics, the observation of CVRF by national periodic surveys is an essential tool to formulate coherent and effective strategies of prevention.

It is well established that early management of CVRF by lifestyle modifications and/or therapeutic interventions leads to marked reduction in mortality, morbidity, and maintaining quality of life.


The considerable percentages of ES and, particularly, PNES participants who fulfilled dissociative disorder criteria according to the DDIS are in line with previous findings and support the contention that PNES might be considered dissociative in nature, and that ES are often associated with various dissociative phenomena (Cardeña, Lewis Fernández, Beahr, Pakianathan, & Spiegel, 1996) . Although we did not find a statistically significant difference in prevalence of dissociative disorders between PNES and ES patients with our relatively small N, a thorough diagnostic interview for the dissociative disorders has previously identified greater dissociation among PNES patients (Bowman & Coons, 2000) . It certainly seems worthwhile to further study total, subscale, and item score differences between individuals with PNES and ES.

The considerable percentages of ES and, particularly, PNES participants who fulfilled dissociative disorder criteria according to the DDIS are in line with previous findings and support the contention that PNES might be considered dissociative in nature, and that ES are often associated with various dissociative phenomena.

Although we did not find a statistically significant difference in prevalence of dissociative disorders between PNES and ES patients with our relatively small N, a thorough diagnostic interview for the dissociative disorders has previously identified greater dissociation among PNES patients.


We consider the following document collections, following previous work [19] . Our machine is an Intel Xeon with 8 processors of 2.4GHz and 12MB cache, with 96GB RAM. It runs Linux 2.6.32-46-server, and we use gcc with full optimization. We choose 40,000 patterns of lengths m = 3 and m = 8 extracted randomly from the collection. Table 1 gives the space obtained by our LZ-Index structure on those collections. ClueWiki and KGS are the most compressible ones, reaching 11-12 bpc, whereas ClueChin and Proteins are the least compressible ones. All are, as roughly expected from the space analysis, 4.3-5.3×|LZ78|. We show how |LZ78| relates to n/n , and how it roughly coincides with the output size of Compress, a classical LZW Unix compressor.

We consider the following document collections, following previous work.


Of course, the open question is what sized subsets or data partitions to create. There really is "no known method of sample selection and estimation which ensures with certainty that the sample estimates will be equal to the unknown population characteristics" (p. 26) [12] . To do any intelligent subsampling, one might need to sort through the entire dataset, which could take away some of the efficiency advantages of distributing the workload in the first place.

There really is "no known method of sample selection and estimation which ensures with certainty that the sample estimates will be equal to the unknown population characteristics" (p. 26).


Single nucleotide polymorphisms (SNPs) are described in the VEGF gene, as well as in VEGFR1 and VEGFR2. For some of these, a direct association with the transcriptional activity of the corresponding genes has been shown [18] [19] [20] . Polymorphisms in the VEGFR2 promoter region have been found to influence the transcription activity of VEGFR2, contributing to the development of coronary artery lesions (CAL) in patients with Kawasaki disease (KD) and various cancers [21] [22] [23] .

For some of these, a direct association with the transcriptional activity of the corresponding genes has been shown.

Polymorphisms in the VEGFR2 promoter region have been found to influence the transcription activity of VEGFR2, contributing to the development of coronary artery lesions (CAL) in patients with Kawasaki disease (KD) and various cancers.


Biofuels are nowadays prospective replacement for the classic fossil energy sources which inventory is slowly declining. The most widely produced biofuel is a biodiesel, which is produced from vegetable oils and ethanol produced from plant polysaccharides derived from corn and sugar cane (PATZEK et al., 2004) . During the biofuels production many secondary products are generated whose disposal is not easy. Such products include glycerol, which occurs mainly in the production of biodiesel from rapeseed and flaxseed oil. Excess glycerol can become environmental problems because it cannot be destroyed naturally in the environment, and its storage and processing is very costly therefore to be should ways to be processed further (ARECHEDERRA and MINTEER, 2008) . One of glycerol disposal options is its use as a source of carbon and energy source for the industrial microbiology. Another possibility is the use of glycerol as a feed component for ruminants. The digestive tract of ruminants possesses the unique microbial ecosystem, which allows them to transform the plant food into microbial biomass. In vitro experiments have shown that the addition of glycerol to the diet has no deleterious effect on ruminants. It has been shown that the microorganisms present in the forestomach of ruminants can tolerate elevated concentrations of the glycerol in the feed, but only up to a certain concentration (RÉMOND et al., 1993; PARSONS et al., 2009; DROUILLARD, 2009; LEE et al., 2011) .

