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This working paper traces the trajectory of Syrian official documents across Syria and Germany in times of political upheaval, flight and integration. Documents issued by the Syrian state continue to be a fundamental element in the life of Syrians in Germany as they are still needed for certain mundane, yet crucial, purposes. Syrians are therefore forced to engage with Syrian state bureaucratic apparatuses at a distance. The journey of the papers across time and geographical borders unveils the highly political ambivalences and tensions embodied in Syrian paperwork in the context of German policies of asylum and integration. In Syria, the documents and their retrieval are embedded in the politics of security governing the Syrian citizenship regime. On arrival in Germany, the papers gain new meanings in their encounter with the German integration process and legal system rooted in the Rule of Law. At the same time, the papers' enmeshment with German bureaucracy reproduces (from a distance) the political dynamics between Syrians and the Syrian state in the past. Situated at a crossroads of the web of state(-s) power in and between Syrian and German bureaucracies, the papers re-integrate Syrians’ past into their present in Germany. By revealing this complex web of relationships, this working paper offers a reflection on the limits of studying the European context of integration and asylum 'fromwithin'.

Context: In 2006 the Labour Government in England published its long awaited White Paper on ‘community services’, following on from the 2005 Green Paper on the future of social care. The policy envisages an unprecedented shift of activity and resources from acute care to community settings, along with a much stronger focus on preventive care. Several mechanisms are to be put in place to ensure this shift takes place, most notably practice-based commissioning, payments-by-results and enhanced partnership working. Purpose: This article outlines the intended changes and assesses the extent to which they add up to a coherent strategy. Conclusion: It is argued that although there is widespread support for the overall vision, the strategy contains some difficult policy tensions that are common to other welfare systems. These will have to be addressed if the vision is to be a reality.

Interdisciplinary inquiry hinges upon abductive arguments that integrate various kinds of information to identify explanations worthy of future study or use. Integrative abduction poses unique challenges, including different kinds of data, too many patterns, too many explanations, mistaken meanings across disciplinary lines, and cognitive, pragmatic, and social biases. Argumentation tools can help explicate and negotiate bias as interdisciplinary investigators sift and winnow candidate patterns and processes in search of the best explanation.

Practice has developed into a key concept in management research, including B2B marketing and purchasing studies. However, the adoption of the term in B2B marketing and purchasing is characterized by some difficulties. Research on B2B practices is growing, but seems marked by fragmentation, inconsistency, and lack of precision among others. Without conceptual consistency and integrity, B2B practice studies are at risk of becoming derailed, compromising the developments of future theory and practice within B2B. In this critical review paper, we therefore seek to create an overview of B2B practice research as perceived through a practice lens. Based on a review of 116 identified practice papers from key B2B journals, we map the topic areas where the practice concept has been applied for investigations, and we also investigate how well the applied practice conceptualization in these papers align with a recognized practice theory conceptualization. We find that the majority of B2B studies align poorly with the three elements of practice: managerial action, habitual behavior, and action-structure duality. Since many of the alignment issues in the review are caused by methodological problems, we propose a series of methodological tools that can provide a more accurate understanding of B2B practices in future research.

Paraguay's power system is based entirely on hydropower. It serves as the largest net electricity exporter in Latin America. Nonetheless, the country´s electricity consumption per capita is one of the lowest in the world and the transmission and distribution network has one of the highest losses in Latin America. This paper presents an electricity expansion investment outlook (2018–2040) for Paraguay using OSeMOSYS, analyzing three electricity demand scenarios under different electricity export prices to Brazil. The study identifies the least-cost power generation mix, future investments and the financial requirements to meet the needs of different demand scenarios. We find that Paraguay will need to invest in hydropower plants, by mainly expanding the capacity of Yacyreta to cover its electricity needs and sustain national electricity exports levels. In the High demand scenario, where the electricity demand could approximately double by 2040, the country's overall electricity exports decrease by 50% compared to the Reference scenario. Based on the different scenarios examined, the government spends approximately 18.3–31.2 billion USD on power plant investments for the period 2018–2040 to cover future electricity demand. The findings could be useful in supporting decision-making concerning socio-economic development pathways in the country. Supplementary Information The online version contains supplementary material available at 10.1007/s12667-020-00420-w.

Fragmentation of processes and interventions plague the psychotherapies (Gilbert & Kirby, 2019). Part of the problem is that we have not agreed on a framework that could be the basis for integrating knowledge and the scientific enquiry of processes and interventions. This paper outlines an approach that brings together a variety of different disciplines in the service of consilience (Wilson, 1998, Consilience: The unity of knowledge, Vintage, New York, NY; Siegel, 2019). It presents the importance of an evolutionary framework for understanding the proclivities and dispositions for mental suffering and antisocial behaviour, and how they are choreographed in different sociodevelopmental contexts. Building on earlier models (Gilbert, 1989, Human nature and suffering, Routledge, London, UK; Gilbert, 1995, Clin. Psychol. Psychother., 2, 135; Gilbert, 1998, Br. J. Med. Psychol., 71, 353; Gilbert, 2016, Case formulation in cognitive behaviour therapy: The treatment of challenging cases, Wiley, Chichester, UK, pp. 50–89) the call is for an integrative, evolutionary, contextual, biopsychosocial approach to psychology and psychotherapy. Practitioner points Evolutionary functional analysis is part of an evolutionary, contextual, biopsychosocial approach to mental health that can serve as a scientific platform for the future developments of psychotherapy.Therapist skills and training will increasing need to focus on the multidimensional textures of mental states especially the context‐social‐body linkages.Therapies of the future will also focus more on the moral aspects of therapy and address the need to promote prosocial and ethical behaviour to self and others.

Increasingly, complexity science concepts are informing health care design and practice. The present paper describes the implementation of early complexity science principles in a Complex Care Program with the aim of strengthening the provision of integrated care. Grounded in cybernetic network theory, Stafford Beer’s Viable Systems Model [1] provided the guiding principles for the program’s redesign. The Viable Systems Model with its broadly applicable principles [1], is now the conceptual model of information management in the program. Beer’s framework has enabled a relatively small number of clinicians to coordinate care for a large cohort of patients with significant clinical complexity, and a multitude of providers, in the community setting.

This study contributes to our understanding of how the emergence of the COVID‐19 pandemic changes the global Banking Financial Services and Insurance (BFSI) landscape. Before the COVID‐19 pandemic, BFSIs corporate strategy was solely aligned to the quest for operational efficiency. However, during the ongoing COVID‐19 pandemic, global BFSIs are forced to adopt digital transformation in their operations due to a rise in transaction volumes. The ongoing COVID‐19 pandemic already triggers holistic innovations concerning the global BFSI's product, process, concept, trend, or idea. Thus, the BFSI cannot survive without efficient and innovative system software for global operations. The study plots the hype cycle to identify relevant technologies to deal with real‐world business problems. The hype cycle indicates that the need for advanced data integration is growing and COVID‐19 pandemic has already triggered it. The study argues that the incorporation of data integration might be challenging initially for BFSIs but eventually it may result in an efficient model to handle these types of pandemic or unexpected circumstances.

