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The Antarctic Peninsula is now warming again after a hiatus in temperatures, and ice masses are receding at an enhanced rate, resulting in the enlargement of proglacial regions. Despite the importance of proglacial regions as sediment sources in polar environments, few studies focus on the Antarctic and sub-Antarctic fluvial sediment dynamics and even fewer have explored the spatio-temporal variability in sediment delivery or compiled a comprehensive source-to-sink description of sediment transportation. Proglacial rivers are shaped by the interplay of glacial meltwater, which erodes, transports, and deposits sediment, and hillslope activity, which provides new sediment to the riverine system during mass transport events. Active layer soils can be an additional source of water and sediment when ground temperatures are above freezing; particularly in catchments with low glacier cover. In this study, we aim to discuss how different environmental factors, such as air temperature, active layer thaw, and precipitation affect sediment yields in two rivers on James Ross Island, Antarctica. Based on field data collected at the start of 2022, we used a multi-disciplinary approach to quantify the spatio-temporal variability in sediment yields across the river catchments of the Algal and Bohemian Streams and their key environmental controls. Additionally, we discuss how X-ray fluorescence and infrared spectroscopy have provided an insight into how sediment composition and, potentially, source change downstream in each stream. We estimate that the annual sediment yield for the Bohemian Stream in the austral summer of 2021/2022 was 400 tonnes/year/ km2 and 530 tonnes/year/ km2 for the Algal Stream. While the Algal Stream has a higher estimated yield, its daily sediment yield values are highly variable and the Bohemian Stream typically exports more sediment into the Southern Ocean. Our results show that the active layer is an important driver of sediment yield variability in the Algal catchment. In contrast, sediment yield from the Bohemian catchment is more sensitive to air temperature. Both catchments are sensitive to changes in precipitation. The differences in sediment yield from the two catchments likely stem from differences in glacier and snowfield coverage. These sediment yield values are exceptionally high by Antarctic standards, and are comparable to that from catchments on Svalbard, although they remain low by global standards. Our identification of the controls on sediment yield provides insight into how other fluvial sedimentary systems across the Antarctic Peninsula could respond as glaciers lose mass in a warming climate.

The three of us devote a significant portion of our research time to publishing in peer-reviewed practitioner accounting journals, in addition to our focus on traditional academic journal publishing. In this article, we first discuss overall considerations when publishing for practitioners, including finding topics, writing, statistics, and implications. Then, we describe the five types of practitioner papers we typically produce and how we develop each type of paper: small literature reviews, empirical papers, thought pieces, skills papers, and current topic updates. We conclude with discussion of related educational opportunities and issues, including using practitioner articles in class, exposing doctoral students to practitioner publishing, and getting academic credit for practitioner publishing in tenure, promotion, and annual performance reviews. At a time when accounting academia is seeking to enhance the relevance and impact of research, we hope this paper will prompt other academics to begin or increase their contributions to practitioner journals.

For the period 2013–2017, we examine top contributors to five practitioner journals published by leading U.S. accounting practitioner or professional organizations, based on an analysis of the authorship of over 1,000 main articles. Further, we survey leading contributors. Our authorship analysis reveals that the leading academic institutions and academic authors in practitioner journals are more likely to be top 100 in accounting education research, rather than in traditional academic accounting research. Further, most of the academic authors are tenured faculty members, and many have extensive practice experience. While some large accounting firms are leading contributors to practitioner journals, most of the top non-academic institutions are other accounting, consulting, and law firms. The survey findings highlight that authors' key motivations to publish in practitioner journals relate to potentially contributing to/influencing practice and gaining wide readership of their work, but the formal rewards to authors often are limited.