The most widely produced biofuel is a biodiesel, which is produced from vegetable oils and ethanol produced from plant polysaccharides derived from corn and sugar cane.

Excess glycerol can become environmental problems because it cannot be destroyed naturally in the environment, and its storage and processing is very costly therefore to be should ways to be processed further.

It has been shown that the microorganisms present in the forestomach of ruminants can tolerate elevated concentrations of the glycerol in the feed, but only up to a certain concentration.


Our experimental results provide some interesting insights into the tradeoff between a sensor network's energy consumption and iterative algorithm convergence. It is conventional wisdom that sensor nodes should be powered down periodically to conserve energy [17, 18] . However, our results indicate that if the sensors are switched off during the iterative estimation process, then the network could end up consuming significant additional energy to achieve a specified estimate error tolerance. In the limit as nodes and links sleep and fail for longer amounts of time, we conjecture that the Jacobi algorithm will be hard to beat.

It is conventional wisdom that sensor nodes should be powered down periodically to conserve energy.


We used our context-dependent rate constants to provide a direct demonstration of the equilibration of a random DNA sequence into the one with overall (genomic base content) and short-range (different k-mer contents) characteristics that closely mirror that of the actual human genome. The L1-derived rates recapitulated fundamental properties of the repeat-masked and therefore L1-free human genome (supplementary fig. S11 ). This simulation thus provides significant evidence in support of the role of core neutral substitutions in shaping the compositional dynamics of complex genomes [60] .

This simulation thus provides significant evidence in support of the role of core neutral substitutions in shaping the compositional dynamics of complex genomes.


We use this coverage to determine the core rate constants for all possible nucleotide substitutions (3 per position) at every single 3.2 billion position in the human genome. The Trek method reveals the r i,j core variation in a model-free manner and at a level beyond accounting for only the two immediate neighbouring nucleotides [34] . Furthermore, we make our dataset, holding the time-dependent rate constants for individual substitutions that account for up to 7-mer sequence context effect, publically available. Importantly, we demonstrate that r i,j core values alone can generate a sequence, from first principles, starting from a random DNA sequence, whose key features reflect the oligomeric organisation of the actual human genome. Next, we calculate the basal substitution propensity profile of the human genome, evaluating the core predisposition to single-nucleotide substitutions. We outline the decreased frequency of the sequence motifs that are stable in germline among the sites linked to somatic cancer mutations.

The Trek method reveals the r i,j core variation in a model-free manner and at a level beyond accounting for only the two immediate neighbouring nucleotides.


Thioridazine hydrochloride (THZ), the hydrochloride of 10-[2-(lmethyl-2-piper-idyl)ethyl]-2-methylthiophenothiazine, is a phenothiazine neuroleptic drug used for the treatment of schizophrenia and other psychiatric disorders [1] . Phenothiazines also possess antiemetic, sedative, antipruritic, antidyskinetic, analgesic, and antihistaminic properties [2] . Thioridazine has been known as one of the most potent phenothiazines which inhibit trypanothione reductase irreversibly and is commonly used as an antipsychotic and antimuscarinic drug to treat behavioral symptoms [3, 4] . Additionally, thioridazine was effective in the treatment of sweating as an antidepressant and sedative drug [5, 6] .

Thioridazine hydrochloride (THZ), the hydrochloride of 10-[2-(lmethyl-2-piper-idyl)ethyl]-2-methylthiophenothiazine, is a phenothiazine neuroleptic drug used for the treatment of schizophrenia and other psychiatric disorders.

Phenothiazines also possess antiemetic, sedative, antipruritic, antidyskinetic, analgesic, and antihistaminic properties.

Thioridazine has been known as one of the most potent phenothiazines which inhibit trypanothione reductase irreversibly and is commonly used as an antipsychotic and antimuscarinic drug to treat behavioral symptoms.