Purpose Within public services there is a widely recognised role for workers who operate across organisational and professional boundaries. Much of this literature focusses on the organisational implications rather than on how boundary spanners engage with citizens. An increased number of public service roles require boundary spanning to support citizens with cross-cutting issues. The purpose of this paper is to explicate the emotional labour within the interactions that boundary spanners have with citizens, requiring adherence to display rules and building trust. Design/methodology/approach This is a conceptual paper which draws on illustrative examples to draw out the emotional labour within two types of boundary spanning: explicit and emergent. Findings Emotional labour theory offers a way to classify these interactions as requiring high, medium or low degrees of emotional labour. Boundary spanning theory contributes an understanding of how emotional labour is likely to be differently experienced depending on whether the boundary spanning is an explicit part of the job, or an emergent property. Originality/value Drawing on examples from public service work in a range of advanced democracies, the authors make a theoretical argument, suggesting that a more complete view of boundary spanning must account for individual-level affect and demands upon workers. Such a focus captures the “how” of the boundary spanning public encounter, and not just the institutional, political and organisational dimensions examined in most boundary spanning literatures.

Objective To enhance the in vitro integration of self-assembled articular cartilage to native articular cartilage using chondroitinase ABC. Design To examine the hypothesis that chondroitinase ABC (C-ABC) integration treatment (C-ABCint) would enhance integration of neocartilage of different maturity levels, this study was conducted in 2 phases. In phase I, the impact on integration of 2 treatments, TCL (TGF-β1, C-ABC, and lysyl oxidase like 2) and C-ABCint, was examined via a 2-factor, full factorial design. In phase II, construct maturity (2 levels) and C-ABCint concentration (3 levels) were the factors in a full factorial design to determine whether the effective C-ABCint dose was dependent on neocartilage maturity level. Neocartilages formed or treated per the factors above were placed into native cartilage rings, cultured for 2 weeks, and, then, integration was studied histologically and mechanically. Prior to integration, in phase II, a set of treated constructs were also assayed to provide a baseline of properties. Results In phase I, C-ABCint and TCL treatments synergistically enhanced interface Young’s modulus by 6.2-fold ( P = 0.004) and increased interface tensile strength by 3.8-fold ( P = 0.02) compared with control. In phase II, the interaction of the factors C-ABCint and construct maturity was significant ( P = 0.0004), indicating that the effective C-ABCint dose to improve interface Young’s modulus is dependent on construct maturity. Construct mechanical properties were preserved regardless of C-ABCint dose. Conclusions Applying C-ABCint to neocartilage is an effective integration strategy with translational potential, provided its dose is calibrated appropriately based on implant maturity, that also preserves implant biomechanical properties.

Background Although the COVID-19 pandemic has significantly boosted the implementation of digital services worldwide, it has become increasingly important to understand how these solutions are integrated into professionals’ routine work. Professionals who are using the services are key influencers in the success of implementations. To ensure successful implementations, it is important to understand the multiprofessional perspective, especially because implementations are likely to increase even more. Objective The aim of this study is to examine health and social care professionals’ experiences of digital service implementations and to identify factors that support successful implementations and should be considered in the future to ensure that the services are integrated into professionals’ routine work. Methods A qualitative approach was used, in which 8 focus group interviews were conducted with 30 health and social care professionals from 4 different health centers in Finland. Data were analyzed using qualitative content analysis. The resulting categories were organized under the components of normalization process theory. Results Our results suggested 14 practices that should be considered when implementing new digital services into routine work. To get professionals to understand and make sense of the new service, (1) the communication related to the implementation should be comprehensive and continuous and (2) the implementation process should be consistent. (3) A justification for the service being implemented should also be given. The best way to engage the professionals with the service is (4) to give them opportunities to influence and (5) to make sure that they have a positive attitude toward the service. To enact the new service into professionals’ routine work, it is important that (6) the organization take a supportive approach by providing support from several easy and efficient sources. The professionals should also have (7) enough time to become familiar with the service, and they should have (8) enough know-how about the service. The training should be (9) targeted individually according to skills and work tasks, and (10) it should be diverse. The impact of the implementation on the professionals’ work should be evaluated. The service (11) should be easy to use, and (12) usage monitoring should happen. An opportunity (13) to give feedback on the service should also be offered. Moreover, (14) the service should support professionals’ work tasks. Conclusions We introduce 14 practices for organizations and service providers on how to ensure sustainable implementation of new digital services and the smooth integration into routine work. It is important to pay more attention to comprehensive and continuing communication. Organizations should conduct a competence assessment before training in order to ensure proper alignment. Follow-ups to the implementation process should be performed to guarantee sustainability of the service. Our findings from a forerunner country of digitalization can be useful for countries that are beginning their service digitalization or further developing their digital services.

Dyslexia has been associated with a problem in visual–audio integration mechanisms. Here, we investigate for the first time the contribution of unisensory cues on multisensory audio and visual integration in 32 dyslexic children by modelling results using the Bayesian approach. Non‐linguistic stimuli were used. Children performed a temporal task: they had to report whether the middle of three stimuli was closer in time to the first one or to the last one presented. Children with dyslexia, compared with typical children, exhibited poorer unimodal thresholds, requiring greater temporal distance between items for correct judgements, while multisensory thresholds were well predicted by the Bayesian model. This result suggests that the multisensory deficit in dyslexia is due to impaired audio and visual inputs rather than impaired multisensory processing per se. We also observed that poorer temporal skills correlated with lower reading skills in dyslexic children, suggesting that this temporal capability can be linked to reading abilities., Multisensory audio visual processing in dyslexia is due to impaired audio and visual inputs rather than impaired multisensory processing per se.

It is demonstrated that using three-dimensional profile fitting of Bragg peaks increases the accuracy and resolution of neutron crystallographic data collected from proteins and reveals new features in nuclear density maps calculated from these data., Neutron crystallography is a powerful technique for directly visualizing the locations of H atoms in biological macromolecules. This information has provided key new insights into enzyme mechanisms, ligand binding and hydration. However, despite the importance of this information, the application of neutron crystallography in biology has been limited by the relatively low flux of available neutron beams and the large incoherent neutron scattering from hydrogen, both of which contribute to weak diffraction data with relatively low signal-to-background ratios. A method has been developed to fit weak data based on three-dimensional profile fitting of Bragg peaks in reciprocal space by an Ikeda–Carpenter function with a bivariate Gaussian. When applied to data collected from three different proteins, three-dimensional profile fitting yields intensities with higher correlation coefficients (CC1/2) at high resolutions, decreased R free factors, extended resolutions and improved nuclear density maps. Importantly, additional features are revealed in nuclear density maps that may provide additional scientific information. These results suggest that three-dimensional profile fitting will help to extend the capabilities of neutron macromolecular crystallography.