Abemaciclib; Adjuvant; Early breast cancer Abemaciclib; Adjuvant; Càncer de mama precoç Abemaciclib; Adyuvante; Cáncer de mama precoz Background Adjuvant abemaciclib combined with endocrine therapy (ET) previously demonstrated clinically meaningful improvement in invasive disease-free survival (IDFS) and distant relapse-free survival (DRFS) in hormone receptor-positive, human epidermal growth factor receptor 2-negative, node-positive, high-risk early breast cancer at the second interim analysis, however follow-up was limited. Here, we present results of the prespecified primary outcome analysis and an additional follow-up analysis. Patients and methods This global, phase III, open-label trial randomized (1 : 1) 5637 patients to adjuvant ET for ≥5 years ± abemaciclib for 2 years. Cohort 1 enrolled patients with ≥4 positive axillary lymph nodes (ALNs), or 1-3 positive ALNs and either grade 3 disease or tumor ≥5 cm. Cohort 2 enrolled patients with 1-3 positive ALNs and centrally determined high Ki-67 index (≥20%). The primary endpoint was IDFS in the intent-to-treat population (cohorts 1 and 2). Secondary endpoints were IDFS in patients with high Ki-67, DRFS, overall survival, and safety. Results At the primary outcome analysis, with 19 months median follow-up time, abemaciclib + ET resulted in a 29% reduction in the risk of developing an IDFS event [hazard ratio (HR) = 0.71, 95% confidence interval (CI) 0.58-0.87; nominal P = 0.0009]. At the additional follow-up analysis, with 27 months median follow-up and 90% of patients off treatment, IDFS (HR = 0.70, 95% CI 0.59-0.82; nominal P < 0.0001) and DRFS (HR = 0.69, 95% CI 0.57-0.83; nominal P < 0.0001) benefit was maintained. The absolute improvements in 3-year IDFS and DRFS rates were 5.4% and 4.2%, respectively. Whereas Ki-67 index was prognostic, abemaciclib benefit was consistent regardless of Ki-67 index. Safety data were consistent with the known abemaciclib risk profile. Conclusion Abemaciclib + ET significantly improved IDFS in patients with hormone receptor-positive, human epidermal growth factor receptor 2-negative, node-positive, high-risk early breast cancer, with an acceptable safety profile. Ki-67 index was prognostic, but abemaciclib benefit was observed regardless of Ki-67 index. Overall, the robust treatment benefit of abemaciclib extended beyond the 2-year treatment period. This work was supported by the sponsor (Eli Lilly and Company) and designed together with the study Executive Committee (no grant number).

Highlights • This ESO-ESMO ABC 5 Clinical Practice Guideline provides key recommendations for managing advanced breast cancer patients • It provides updates on the management of patients with all breast cancer subtypes, LABC, follow-up, palliative and supportive care • Updated diagnostic and treatment algorithms are also provided • All recommendations were compiled by a multidisciplinary group of international experts • Recommendations are based on available clinical evidence and the collective expert opinion of the authors

The address presents the recently discovered second, Roman commentary of St. Thomas Aquinas on Peter Lombard’s Liber sententiarum and offers some reflections on work to be done by scholars in the study of this text. The first part of the address presents the manuscript and its circumstances to argue for the authenticity of the text. The second part briefly describes the character and content of Thomas’ Lectura romana. The third part addresses a concern expressed by Frs. Dondaine and Torrell that a rationalist tendency in the text’s consideration of the Trinity raises questions of its authenticity.

Recent evidence suggests that the ion channel TRPA1 is implicated in lung adenocarcinoma (LUAD), where its role and mechanism of action remain unknown. We have previously established that the membrane receptor FGFR2 drives LUAD progression through aberrant protein–protein interactions mediated via its C-terminal proline-rich motif. Here we report that the N-terminal ankyrin repeats of TRPA1 directly bind to the C-terminal proline-rich motif of FGFR2 inducing the constitutive activation of the receptor, thereby prompting LUAD progression and metastasis. Furthermore, we show that upon metastasis to the brain, TRPA1 gets depleted, an effect triggered by the transfer of TRPA1-targeting exosomal microRNA (miRNA-142-3p) from brain astrocytes to cancer cells. This downregulation, in turn, inhibits TRPA1-mediated activation of FGFR2, hindering the metastatic process. Our study reveals a direct binding event and characterizes the role of TRPA1 ankyrin repeats in regulating FGFR2-driven oncogenic process; a mechanism that is hindered by miRNA-142-3p., TRPA1 has been reported to contribute lung cancer adenocarcinoma (LUAD), but the mechanisms are unclear. Here the authors propose that TRPA1/FGFR2 interaction is functional in LUAD and show that astrocytes oppose brain metastasis by mediating the downregulation of TRPA1 through exosome-delivered miRNA-142-3p.