Additionally, thioridazine was effective in the treatment of sweating as an antidepressant and sedative drug.


Here we show, in contrast to previous work, that several phenotypes associated with Orb6 inactivation, including increased cell width, are independent of Gef1. We further find that Orb6 positively regulates exocytosis, also independently of Gef1. To identify novel targets of Orb6, we performed a quantitative global phosphoproteomics analyses of cells with decreased Orb6 kinase activity and generated a high-quality dataset of Orb6 targets in vivo. Targets include proteins involved in kinase signalling, membrane trafficking, and the exocyst complex, a conserved octameric complex involved in vesicle tethering prior to membrane fusion [26] [27] [28] . We further show that Orb6 phosphorylates exocyst in vitro and that exocyst phosphorylation in vivo mediates a subset of Orb6-dependent phenotypes. Overall, our results suggest that Orb6 regulates cell polarity via multiple targets involved in membrane trafficking and exocytosis.

Targets include proteins involved in kinase signalling, membrane trafficking, and the exocyst complex, a conserved octameric complex involved in vesicle tethering prior to membrane fusion.


There are several reports that suggest that flavonoids act through a variety of mechanisms to prevent and attenuate inflammatory responses and serve as possible cardioprotective, neuroprotective and chemoprotective agents (Gomes et al., 2008) . Generally, the crude nature of the extracts could be responsible for their low anti-inflammatory activities compared with the standard control. Further separation of the various phytochemicals found in the crude could yield better results.

There are several reports that suggest that flavonoids act through a variety of mechanisms to prevent and attenuate inflammatory responses and serve as possible cardioprotective, neuroprotective and chemoprotective agents.


Both classes of results suggest that, when the coupling constants are small; i.e. when λ = 0 in our case, the system is non-integrable -but for small values of λ the models are not that different from being integrable. Hence, its properties partially support the ideas of quasi-integrability [13] . At the same time the property of the field theory of 'being BPS' does not appear to be extremely important. Of course, this is all in (1+1) dimensions. This may be very different for the field theories in higher dimensions -and, in particular, in models in which multisoliton solutions can be determined by self-duality (i.e.) like monopoles in (3+1) dimensions or baby skyrmions in (2+1) dimensions. We plan to look in more detail at such theories also in our future work.

Hence, its properties partially support the ideas of quasi-integrability.


One important quantity related to the BPS property is the existence of the so-called prepotential (see below) which is related to the potential of a particular model by a differential equation on the target space. In particular, BPS solutions follow a sort of a gradient flow equation of the pre-potential [2] , [4] . However, the relation between the pre-potential and the BPS solutions as well as the role of the pre-potential in the time dependent processes (relaxation and scattering) has not been systematically investigated. One of the aims of the present paper to analyse this issue in some detail.

In particular, BPS solutions follow a sort of a gradient flow equation of the pre-potential.


Due to the higher degree of coherency of the main strengthening precipitates with the aluminium lattice for naturally aged conditions, they are mainly sheared by dislocations promoting planar slip conducing to a higher roughness due to an extensive crack deflection. Therefore, the naturally aged aluminium alloys are classified in group II [7] . Artificially aged conditions such as T6, having a lower coherency of its precipitates with the aluminium lattice, a lower crack deflection and roughness are expected because a significant fraction of precipitates are looped or bypassed. Thus, they are included in group I [7] . Fig. 5 shows that while alloy A, being in artificially aged condition T6, is in agreement of the above statements, as it presents a crack growth rate of approximately 1:69 Â 10 À4 mm=cycle at DK 0 ¼ 10 MPa m 1=2 . Alloys B and C, although being in the same T6 condition, have significantly lower values of da=dN at DK 0 , approximately 1:5 Â 10 À5 and 7:5 Â 10 À6 mm= cycle, respectively, being better included in group II.

Therefore, the naturally aged aluminium alloys are classified in group II.

Thus, they are included in group I.