Background: A pilot study to identify if the delivery of teaching session to medical students would have the potential to enhance communication and a culture of integration between primary and social care, ultimately improving interprofessional relationships between primary and social care. Health and social care integration is a topic of great debate in the developed world and the focus of the upcoming Green Paper by the Secretary of State for Health and Social Care in the NHS. There is much uncertainty to how this should be done and is hindered by the various current barriers. The literature identifies that collaborative cultures encourage effective interprofessional relationships and that communication is vital to integration of primary and social care and should be established early in medical training. Materials and Method: The General Medical Council’s Outcomes for Graduates and Imperial College School of Medicine curriculum were reviewed out to identify outcomes relating to inter-professional relationships between primary and social care. The relevant year group was surveyed to identify if the learning objective was delivered. In order to determine if delivery of a teaching session on nurturing interprofessional relationships between primary and social care would be effective, it was delivered to early clinical years to measure benefits as a pilot study. This was devised of case-based scenarios derived from learning objectives developed with experienced health care professionals. A survey was administered before and after the teaching session to determine if the students felt they had improved with respect to the learning objectives. Results: The initial survey identified the majority of students found the learning objectives were not delivered. The teaching session found a statistically significant improvement in confidence to nurture interprofessional relationships between primary and social care. Conclusion: Effective interprofessional relationships between primary and social care, improving communication and collaborative cultures, can be effectively taught in medical school, to improve integration of primary and social care.

Background The PRogramme for Improving Mental Health carE (PRIME) evaluated the process and outcomes of the implementation of a mental healthcare plan (MHCP) in Chitwan, Nepal. Aims To describe the process of implementation, the barriers and facilitating factors, and to evaluate the process indicators of the MHCP. Method A case study design that combined qualitative and quantitative methods based on a programme theory of change (ToC) was used and included: (a) district-, community- and health-facility profiles; (b) monthly implementation logs; (c) pre- and post-training evaluation; (d) out-patient clinical data and (e) qualitative interviews with patients and caregivers. Results The MHCP was able to achieve most of the indicators outlined by the ToC. Of the total 32 indicators, 21 (66%) were fully achieved, 10 (31%) partially achieved and 1 (3%) were not achieved at all. The proportion of primary care patients that received mental health services increased by 1200% over the 3-year implementation period. Major barriers included frequent transfer of trained health workers, lack of confidential space for consultation, no mental health supervision in the existing system, and stigma. Involvement of Ministry of Health, procurement of new psychotropic medicines through PRIME, motivation of health workers and the development of a new supervision system were key facilitating factors. Conclusions Effective implementation of mental health services in primary care settings require interventions to increase demand for services and to ensure there is clinical supervision for health workers, private rooms for consultations, a separate cadre of psychosocial workers and a regular supply of psychotropic medicines.

Background Electronic medical records (EMRs) are integrated information sources generated by health care professionals (HCPs) from various health care information systems. EMRs play crucial roles in improving the quality of care and medical decision-making and in facilitating cross-hospital health information exchange. Although many hospitals have invested considerable resources and efforts to develop EMRs for several years, the factors affecting the long-term success of EMRs, particularly in the EMR infusion stage, remain unclear. Objective The aim of this study was to investigate the effects of technology, user, and task characteristics on EMR infusion to determine the factors that largely affect EMR infusion. In addition, we examined the effect of EMR infusion on individual HCP performance. Methods A questionnaire survey was used to collect data from HCPs with >6 months experience in using EMRs in a Taiwanese teaching hospital. A total of 316 questionnaires were distributed and 211 complete copies were returned, yielding a valid response rate of 66.8%. The collected data were further analyzed using WarpPLS 5.0. Results EMR infusion (R2=0.771) was mainly affected by user habits (β=.411), portability (β=.217), personal innovativeness (β=.198), technostress (β=.169), and time criticality (β=.168), and individual performance (R2=0.541) was affected by EMR infusion (β=.735). This finding indicated that user (habit, personal innovativeness, and technostress), technology (portability), and task (mobility and time criticality) characteristics have major effects on EMR infusion. Furthermore, the results indicated that EMR infusion positively affects individual performance. Conclusions The factors identified in this study can extend information systems infusion theory and provide useful insights for the further improvement of EMR development in hospitals and by the government, specifically in its infusion stage. In addition, the developed instrument can be used as an assessment tool to identify the key factors for EMR infusion, and to evaluate the extent of EMR infusion and the individual performance of hospitals that have implemented EMR systems. Moreover, the results can help governments to understand the urgent needs of hospitals in implementing EMR systems, provide sufficient resources and support to improve the incentives of EMR development, and develop adequate EMR policies for the meaningful use of electronic health records among hospitals and clinics.

We propose a complete-search algorithm for solving a class of non-convex, possibly infinite-dimensional, optimization problems to global optimality. We assume that the optimization variables are in a bounded subset of a Hilbert space, and we determine worst-case run-time bounds for the algorithm under certain regularity conditions of the cost functional and the constraint set. Because these run-time bounds are independent of the number of optimization variables and, in particular, are valid for optimization problems with infinitely many optimization variables, we prove that the algorithm converges to an \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\varepsilon $$\end{document}ε-suboptimal global solution within finite run-time for any given termination tolerance \documentclass[12pt]{minimal} \usepackage{amsmath} \usepackage{wasysym} \usepackage{amsfonts} \usepackage{amssymb} \usepackage{amsbsy} \usepackage{mathrsfs} \usepackage{upgreek} \setlength{\oddsidemargin}{-69pt} \begin{document}$$\varepsilon > 0$$\end{document}ε>0. Finally, we illustrate these results for a problem of calculus of variations.

BackgroundWe describe the introduction, use, and evaluation of an automation and integration pharmacy development program in a private facility in Saudi Arabia. The project was specifically undertaken to increase throughput, reduce medication dispensing error rates, improve patient satisfaction, and free up pharmacists’ time to allow for increased face-to-face consultations with patients.ObjectiveWe forecasted growth of our outpatient service at 25% per annum over 5- and 10-year horizons and set out to prepare our outpatient pharmacy service to meet this demand. Initial project goals were set as a 50% reduction in the average patient wait time, a 15% increase in patient satisfaction regarding pharmacy wait time and pharmacy services, a 25% increase in pharmacist productivity, and zero dispensing errors. This was expected to be achieved within 10 months of go-live. Realignment of pharmacist activity toward counseling and medication review with patients was a secondary goal, along with the rapid development of a reputation in the served community for patient-centered care.MethodsPreimplementation data for patient wait time for dispensing of prescribed medications as a specific measure of patient satisfaction was gathered as part of wider ongoing data collection in this field. Pharmacist activity and productivity in terms of patient interaction time were gathered. Reported and discovered dispensing errors per 1000 prescriptions were also aggregated. All preimplementation data was gathered over an 11-month period.ResultsFrom go-live, data were gathered on the above metrics in 1-month increments. At the 10-month point, there had been a 53% reduction in the average wait time, a 20% increase in patient satisfaction regarding pharmacy wait time, with a 22% increase in overall patient satisfaction regarding pharmacy services, and a 33% increase in pharmacist productivity. A zero dispensing error rate was reported.ConclusionsThe robotic pharmacy solution studied was highly effective, but a robust upstream supply chain is vital to ensure stock levels, particularly when automated filling is planned. The automation solution must also be seamlessly and completely integrated into the facility’s software systems for appointments, medication records, and prescription generation in order to garner its full benefits. Overall patient satisfaction with pharmacy services is strongly influenced by wait time and follow-up studies are required to identify how to use this positive effect and make optimal use of freed-up pharmacist time. The extra time spent by pharmacists with patients and the opportunity for complete overview of the patient’s medication history, which full integration provides, may allow us to address challenging issues such as medication nonadherence. Reduced wait times may also allow for smaller prescription fill volumes, and more frequent outpatient department visits, allowing patients to have increased contact time with pharmacists.