Background Information is scarce regarding effects of antihypertensive medication on blood pressure variability ( BPV ) and associated clinical outcomes. We examined whether antihypertensive treatment changes BPV over time and whether such change (decline or increase) has any association with long‐term mortality in an elderly hypertensive population. Methods and Results We used data from a subset of participants in the Second Australian National Blood Pressure study (n=496) aged ≥65 years who had 24‐hour ambulatory blood pressure recordings at study entry (baseline) and then after a median of 2 years while on treatment (follow‐up). Weighted day‐night systolic BPV was calculated for both baseline and follow‐up as a weighted mean of daytime and nighttime blood pressure standard deviations. The annual rate of change in BPV over time was calculated from these BPV estimates. Furthermore, we classified both BPV estimates as high and low based on the baseline median BPV value and then classified BPV changes into stable: low BPV , stable: high BPV , decline: high to low , and increase: low to high . We observed an annual decline (mean± SD : −0.37±1.95; 95% CI, −0.54 to −0.19; P BPV between baseline and follow‐up. Having constant stable: high BPV was associated with an increase in all‐cause mortality (hazard ratio: 3.03; 95% CI, 1.67–5.52) and cardiovascular mortality (hazard ratio: 3.70; 95% CI, 1.62–8.47) in relation to the stable: low BPV group over a median 8.6 years after the follow‐up ambulatory blood pressure monitoring. Similarly, higher risk was observed in the decline: high to low group. Conclusions Our results demonstrate that in elderly hypertensive patients, average BPV declined over 2 years of follow‐up after initiation of antihypertensive therapy, and having higher BPV (regardless of any change) was associated with increased long‐term mortality.

Introduction: Previous studies have shown that apparently healthy animals participating in Animal-Assisted Interventions (AAI) have the potential to asymptomatically carry and even transmit zoonotic pathogens to people, which is of particular concern for therapy animal teams visiting healthcare settings. This two-part study was designed to investigate the risk of zoonotic pathogen transmission within a university-based AAI program as a combination of the prevalence of these pathogens in the animal population as well as the handlers’ understanding of the risks of zoonoses in AAI and their adherence to infection control practices. Methods: In part one of the study, AAI program records were retrospectively reviewed and infectious disease screening test results were compiled from 22 dogs and 2 cats. Screening tests for dogs and cats included a zinc sulfate fecal float, fecal culture, and nasal and perianal skin swabs for methicillin-resistant Staphylococcus aureus (MRSA) and methicillin-resistant Staphylococcus pseudointermedius (MRSP). Additional tests for cats were blood cultures for Bartonella henselae and Toxoplasmosis IgG and IgM antibody titers. In part two, a survey was conducted of 40 registered therapy animal handlers to assess knowledge, attitudes, and perceptions regarding risk of infectious disease transmission in AAI settings, including risk to the animal, the handler, and those being visited. Results: In part one, there were 17 total positive results of the 118 infectious disease screenings performed, 14 of which were potentially zoonotic organisms. In part two of the study, a majority (70%) of respondents expressed they had no concerns regarding infectious disease transmission in AAI settings. Despite handler education and guidelines, adherence to infection control practices was lacking. Discussion: The results of this study support prior findings that animals participating in AAI can be asymptomatic carriers of zoonotic organisms. Compliance with infection control practices and hand hygiene are paramount to mitigate risk of zoonotic disease transmission, but was inconsistent among this group of handlers. Given the popularity of AAI programs in the U.S., similar studies should be performed on a larger scale to determine the level of adherence to currently recommended practices and potential need for improvement in infectious disease control education and/or policies. No funding was received to conduct the studies. Open access publication fees will be paid by the Small Animal Department at the Virginia-Maryland College of Veterinary Medicine.