The phenomenon of plasticity-induced closure seems to be the main cause of the post-overload crack growth transients for alloy A depicted in Fig. 10 . The overload cycle induces crack tip blunting, which tends to remove near tip closure and reduces far field closure. Consequently, the crack closure level is reduced to the value prior to the overload increasing the effective stress intensity DK eff and, thus, leading to the brief initial crack acceleration [27, 28] . As the crack grows into the compressive residual stress field formed by the overload cycle, it encounters increased levels of plasticity that induce near tip crack closure. This results in a gradual increase of the closure level (see Fig. 11 ), which implies a gradual reduction of DK eff and therefore of the crack growth rate. As the crack grows outside the zone of largest plastic deformations, the crack closure level and, hence, da=dN gradually approach the values corresponding to the baseline level. However, there is some discrepancy between the crack growth rate transients and the corresponding crack closure trend presented in Figs. 10 and 11 , respectively. This disagreement is due, as already mentioned, to the discontinuous closure or partial closure phenomenon.

Consequently, the crack closure level is reduced to the value prior to the overload increasing the effective stress intensity DK eff and, thus, leading to the brief initial crack acceleration.


The interviewees considered lack of estimation and allocation of required human resources as the most significant elements in regard with lack of required mechanism for implementing the Act. Smeet study showed that human resources productivity is changed as a result of the pattern and organization of human resources within hospitals (Mc-Neese-Smeet, 2001) . Similarly, in another study, 37% of the participants considered over workload and inappropriate organization of human resources at the time of shortage as obstacles to productivity (Eastaugh, 2002) .

Smeet study showed that human resources productivity is changed as a result of the pattern and organization of human resources within hospitals.

Similarly, in another study, 37% of the participants considered over workload and inappropriate organization of human resources at the time of shortage as obstacles to productivity.


Tests has been done to characterize the resolution, static and dynamic spatial accuracy of the overall tracking system. The resolution is the smallest change of position or orientation that the tracking system is able to detect. Resolution is limited either by jitter or quantization levels. The visual effect of the jitter on computer display can affect the user's haptic experiences. Static accuracy is the amount of reading error when the position and orientation remain constant. Errors due to noise, scale factor error and non-linearity can be shown on static accuracy tests. Very low frequency error components which can be perceived over a period of time are categorized under the term stationary drift. The jitter is the rapidly changing error component [5] . The static accuracy is calculated as the Root Mean Square (RMS) error of the recorded position and orientation angles from the true ones when the tracking sensors are held at a known fixed position and recording the position and orientation output data stream for a 10 min period of time.

The jitter is the rapidly changing error component.


The quality of estimates are evaluated by using the deviation of the estimate from the exact trace, d i , defined in Eq. (8) . In the numerical experiments we performed, it turns out that d i is following the normal distribution. Hence we use the standard deviation of d i as an uncertainty of the trace estimates. The trace estimates of the probing vector estimators can be biased, but a bias correction method using d i is introduced in Eq. (9). Another unbiased estimator, which converts the systematic error of the trace estimator to a statistical uncertainty, is presented in Eq. (10) .

The quality of estimates are evaluated by using the deviation of the estimate from the exact trace, d i , defined in Eq..

Another unbiased estimator, which converts the systematic error of the trace estimator to a statistical uncertainty, is presented in Eq..


In Figure 9 , mean cumulative frequency of response to S+ and S-over 20 successive 30-s periods in extinction is plotted for the punishment and the conventional groups. Coming into contact with tap water in extinction, an animal would immediately fly up, return to one of the targets, taste the tap water, fly up, return, and so forth, with the number of target contacts progressively decreasing-a pattern of behavior perfectly familiar from previous experiments (Couvillon & Bitterman, 1980) . Although the performances of the punishment and the conventional animals were much the same in terms of errors made during acquisition, the preference for S+ during extinction was significantly greater in the conventional group. Analysis of variance revealed no significant groups effect (F< 1) but a significant Groups x Stimuli interaction, F([, 14) = 6.08, p = .0272. On the assumption that resistance to extinction is a more sensitive measure than choice during acquisition, it might be assumed that to pair S-with water produces better discrimination than to pair it with sucrose plus shock, although it is not immediately clear why the difference should show up in terms of response to S+ or why the performances of the punishment and delayed punishment animals, different in training, were essentially identical in extinction (F < 1). A more likely explanation is that the change in conditions from training to extinction was greater for these animals than for the conventional animals.

Coming into contact with tap water in extinction, an animal would immediately fly up, return to one of the targets, taste the tap water, fly up, return, and so forth, with the number of target contacts progressively decreasing-a pattern of behavior perfectly familiar from previous experiments.