This is one of the few studies that explores preferences of and experiences with integrated sexual and reproductive health (SRH)-HIV care among users of mainstream family planning and postnatal care services who are women living with HIV (WLWH). This paper reports on the quantitative data from 179 clients attending public sector clinics and from 30 qualitative in-depth interviews with WLHIV in Kenya. Quantitative data show that integration is happening for the vast majority of these clients at their last HIV visit. However, qualitative data show that very often the care received by WLWH is fragmented as providers do not offer multiple same-day appointments for FP and ARV refills. Our study has shown factors that could either prevent or enable receipt of integrated SRH and HIV care for WLWH. To address these factors, management systems need to be able to support providers to make flexible decisions and facilitate better coordination and communication across clinics within facilities.

First class transport is fundamental for a healthy society and a thriving economy. By providing a high degree of mobility for ideas, people and goods, it enables innovation to flourish, businesses to serve wide markets and citizens to travel easily for work and for pleasure. This leads to job creation; regional, national and European Union (EU) economic development; better social cohesion and a better quality of life. This is why transport is one of the seven ‘Societal Challenges’ on which Europe's Horizon 2020 research programme is focusing in 2014–2020. Much is being done to improve transport in Europe in specific topics, including in technology, in networks and in financing. Yet Europe is failing to capture the full benefits of these investments. As the European Commission's 2011 Transport White Paper recognises, today's European transport system remains fragmented, inefficient and inadequate. Analysis of the root causes of this poor performance shows that, while technology barriers are significant, policy issues dominate. The authors examine the arguments for a more connected approach and report on progress towards achieving such an approach. This sees European transport as one system and optimises it as such. This contrasts with the present situation of many fragments, individually good but poorly related. This connected approach will lead to better overall transport provision and better results for the resources invested. However, transport involves many stakeholders, who tend to focus on their own specific modes and issues. Truly effective transport will only develop if all stakeholders work together. We consider new initiatives to bring together all relevant actors at EU, national and regional levels to tackle the problems described above. These would, for example: (i) bring a stronger systems-level perspective to research and development efforts; (ii) coordinate investments in demonstrators and pilots; (iii) identify and fast-track changes necessary in regulations and standards; and (iv) mobilise demand, in particular through better coordinated public procurement. Such an approach will build on existing initiatives, at modal, sectoral and administrative levels, and unlock the full value creation potential of existing investment programmes.

The connection between science and mathematics is undeniable but also a complex phenomenon. The present study aimed to examine types of questions in science exam papers in 7 th grade “force and motion” unit and the consistency between questions and objectives in this unit. The study also aimed to determine if there are questions related to mathematics. If yes, which mathematics subjects they are related with. Document analysis was used for data collection. 19 exam papers prepared by different science teachers were collected and examined. Findings revealed that science teachers mainly used multiple choice questions and their questions included mathematical knowledge.

Objectives In children, there is often lack of sufficient information concerning the pharmacokinetics (PK) and pharmacodynamics (PD) of a study drug to support dose selection and effective evaluation of efficacy in a randomised clinical trial (RCT). Therefore, one should consider the relevance of relatively small PKPD studies, which can provide the appropriate data to optimise the design of an RCT. Methods Based on the experience of experts collaborating in the EU-funded Global Research in Paediatrics consortium, we aimed to inform clinician-scientists working with children on the design of investigator-initiated PKPD studies. Key findings The importance of the identification of an optimal dose for the paediatric population is explained, followed by the differences and similarities of dose-ranging and efficacy studies. The input of clinical pharmacologists with modelling expertise is essential for an efficient dose-finding study. Conclusions The emergence of new laboratory techniques and statistical tools allows for the collection and analysis of sparse and unbalanced data, enabling the implementation of (observational) PKPD studies in the paediatric clinic. Understanding of the principles and methods discussed in this study is essential to improve the quality of paediatric PKPD investigations, and to prevent the conduct of paediatric RCTs that fail because of inadequate dosing.

33 Pag., 5 Fig. The definitive version is available at: http://www.springerlink.com/content/0040-5752/, This paper is concerned with a novel statistical–genetic approach for the construction of linkage maps in populations obtained from reciprocal translocation heterozygotes of barley (Hordeum vulgare L.). Using standard linkage analysis, translocations usually lead to ‘pseudo-linkage’: the mixing up of markers from the chromosomes involved in the translocation into a single linkage group. Close to the translocation breakpoints recombination is severely suppressed and, as a consequence, ordering markers in those regions is not feasible. The novel strategy presented in this paper is based on (1) disentangling the “pseudo-linkage” using principal coordinate analysis, (2) separating individuals into translocated types and normal types and (3) separating markers into those close to and those more distant from the translocation breakpoints. The methods make use of a consensus map of the species involved. The final product consists of integrated linkage maps of the distal parts of the chromosomes involved in the translocation., This study has been supported by the Spanish Ministry of Science and Innovation (Project AGL2008-05541-C02 and the Agrogenomics CONSOLIDER).

Purpose: This joint position statement, by the Indian Association of Palliative Care (IAPC) and Academy of Family Physicians of India (AFPI), proposes to address gaps in palliative care provision in the country by developing a community-based palliative care model that will empower primary care physicians to provide basic palliative care.Evidence: India ranks very poorly, 67th of 80 countries in the quality of death index. Two-thirds of patients who die need palliative care and many such patients spend the last hours of life in the Intensive care unit. The Indian National Health Policy (NHP) 2017 and other international bodies endorse palliative care as an essential health-care service component. NHP 2017 also recommends development of distance and continuing education options for general practitioners to upgrade their skills to provide timely interventions and avoid unnecessary referrals.Methods: A taskforce was formed with Indian and International expertise in palliative care and family medicine to develop this paper including an open conference at the IAPC conference 2017, agreement of a formal liaison between IAPC and AFPI and wide consultation leading to the development of this position paper aimed at supporting integration, networking, and joint working between palliative care specialists and generalists. The WHO model of taking a public health approach to palliative care was used as a framework for potential developments; policy support, education and training, service development, and availability of appropriate medicines.Recommendations: This taskforce recommends the following (1) Palliative care should be integrated into all levels of care including primary care with clear referral pathways, networking between palliative care specialist centers and family medicine physicians and generalists in community settings, to support education and clinical services. (2) Implement the recommendations of NHP 2017 to develop services and training programs for upskilling of primary care doctors in public and private sector. (3) Include palliative care as a mandatory component in the undergraduate (MBBS) and postgraduate curriculum of family physicians. (4) Improve access to necessary medications in urban and rural areas. (5) Provide relevant in-service training and support for palliative care to all levels of service providers including primary care and community staff. (6) Generate public awareness about palliative care and empower the community to identify those with chronic disease and provide support for those choosing to die at home.