WOS: 000442229500021, PubMed ID: 30101073, Background: In infants with phenylketonuria (PKU), dietary management is based on lowering and titrating phenylalanine (Phe) intake from breast milk or standard infant formula in combination with a Phe-free infant formula in order to maintain blood Phe levels within target range. Professionals use different methods to feed infants with PKU and our survey aimed to document practices across Europe. Methods: We sent a cross sectional, survey monkey (R) questionnaire to European health professionals working in IMD. It contained 31 open and multiple-choice questions. The results were analysed according to different geographical regions. Results: Ninety-five centres from 21 countries responded. Over 60% of centres commenced diet in infants by age 10 days, with 58% of centres implementing newborn screening by day 3 post birth. At diagnosis, infant hospital admission occurred in 61% of metabolic centres, mainly in Eastern, Western and Southern Europe. Breastfeeding fell sharply following diagnosis with only 30% of women still breast feeding at 6 months. 53% of centres gave pre-measured Phe-free infant formula before each breast feed and 23% alternated breast feeds with Phe-free infant formula. With standard infant formula feeds, measured amounts were followed by Phe-free infant formula to satiety in 37% of centres (n = 35/95), whereas 44% (n = 42/95) advised mixing both formulas together. Weaning commenced between 17 and 26 weeks in 85% centres, >= 26 weeks in 12% and < 17 weeks in 3%. Discussion: This is the largest European survey completed on PKU infant feeding practices. It is evident that practices varied widely across Europe, and the practicalities of infant feeding in PKU received little focus in the PKU European Guidelines (2017). There are few reports comparing different feeding techniques with blood Phe control, Phe fluctuations and growth. Controlled prospective studies are necessary to assess how different infant feeding practices may influence longer term feeding development., Vitaflo, We thank Vitaflo for supporting the publication cost of this paper.

This paper follows on from the authors’ previous research into minimal Black teacher representation in Liverpool schools [Boyle, B., and M. Charles. 2010. “Tightening the Shackles: The Continued In...

Robotic Refueling Mission-3 (RRM3) is an external payload on the International Space Station (ISS) to demonstrate the techniques for storing and transferring a cryogenic fuel on orbit. RRM3 was designed and built at the National Aeronautics and Space Administration/Goddard Space Flight Center (NASA/GSFC). Initial testing was performed at GSFC using liquid nitrogen and liquid argon. Final testing and flight fill of methane was performed at the NASA Kennedy Space Center (KSC) to take advantage of KSC’s facilities and expertise for handling a combustible cryogen. This paper gives an overview of the process and challenges of developing the payload and the results of its on-orbit performance.

Background: Due to the high prevalence of obesity, individuals may be desensitized to weight as a personal health concern. Purpose: To evaluate changes in obesity awareness associated with a statewide public education campaign in Colorado. Methods: Cross-sectional random digit dial telephone surveys (n = 1,107 pre, n = 1101 post) were conducted before and after an intensive 22-week stretch of television advertising, embedded within a multimedia campaign. The main outcomes were awareness of obesity as a personal health issue; correct identification of overweight and obesity; and self-assessment of health status and health behaviors. Results: The pre-advertising survey showed that most individuals believed that their own behaviors were healthier than those of their friends. Respondents frequently were not able to correctly identify an individual as overweight or obese based on height and weight. In the postadvertising survey, individuals were less optimistic about their weight and their health behaviors and...

A new Global Investment Framework for Women's and Children's Health demonstrates how investment in women's and children's health will secure high health, social, and economic returns. We costed health systems strengthening and six investment packages for: maternal and newborn health, child health, immunisation, family planning, HIV/AIDS, and malaria. Nutrition is a cross-cutting theme. We then used simulation modelling to estimate the health and socioeconomic returns of these investments. Increasing health expenditure by just $5 per person per year up to 2035 in 74 high-burden countries could yield up to nine times that value in economic and social benefits. These returns include greater gross domestic product (GDP) growth through improved productivity, and prevention of the needless deaths of 147 million children, 32 million stillbirths, and 5 million women by 2035. These gains could be achieved by an additional investment of $30 billion per year, equivalent to a 2% increase above current spending.