Larger dimensions -When learning higher dimensional embeddings, which is an advantage of our joint models as it is very fast to train compared to other methods, the results across all metrics well correlate with the embedding sizes as we increase from 40, 128, 256, to 512. Our 256-and 512-dimensional embeddings trained with unsupervised alignments produce strong results, significantly better than all other models in terms of the word similarity datasets and achieve state-of-theart performance in terms of the CLDC de→en with an accuracy of 80.3. For CLDC en→de , our model reaches a very high score of 90.7, close to the best published result of 91.8 produced by the autoencoder model. Table 2 : Nearest neighbor words -shown are the top 10 nearest English (en) and German (de) words for each of the following words in the list {january, microsoft, distinctive} as measured by the Euclidean distances given a set of embeddings. We compare our learned vectors (BiSkip-UnsupAlign, d = 128) with those produced by the autoencoder model (Chandar A P et al., 2014) . For the word distinctive, we provide Google Translate glosses for German words. The word telekommunikationsunternehmen is truncated into telekommun*.

We compare our learned vectors (BiSkip-UnsupAlign, d = 128) with those produced by the autoencoder model.


To assess humans ' ability to identify individual Andean bears we fi rst created online surveys in English and Spanish, the common language across the species ' range, using 65 diff erent photographs of 39 known bears. To evaluate participants with a variety of personal and professional backgrounds we solicited participation in the survey by emails to colleagues, peers, and personal contacts, as well as through an announcement in the International Bear News (Paisley et al. 2010) . Participants reviewed 21 pairs of images: six pairs of images of adults spanning up to 13 years from the same bear, and 15 pairs that included one photo of a cub and one photo of an adult ( ' cub -adult ' pairs) spanning up to 23 years from the same bear. For each pair, participants responded to the question " Are the photos above of the same bear? " with one of three responses: " yes " , " no " , and " unable to determine " . Th is task mimics some of the identifi cation tasks faced during fi eld research, such as when a bear under observation in a corn fi eld must be compared to a photo taken earlier during a similar event, or when a recently retrieved camera trap photo must be compared to a camera trap photo taken at another location. To examine whether success was aff ected by participants ' background or personal characteristics we collected information on participant sex, age and experience working with bears, Andean bears, or with visual identifi cation of individuals of any wildlife species. To remove potential biases caused by poorly motivated participants, or by missing data, we only analyzed data from participants who answered at least 15 of the 21 questions. We measured participant performance as the proportion of responses that were correct. Th e average age of the 120 online participants (50 men, 70 women) who answered at least 15 of the 21 questions was 36.4 Ϯ 12.1 years. Nineteen participants (16%) had experience working with bears but not Tremarctos , 10 participants (8.3%) had experience working with Tremarctos , and 68 participants (56.7%) had experience with visual identifi cation of individual wild animals.

To evaluate participants with a variety of personal and professional backgrounds we solicited participation in the survey by emails to colleagues, peers, and personal contacts, as well as through an announcement in the International Bear News.


Granulomatosis with polyangiitis (GPA) is a small-vessel vasculitis characterized by necrotizing granulomatous inflammation in the upper and/or lower respiratory tract and glomeruli. Circulating anti-neutrophil cytoplasmic antibodies (ANCAs) predominantly directed against the neutrophil serine proteinase-(PR-) 3, but also myeloperoxidase (MPO), is seen in 80-94% of affected patients [1] . The cause of this disease and other autoimmune conditions remains unclear with several postulated theories. An association with cytomegalovirus (CMV) has been reported as an etiologic trigger. Furthermore, CMV reactivation is being diagnosed more frequently in active autoimmune disease with resulting deleterious effects. We report a case of a patient who presented with manifestations of severe pulmonary-renal syndrome (PRS) secondary to GPA and who developed fatal CMV disease causing severe pneumonitis and viremia three weeks into her hospital stay and discuss the factors that contribute to CMV reactivation and the potential indications for antimicrobial prophylaxis.

Circulating anti-neutrophil cytoplasmic antibodies (ANCAs) predominantly directed against the neutrophil serine proteinase-(PR-) 3, but also myeloperoxidase (MPO), is seen in 80-94% of affected patients.