Vector delivery is still a bottleneck for gene therapy. To overcome some disadvantages of adenoviral and retroviral vectors, we developed a hybrid vector. This hybrid vector, AdLTR-luc, was created by adding two elements from Moloney murine leukemia virus (MoMLV) flanking the luciferase cDNA into an E1/E3-deleted, replication deficient serotype 5 adenovirus vector (Zheng et al., Nature Biotechnol, 2000), and demonstrated that the MoMLV element upstream of the luciferase cDNA was broken during the integration event. The purpose of the current study was to determine if the MoMLV element downstream of the luciferase cDNA was also broken when integration occurred. We used the same A5 cell clones (#10 and 11) from the earlier the paper along with restriction endonuclease digestions, plus Southern hybridization, and PCR. Southern hybridization indicated that the luciferase cDNA was intact in the cloned cells. Results from Xho I and Sal I digestions showed that integration occurred in cloned cells. Southern hybridizations after Nco I digestion suggested that there was a break in both MoMLV elements, upstream and downstream of the luciferase cDNA. After DNA digestion with Not I, hybridization analyses indicated that the MoMLV upstream element was broken during integration. Digestion of genomic DNA with either Xba I/Kpn I, Bam HI/Sac I, or Bam HI/Nco I demonstrated that the MoMLV downstream element was also broken during integration. A PCR assay was unable to amplify the junctional region between the downstream MoMLV element and the adenoviral E2B gene, consistent with a break in that element. Although AdLTR-luc integration is atypical (Zheng et al., Nature Biotechnol, 2000), the present results suggest that both MoMLV elements have important roles in this event.

The present work investigates the conjugation of flotation and photo-Fenton techniques on oil removal performance from oilfield produced water. The experiments were conducted in a column flotation and annular lamp reactor for induced air flotation and photodegradation steps, respectively. A nonionic surfactant was used as a flotation agent. The flotation experimental data were analyzed in terms of a first-order kinetic rate model. Two experimental designs were employed to evaluate the oil removal efficiency: fractional experimental design and central composite rotational design (CCRD). Overall oil removal of 99% was reached in the optimum experimental condition after 10 min of flotation followed by 45 min of photo-Fenton. The results of the conjugation of induced air flotation and photo-Fenton processes allowed meeting the wastewater limits established by the legislations for disposal.

peer-reviewed In multiphase fermentations where the product forms a second liquid phase or where solvents are added for product extraction, turbulent conditions disperse the oil phase as droplets. Surface-active components (SACs) present in the fermentation broth can stabilize the product droplets thus forming an emulsion. Breaking this emulsion increases process complexity and consequently the production cost. In previous works, it has been proposed to promote demulsification of oil/supernatant emulsions in an off-line batch bubble column operating at low gas flow rate. The aim of this study is to test the performance of this recovery method integrated to a fermentation, allowing for continuous removal of the oil phase. A 500mL bubble column is successfully integrated with a 2 L reactor during 24 h without affecting cell growth or cell viability. However, higher levels of surfactants and emulsion stability are measured in the integrated system compared to a base case, reducing its capacity for oil recovery. This is related to release of SACs due to cellular stress when circulating through the recovery column. Therefore, it is concluded that the gas bubble-induced oil recovery method allows for oil separation and cell recycling without compromising fermentation performance; however, tuning of the column parameters considering increased levels of SACs due to cellular stress is required for improving oil recovery.

Integration of wheat straw for a biorefinery-based energy generation process by producing ethanol and biogas together with the production of high-protein fungal biomass (suitable for feed application) was the main focus of the present study. An edible ascomycete fungal strain Neurospora intermedia was used for the ethanol fermentation and subsequent biomass production from dilute phosphoric acid (0.7 to 1.2% w/v) pretreated wheat straw. At optimum pretreatment conditions, an ethanol yield of 84 to 90% of the theoretical maximum, based on glucan content of substrate straw, was observed from fungal fermentation post the enzymatic hydrolysis process. The biogas production from the pretreated straw slurry showed an improved methane yield potential up to 162% increase, as compared to that of the untreated straw. Additional biogas production, using the syrup, a waste stream obtained post the ethanol fermentation, resulted in a combined total energy output of 15.8 MJ/kg wheat straw. Moreover, using thin stillage (a waste stream from the first-generation wheat-based ethanol process) as a co-substrate to the biogas process resulted in an additional increase by about 14 to 27% in the total energy output as compared to using only wheat straw-based substrates.

This paper locates the collapse of East German communism in Marxist-Leninist monetary theory. By exploring the economic and cultural functions of money in East Germany, it argues that the communist party failed to reconcile its ideological aspirations ­ a society free of the social alienation represented by money and merchandise ­ with the practical exigencies of governing an industrial society by force. Using representative examples of market failure in production and consumption, the paper shows how the party’s deep-seated hostility to money led to economic inefficiency and waste. Under Honecker, the party sought to improve living standards by trading political liberalization for West German money. Over time, however, this policy devalued the meaning of socialism by undermining the actual currency, facilitating the communist collapse and overdetermining the pace and mode of German unification.

Microfluidic biosensing systems with enzyme-based detection have been extensively studied in the last years owing to features such as high specificity, a broad range of analytes and a high degree of automation. This review gives an overview of the most important factors associated with these systems. In the first part, frequently used immobilization protocols such as physisorption and covalent bonding and detection techniques such as amperometry and fluorescence measurements are discussed with respect to effort, lifetime and measurement range. The Michaelis–Menten model describing the kinetics of enzymatic reactions, the role of redox mediators and the limitations of the linear measurement range of enzymatic sensors are introduced. Several possibilities of extending the linear measurement range in microfluidic systems such as diffusion-limiting membranes and the flow injection setup are presented. Regarding the integration of enzymes into microfluidic systems during the fabrication process, the constraints imposed by the biomolecules due to the limited usage of high temperatures and solvents are addressed. In the second part, the most common forms of enzyme integration into microfluidic systems, i.e. in channels and on electrodes, on microparticles, on paper and thread and as injected enzyme solutions, are reviewed, focusing on fabrication, applications and performance.