Introduction Project ECHO Pain, the innovative telementoring program for health professionals, was developed in 2009 at the University Of New Mexico Health Sciences Center to fill considerable gaps in pain management expertise. Substantive continuing education for clinicians who practice in rural and underserved communities convenes weekly by means of telehealth technology. Case-based learning, demonstrations, and didactics are incorporated into the interprofessional program that helps to improve pain management in the primary care setting. Method Three different approaches were used to evaluate the program over a 3-year period: (1) evaluation of all weekly continuing medical education surveys; (2) aggregation of annual clinic data; and (3) assessment of practice change in clinicians who joined Project ECHO Pain for at least 1 year. Results Between January 2010 and December 2012, 136 Project ECHO Pain clinics were held, with 3835 total instances of participation, representing 763 unique individuals from 191 different sites. Sixty percent self-identified as advanced practice or other nonphysician health professional. Statistically significant improvements in participant self-reported knowledge, skills, and practice were demonstrated. Focus group analyses of 9 subjects detailed specific practice improvements. Discussion Project ECHO Pain is a successful continuing professional development program. The telementoring model closes the large knowledge gap in pain education seen in primary care and other settings. Expertise is delivered by implementing effective, evidence-based, and work-based education for diverse health professionals. Project ECHO Pain serves as a model for interprofessional collaborative practice.

Background The aim was to carry out phase 4 international field-testing of the European Organisation for Research and Treatment of Cancer (EORTC) breast reconstruction (BRECON) module. The primary objective was finalization of its scale structure. Secondary objectives were evaluation of its reliability, validity, responsiveness, acceptability and interpretability in patients with breast cancer undergoing mastectomy and reconstruction. Methods The EORTC module development guidelines were followed. Patients were recruited from 28 centres in seven countries. A prospective cohort completed the QLQ-BRECON15 before mastectomy and the QLQ-BRECON24 at 4–8 months after reconstruction. The cross-sectional cohort completed the QLQ-BRECON24 at 1–5 years after reconstruction, and repeated this 2–8 weeks later (test–retest reliability). All participants completed debriefing questionnaires. Results A total of 438 patients were recruited, 234 in the prospective cohort and 204 in the cross-sectional cohort. A total of 414 reconstructions were immediate, with a comparable number of implants (176) and donor-site flaps (166). Control groups comprised patients who underwent two-stage implant procedures (72, 75 per cent) or delayed reconstruction (24, 25 per cent). Psychometric scale validity was supported by moderate to high item-own scale and item-total correlations (over 0·5). Questionnaire validity was confirmed by good scale-to-sample targeting, and computable scale scores exceeding 50 per cent, except nipple cosmesis (over 40 per cent). In known-group comparisons, QLQ-BRECON24 scales and items differentiated between patient groups defined by clinical criteria, such as type and timing of reconstruction, postmastectomy radiotherapy and surgical complications, with moderate effect sizes. Prospectively, sexuality and surgical side-effects scales showed significant responsiveness over time (P < 0·001). Scale reliability was supported by high Cronbach's α coefficients (over 0·7) and test–retest (intraclass correlation more than 0·8). One item (finding a well fitting bra) was excluded based on high floor/ceiling effects, poor test–retest and weak correlations in factor analysis (below 0·3), thus generating the QLQ-BRECON23 questionnaire. Conclusion The QLQ-BRECON23 is an internationally validated tool to be used alongside the EORTC QLQ-C30 (cancer) and QLQ-BR23 (breast cancer) questionnaires for evaluating quality of life and satisfaction after breast reconstruction.

Bone Health ECHO telementors healthcare professionals to develop the clinical skills needed to provide advanced levels of care for patients with skeletal disorders. The goal of this mentorship model is to improve osteoporosis care in underserved areas, decrease the need for referral to specialty centers, and reduce the osteoporosis treatment gap. The Project ECHO (Extension for Community Healthcare Outcomes) model of telementoring has been shown to improve the care individuals with chronic hepatitis C. ECHO has since been adapted to the address unmet needs in the care of other chronic complex diseases and recently applied to the care of osteoporosis and metabolic bone diseases. Bone Health ECHO outcomes are assessed through an electronic data collector asking qualitative questions about self-efficacy. This is a progress report of Bone Health ECHO from its launch in October 2015 through May 2016. A total of 31 weekly Bone Health ECHO clinics were held over 8 months, with 43 individuals participating at least one clinic session. The number of clinics attended range from 1 to 30, with 13 learners attending more than 10 clinics and an average of 11 learners per clinic. Self-efficacy information provided by learners was diverse with many favorable anticipated changes in clinical practice. Bone Health ECHO telementors healthcare professionals in underserved areas to provide advanced levels of care for patients with skeletal disorders. The experience of Bone Health ECHO will guide the development of similar telementoring clinics in other locations. More data are needed to fully evaluate this novel approach to reducing the osteoporosis treatment gap.

著者人数: 44名, Accepted: 2006-10-03, 資料番号: SA1000630000

Hydrodynamic dispersion of particle agglomerates occurs whenever the applied shear stresses can break the interparticle bonds responsible for the cohesivity of the agglomerate. Various mechanisms of hydrodynamic dispersion have been demonstrated for silica agglomerates infiltrated to different extents by the suspending fluid. In some cases, hydrodynamic forces are sufficient to induce the removal of incompletely infiltrated fragments from the parent agglomerate (dry cohesive failure) or the breakage of wetted fragments from the infiltrated portion of the parent agglomerate (wet cohesive failure). Dispersion can also occur such that a portion of the fracture surface originates at the interface between the infiltrated periphery of the agglomerate and its dry core (adhesive failure). To elucidate the tendencies for dispersion via various modes, a hydrodynamic analysis of the forces acting on and within the agglomerate has been performed for both uninfiltrated and partially infiltrated structures. This analysis reveals that the size of the region on which the hydrodynamic stress bears is sensitive to the degree of infiltration, which is consistent with the observed shifts in dispersion mechanism.

The dispersion behavior of agglomerates of several grades of fumed silica in poly(dimethyl siloxane) liquids has been studied as a function of particle morphology and applied flow conditions. The effects of primary particle size and aggregate density and structure on cohesivity were probed through tensile and shear strength tests on particle compacts. These cohesivity tests indicated that the shear strength of particle compacts was two orders of magnitude higher than the tensile strength at the same overall packing density. Experiments carried out in both steady and time-varying simple-shear flows indicate that dispersion occurs through tensile failure. In the steady-shear experiments,enhanced dispersion was obtained at higher levels of applied stress and, at comparable levels of applied stress, dispersion was found to proceed faster at higher shear rates. Experiments conducted in time-varying flows further corroborated the results obtained in tensile cohesivity tests. Experiments in which the mean and maximum stresses in the time-varying flows were matched to the stresses produced in steady shear flows highlight the influence of flow dynamics on dispersion behavior.

The Ramaty High Energy Solar Spectroscopic Imager (RHESSI) spacecraft was launched on February 5, 2002. With more than a year of operation on-orbit, its Sunpower M77 cryocooler continues to maintain the array of nine germanium detectors below 80 K. Trends have begun to emerge in cryocooler power and vibration, suggesting that the cooler's operating point is slowly changing. Possible causes are identified and discussed.

RNA-binding proteins of coronavirus MHV-A59 were identified using an RNA overlay-protein blot assay (ROPBA). The major viral RNA-binding protein in virions and infected cells was the phosphorylated nucleocapsid protein N (50K). A new 140K virus structural protein was identified as a minor RNA-binding protein both in virions and in infected cells. The 140K protein was antigenically related to N, and upon reduction, yielded only 50K N. Thus, the 140K protein is probably a trimer of N subunits linked by intermolecular disulfide bonds. Several cellular RNA-binding proteins were also detected. RNA-binding of N was not nucleotide sequence specific. Single-stranded RNA of MHV, VSV, or cellular origin, a DNA probe of the MHV leader sequence, and double-stranded bovine rotavirus RNA could all bind to N. Binding of MHV RNA was optimal between pH 7 and 8, and the RNA could be eluted in 0.1 M NaCl. The ROPBA is a useful method for the initial identification of RNA-binding proteins, such as N and the 140K protein of murine coronavirus.