This paper examines the origins of nationalism in nineteenth century Philippines through cultural translation practices. Its central thesis is that Filippino nationalism did not originate with the discovery of an indigenous identity by the colonized and his/her subsequent assertion of an essential difference from the colonizer. Rather, its genesis lay in the transmission of messages across social and linguistic borders among diverse people whose identities and identifications were far from settled. The paper traces this process along three fronts: Spanish conversion practices, vernacular plays, and Phillipine nationalist activism. Due to a shortage of missionaries in the archipelago, Spanish clergy chose to learn the numerous languages of the colonized rather than preaching in their own, and in so doing, made translation into an evangelical instrument. This practice rendered native languages ‘foreign’ in some respects to their local users, and turned conversion into a way of identifying with the uncanny presence of alien messages from alien speakers, from within one’s own speech. Because missionary translation localized Christian discourse while at the same time retaining certain Castilian and Latin words deemed sacred in their original forms, translation also instituted a linguistic hierarchy that made local languages appear to be naturally subordinate to Castilian and Latin. Castilian words, most of which were unfamiliar to mass audiences, were also used in the domain of vernacular theater or Comedyas. Rafael argues that it was precisely a widespread mass belief in the link between Castillian’s untranslated foreignness and its perceived telecommunicative properties, which accounted for the popularity of vernacular plays. He thus understands Comedyas as performative modes which mobilized Castilian’s potential for communicating in and through different local languages, across geographic and social distances, and through the boundaries of class. Preceded by the drama of Christian conversion, Comedyas were also products of translation themselves, providing venues for domesticating alien places and alien sources of power lying at the basis of colonial-Christian authority. But, unlike Catholic prayers that were directed to God, vernacular plays relied on the recognition of an audience which was yet to consolidate its position as such. The comedya anticipated nationalist attempts to invest a second language with the capacity to recast vernacular languages and local identities into something other that could then be commonly shared. In forming a Filipino nationalist identity, appealing for the expansion of limits to citizenship and political representation under colonial rule, Ilustrado nationalists also sought to become agents of translation – using Castilian, a language deployed by those in authority. Thus, this paper argues that Filipino nationalism was a practice of translation, understood first as the coming into contact with the foreign and subsequently reformulating it into an element of oneself. This process entailed at least in its formative moments, discovering an alien aspect residing within colonial society and translating it into a basis for a future history.

This White Paper sets out a Life Sciences Grand Challenge for Proteomics Technologies to enhance our understanding of complex biological systems, link genomes with phenotypes, and bring broad benefits to the biosciences and the US economy. The paper is based on a workshop hosted by the National Institute of Standards and Technology (NIST) in Gaithersburg, MD, 14-15 February 2011, with participants from many federal R&D agencies and research communities, under the aegis of the US National Science and Technology Council (NSTC). Opportunities are identified for a coordinated R&D effort to achieve major technology-based goals and address societal challenges in health, agriculture, nutrition, energy, environment, national security, and economic development.

Understanding biological complexity demands a combination of high-throughput data and interdisciplinary skills. One way to bring to bear the necessary combination of data types and expertise is by encapsulating domain knowledge in software and composing that software to create a customized data analysis environment. To this end, simple flexible strategies are needed for interconnecting heterogeneous software tools and enabling data exchange between them. Drawing on our own work and that of others, we present several strategies for interoperability and their consequences, in particular, a set of simple data structures--list, matrix, network, table and tuple--that have proven sufficient to achieve a high degree of interoperability. We provide a few guidelines for the development of future software that will function as part of an interoperable community of software tools for biological data analysis and visualization.

// Daria A. Gaykalova 1 , Veronika Zizkova 1, 2 , Theresa Guo 1 , Ilse Tiscareno 1 , Yingying Wei 3, 10 , Rajita Vatapalli 1, 4 , Patrick T. Hennessey 1, 5 , Julie Ahn 1 , Ludmila Danilova 3, 11 , Zubair Khan 1 , Justin A. Bishop 1, 6 , J. Silvio Gutkind 7 , Wayne M. Koch 1 , William H. Westra 1, 6 , Elana J. Fertig 3 , Michael F. Ochs 3, 8 , Joseph A. Califano 1, 9 1 Department of Otolaryngology—Head and Neck Surgery, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA 2 Institute of Molecular and Translational Medicine, Faculty of Medicine and Dentistry, Palacky University, Olomouc, Czech Republic 3 Division of Oncology Biostatistics, Department of Oncology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA 4 Department of Urology, Northwestern University, Chicago, Illinois, USA 5 Department of Otolaryngology, Mid-Michigan Ear Nose and Throat, East Lansing, Michigan, USA 6 Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland, USA 7 Department of Pharmacology, UC San Diego Moores Cancer Center, La Jolla, California, USA 8 Department of Mathematics and Statistics, The College of New Jersey, Ewing, New Jersey, USA 9 Department of Surgery, UC San Diego, Moores Cancer Center, La Jolla, California, USA 10 Department of Statistics, The Chinese University of Hong Kong, NT, Shatin, Hong Kong 11 Laboratory of Systems Biology and Computational Genetics, Vavilov Institute of General Genetics, Russian Academy of Sciences, Moscow, Russia Correspondence to: Joseph A. Califano, email: jcalifano@ucsd.edu Daria A. Gaykalova, email: dgaykal1@jhmi.edu Keywords: HNSCC, DTX1, expression, methylation, integration Received: September 07, 2016 Accepted: January 16, 2017 Published: January 27, 2017 ABSTRACT Over a half million new cases of Head and Neck Squamous Cell Carcinoma (HNSCC) are diagnosed annually worldwide, however, 5 year overall survival is only 50% for HNSCC patients. Recently, high throughput technologies have accelerated the genome-wide characterization of HNSCC. However, comprehensive pipelines with statistical algorithms that account for HNSCC biology and perform independent confirmatory and functional validation of candidates are needed to identify the most biologically relevant genes. We applied outlier statistics to high throughput gene expression data, and identified 76 top-scoring candidates with significant differential expression in tumors compared to normal tissues. We identified 15 epigenetically regulated candidates by focusing on a subset of the genes with a negative correlation between gene expression and promoter methylation. Differential expression and methylation of 3 selected candidates ( BANK1 , BIN2 , and DTX1 ) were confirmed in an independent HNSCC cohorts from Johns Hopkins and TCGA (The Cancer Genome Atlas). We further performed functional evaluation of NOTCH regulator, DTX1 , which was downregulated by promoter hypermethylation in tumors, and demonstrated that decreased expression of DTX1 in HNSCC tumors maybe associated with NOTCH pathway activation and increased migration potential.

The application of a robust generalized linear model framework for the modelling of reflection backgrounds in X-ray diffraction images is described., A method for estimating the background under each reflection during integration that is robust in the presence of pixel outliers is presented. The method uses a generalized linear model approach that is more appropriate for use with Poisson distributed data than traditional approaches to pixel outlier handling in integration programs. The algorithm is most applicable to data with a very low background level where assumptions of a normal distribution are no longer valid as an approximation to the Poisson distribution. It is shown that traditional methods can result in the systematic underestimation of background values. This then results in the reflection intensities being overestimated and gives rise to a change in the overall distribution of reflection intensities in a dataset such that too few weak reflections appear to be recorded. Statistical tests performed during data reduction may mistakenly attribute this to merohedral twinning in the crystal. Application of the robust generalized linear model algorithm is shown to correct for this bias.

Despite the perceived value of DSS in informing environmental and natural resource management, DSS tools often fail to be adopted by intended end users. By drawing together the experience of a global group of EDSS developers, we have identified and assessed key challenges in EDSS development and offer recommendations to resolve them. Challenges related to engaging end users in EDSS development emphasise the need for a participatory process that embraces end users and stakeholders throughout the design and development process. Adoption challenges concerned with individual and organisational capacities to use EDSS and the match between EDSS and organisational goals can be overcome through the use of an internal champion to promote the EDSS at different levels of a target organisation; co-ordinate and build capacity within the organisation, and; ensure that developers maintain focus on developing EDSS which are relatively easy and inexpensive to use and update (and which are perceived as such by the target users). Significant challenges exist in relation to ensuring EDSS longevity and financial sustainability. Such business challenges may be met through planning and design that considers the long-term costs of training, support, and maintenance; revenue generation and licensing by instituting processes which support communication and interactions; and by employing software technology which enables easy model expansion and re use to gain an economy of scale and reduce development costs. A final group of perhaps more problematic challenges relate to how the success of EDSS ought to be evaluated. Whilst success can be framed relatively easily in terms of interactions with end users, difficulties of definition and measurability emerge in relation to the extent to which EDSS achieve intended outcomes. To tackle the challenges described, the authors provide a set of best practice recommendations concerned with promoting design for ease of use, design for usefulness, establishing trust and credibility, promoting EDSS acceptance, and starting simple and small in functionality terms. Following these recommendations should enhance the achievement of successful EDSS adoption, but more importantly, help facilitate the achievement of desirable social and environmental outcomes.

The working principles of important steps in processing rotation data are described as employed by the program XDS., Important steps in the processing of rotation data are described that are common to most software packages. These programs differ in the details and in the methods implemented to carry out the tasks. Here, the working principles underlying the data-reduction package XDS are explained, including the new features of automatic determination of spot size and reflecting range, recognition and assignment of crystal sym­metry and a highly efficient algorithm for the determination of correction/scaling factors.

Cognitive brain functions including sensory processing and control of behavior are understood as "neurocomputation" in axonal-dendritic synaptic networks of "integrate-and-fire" neurons. Cognitive neurocomputation with consciousness is accompanied by 30- to 90-Hz gamma synchrony electroencephalography (EEG), and non-conscious neurocomputation is not. Gamma synchrony EEG derives largely from neuronal groups linked by dendritic-dendritic gap junctions, forming transient syncytia ("dendritic webs") in input/integration layers oriented sideways to axonal-dendritic neurocomputational flow. As gap junctions open and close, a gamma-synchronized dendritic web can rapidly change topology and move through the brain as a spatiotemporal envelope performing collective integration and volitional choices correlating with consciousness. The "conscious pilot" is a metaphorical description for a mobile gamma-synchronized dendritic web as vehicle for a conscious agent/pilot which experiences and assumes control of otherwise non-conscious auto-pilot neurocomputation.

Spinal lamina I is the first site in the central nervous system where somatic and visceral pathways monosynaptically converge onto projection and local circuit neurons., Referred pain is a phenomenon of feeling pain at a site other than the site of the painful stimulus origin. It arises from a pathological mixing of nociceptive processing pathways for visceral and somatic inputs. Despite numerous studies based on unit recordings from spinal and supraspinal neurons, the exact mechanism and site of this mixing within the central nervous system are not known. Here, we selectively recorded from lamina I neurons, using a visually guided patch-clamp technique, in thoracic spinal cord preparation with preserved intercostal (somatic) and splanchnic (visceral) nerves. We show that somatic and visceral C fibers converge monosynaptically onto a group of lamina I neurons, which includes both projection and local circuit neurons. Other groups of lamina I neurons received inputs from either somatic or visceral afferents. We have also identified a population of lamina I local circuit neurons showing overall inhibitory responses upon stimulation of both nerves. Thus, the present data allow us to draw two major conclusions. First, lamina I of the spinal cord is the first site in the central nervous system where somatic and visceral pathways directly converge onto individual projection and local circuit neurons. Second, the mechanism of somatovisceral convergence is complex and based on functional integration of monosynaptic and polysynaptic excitatory as well as inhibitory inputs in specific groups of neurons. This complex pattern of convergence provides a substrate for alterations in the balance between visceral and somatic inputs causing referred pain.

Quantitative analysis using comprehensive two-dimensional (2D) gas chromatography (GC) is still rarely reported. This is largely due to a lack of suitable software. The objective of the present study is to generate quantitative results from a large GC x GC data set, consisting of 32 chromatograms. In this data set, six target components need to be quantified. We compare the results of conventional integration with those obtained using so-called "multiway analysis methods". With regard to accuracy and precision, integration performs slightly better than Parallel Factor (PARAFAC) analysis. In terms of speed and possibilities for automation, multiway methods in general are far superior to traditional integration. © 2003 Elsevier B.V. All rights reserved.

In the wake of intensified global economic competition, economic liberalization, waves of immigration, and the rise of European Union governance, many observers suggest that there has been a sharp diminution of the long-standing differences between hierarchically-organized European legal processes and the more fragmented, malleable “adversarial legalism” of the United States. It is not easy to find meaningful quantitative indicators of convergence (or of continued divergence) in systems as complex and multi-faceted as contemporary legal systems. I argue, however, that six salient features of the American way of law have not emerged and are unlikely to emerge in European legal systems. Two of these differences are structural or procedural: (1) the political nature and powerful remedial powers of American judiciaries; (2) the high levels of adversarial legalism in the American regulatory process. The next four differences are substantive, relating to differences in the content of bodies of law that are central to the experience of citizens: (3) laws and institutional practices that make American tort law uniquely threatening; (4) the more limited rights to social provision and employee protections that prevail in American law; (5) the less demanding obligations of American tax law; (6) America’s more punitive criminal sanctions, more permissive gun laws, and greater reliance on adversarial legalism in criminal adjudication and police accountability. These six differences are not likely to narrow significantly, I will argue, since they are rooted in the distinctive features of American and European political structures, political belief systems, and legal cultures.

Background Characterising the correlates of HIV persistence improves understanding of disease pathogenesis and guides the design of curative strategies. This study investigated factors associated with integrated HIV-1 DNA load during consistently suppressive first-line antiretroviral therapy (ART). Method Total, integrated, and 2-long terminal repeats (LTR) circular HIV-1 DNA, residual plasma HIV-1 RNA, T-cell activation markers, and soluble CD14 (sCD14) were measured in peripheral blood of 50 patients that had received 1–14 years of efavirenz-based or nevirapine-based therapy. Results Integrated HIV-1 DNA load (per 106 peripheral blood mononuclear cells) was median 1.9 log10 copies (interquartile range 1.7–2.2) and showed a mean difference of 0.2 log10 copies per 10 years of suppressive ART (95% confidence interval − 0.2, 0.6; p = 0.28). It was positively correlated with total HIV-1 DNA load and frequency of CD8+HLA-DR/DP/DQ+ cells, and was also higher in subjects with higher sCD14 levels, but showed no correlation with levels of 2-LTR circular HIV-1 DNA and residual plasma HIV-1 RNA, or the frequency of CD4+CD38+ and CD8+CD38+ cells. Adjusting for pre-ART viral load, duration of suppressive ART, CD4 cell counts, residual plasma HIV-1 RNA levels, and sCD14 levels, integrated HIV-1 DNA load was mean 0.5 log10 copies higher for each 50% higher frequency of CD8+HLA-DR/DP/DQ+ cells (95% confidence interval 0.2, 0.9; p = 0.01). Conclusions The observed positive association between integrated HIV-1 DNA load and frequency of CD8+DR/DP/DQ+ cells indicates that a close correlation between HIV persistence and immune activation continues during consistently suppressive therapy. The inducers of the distinct activation profile warrant further investigation., Highlights • Data from a homogenously treated population with consistent virological suppression • Integrated HIV-1 DNA load did not vary significantly by duration of therapy • Integrated HIV-1 DNA load was not associated with markers of recent virus replication • Integrated HIV-1 DNA load and CD8+HLA-DR/DP/DQ+ frequency were positively associated • Subjects with top quartile integrated HIV-1 DNA load showed high sCD14 levels Integrated HIV-1 DNA load remains constant in the peripheral blood of individuals receiving long-term suppressive antiretroviral therapy (ART). However, the mechanisms preventing decay of the reservoir remain unclear. We studied a cross-sectional population, defined by the duration of suppressive ART. Integrated HIV-1 DNA load did not differ significantly according to the duration of suppressive ART, and showed no association with direct or indirect markers of ongoing virus replication. Rather, there was an independent, positive association between integrated HIV-1 DNA load and the frequency of CD8 cells expressing the activation marker HLA-DR/DP/DQ. These cells appear to have important regulatory and effector function. Our findings add to growing evidence that immune activation sustains the HIV-1 reservoir during long-term suppressive ART.

Fulvio Attinà examines the concept of "regional security partnership" both theoretically and in the context of Euro-Mediterranean region-building. He argues that this partnership is an intermediate venture on the road to the possible appearance of a Euro-Mediterranean security community. By discussing the difficulties of negotiating a security partnership in the framework of the Euro-Mediterranean Partnership, Attinà highlights the security culture divide on both sides of Mediterranean. The differences in the security culture between European and Arab states have deepened in recent years in view of regional and global developments, constituting a major obstacle to the implementation of a security partnership. Attinà argues, however, that the interaction between the two shores of the Mediterranean in coping with globalization-driven problems may prevail over the factors that have led to a deepening of the security culture divide in recent years.

There is, in theory, a plausible role for the European Union as the partner of a militarily assertive United States: the peacekeeper that follows in the wake of the peacemaker. The war in Iraq, however, has raised the possibility of a diametrically different role for Europe: as a potential imperial rival to the United States. There is no need to invoke the memory of either Rome or Byzantium to make the case that Europe is capable of spoiling America’s unipolar party. The successful conclusion of accession agreements with ten new member countries – not to mention the sustained appreciation of the euro against the dollar since Kennedy’s article appeared – have seemingly vindicated this analysis. So too, in the eyes of some commentators, has the vociferous and not wholly ineffectual opposition of at least some E.U. member states to American policy in Iraq. If the U.S. has an imperial rival today, then the E.U. appears to be it.

Here is a special emphasis today on integrating traditional healing within health services. However, most areas in which there is a system of traditional healing have undergone colonization and a number of pressures suppressing tradition for hundreds of years. The question arises as to how one can understand today’s tradition in light of earlier traditions. This article is based on material collected in Sa ́mi areas of Finnmark and Nord-Troms Norway; it compares local healing traditions with what is known of earlier shamanic traditions in the area. The study is based on 27 interviews among healers and their patients. The findings suggest that although local healing traditions among the Sami in northern Norway have undergone major transformations during the last several hundred years, they may be considered an extension of a long- standing tradition with deep roots in the region. Of special interest are also the new forms tradition may take in today’s changing global society.

This paper presents the main outcomes of a joint research project conducted at ZMO Berlin between March 2018 and July 2021 with funding from the German Federal Ministry of Education and Research. The project analyzed how Syrians remembered their "normal lives" through daily interactions with each other, in neighbourhoods, institutions, or families, as well as routine encounters with the state through the interface of infrastructural provision and bureaucratic practices. Describing three distinct modalities of connection through which incomers of Syrian origin continue to engage with their distant homeland, the paper demonstrates that 'crisis' and 'normality' are not mutually exclusive states of reality, but can be experienced as overlapping states of being that may shape a given life alternately or simultaneously. Secondly, engaging with efforts to communicate the research findings to a wider public, this paper discusses the communicative "balancing acts" that arise when presenting and discussing the project findings with members of the public in Germany. It is suggested that social and political hierarchies inherent to "integration" contexts may complicate or hinder communication. Thus, opportunities to learn about life in Syria, but also Germany, from the perspective of new citizens, may be obscured and even lost. In conclusion, this paper argues for a perspective that does not essentialize (and generically flatten) people as "refugees" despite the distinct and specific legal and political regimes that shape their condition and set them apart from other categories of migrants. Rather, their experiences must be seen in the context of longer-term trajectories that encompass Syrian and German realities as intertwined and linked in many, often unexpected, ways.

A new procedure for benchmarking analysis has been developed to evaluate the energy efficiency of a chemical process. Benchmarking is performed to identify process inefficiencies before developing energy enhancement measures. The new procedure combines typical techniques, such as the comparison with current practice, with utilization of new performance indicators based on exergy and energy content and the targeting by Pinch Analysis and Water Pinch. All process sections and the steam and water utility systems are evaluated. The procedure consists of five phases. In the first phase the data required is compiled. The second phase consists of comparing the energy and water efficiency of the base case to the current practice of the industry. In the third phase, the new energy and exergy content indicators are used to analyze the efficiency of utilities systems and to quantify the heat rejected by the process. In the fourth phase the minimum energy and water requirements are determined. The last phase is a synthesis by which the inefficiencies are identified and guidelines established for process improvement. Interactions between the utilities systems and the process are developed. The procedure has been applied to an operating Kraft pulping mill in Eastern Canada. (C) 2010 The Institution of Chemical Engineers. Published by Elsevier B.V. All rights reserved.

The integration of environmental education is embedded with challenges such as inadequate knowledge of what environmental education entails. This situation was not different to what was encountered during the researchers’ training to be a teacher from the schools where they acquired their teaching practice. It was observed that there was minimal or no integration of environmental education in the teaching and learning process. Therefore, this paper reflected on how a primary school teacher integrated environmental education in teaching and learning. The findings from this paper may assist teachers in developing a positive approach to the process of ongoing attempts and the will to integrate environmental education. It may expose the kinds of knowledge other teachers have of what environmental education entails and its integration in school subjects as well as the instructional strategies that they use. The focus on the challenges and the opportunities may excite teachers in that those who have similar circumstances would use the findings from this paper as a launch pad to work on their strengths or weakness in the endeavor to integrate environmental education.