Background The Commission on Investing in Health published its report, GlobalHealth2035, in 2013, estimating an investment case for a grand convergence in health outcomes globally. In support of the drafting of the Sustainable Development Goals (SDGs), we estimate what the grand convergence investment case might achieve—and what investment would be required—by 2030. Methods and Findings Our projection focuses on a sub-set of low-income (LIC) or lower-middle-income countries (LMIC). We start with a country-based (bottom-up) analysis of the costs and impact of scaling up reproductive, maternal, and child health tools, and select HIV and malaria interventions. We then incorporate global (top-down) analyses of the costs and impacts of scaling up existing tools for tuberculosis, additional HIV interventions, the costs to strengthen health systems, and the costs and benefits from scaling up new health interventions over the time horizon of this forecast. These data are then allocated to individual countries to provide an aggregate projection of potential cost and impact at the country level. Finally, incremental costs of R&D for low-income economies and the costs of addressing NTDs are added to provide a global total cost estimate of the investment scenario. Results Compared with a constant coverage scenario, there would be more than 60 million deaths averted in LIC and 70 million deaths averted in LMIC between 2016 and 2030. For the years 2015, 2020, 2025, and 2030, the incremental costs of convergence in LIC would be (US billion) $24.3, $21.8, $24.7, and $27, respectively; in LMIC, the incremental costs would be (US billion) $34.75, $38.9, $48.7, and $56.3, respectively. Conclusion Key health outcomes in low- and low-middle income countries can significantly converge with those of wealthier countries by 2030, and the notion of a “grand convergence” may serve as a unifying theme for health indicators in the SDGs.

Delirium is a common cause of disturbed behaviour in medically ill people and is often undetected and poorly managed. It is a condition at the interface of medicine and psychiatry that is all too often owned by neither. Although various terms have been used to describe it—including acute confusional state, acute brain syndrome, and acute organic reaction—delirium is the term used in the current psychiatric diagnostic classifications and the one we will use here.

RHESSI is the sixth in the NASA line of Small Explorer (SMEX) missions and the first managed in the Principal Investigator mode, where the PI is responsible for all aspects of the mission except the launch vehicle. RHESSI is designed to investigate particle acceleration and energy release in solar flares, through imaging and spectroscopy of hard X-ray/gamma-ray continua emitted by energetic electrons, and of gamma-ray lines produced by energetic ions. The single instrument consists of an imager, made up of nine bi-grid rotating modulation collimators (RMCs), in front of a spectrometer with nine cryogenically-cooled germanium detectors (GeDs), one behind each RMC. It provides the first high-resolution hard X-ray imaging spectroscopy, the first high-resolution gamma-ray line spectroscopy, and the first imaging above 100 keV including the first imaging of gamma-ray lines. The spatial resolution is as fine as ~ 2.3 arc sec with a full-Sun (≳ 1°) field of view, and the spectral resolution is ~ 1–10 keV FWHM over the energy range from soft X-rays (3 keV) to gamma-rays (17 MeV). An automated shutter system allows a wide dynamic range (> 107) of flare intensities to be handled without instrument saturation. Data for every photon is stored in a solid-state memory and telemetered to the ground, thus allowing for versatile data analysis keyed to specific science objectives. The spin-stabilized (~ 15 rpm) spacecraft is Sun-pointing to within ~ 0.2° and operates autonomously. RHESSI was launched on 5 February 2002, into a nearly circular, 38° inclination, 600-km altitude orbit and began observations a week later. The mission is operated from Berkeley using a dedicated 11-m antenna for telemetry reception and command uplinks. All data and analysis software are made freely and immediately available to the scientific community.

This article explores relationships between pupil attainments on standard National Curriculum tests at the end of Key Stage 2, teacher assessments, and pupil characteristics of gender, age, English as an additional language (EAI), and special educational needs (SEN) using representative samples drawn from schools in England in 1996, 1997 and 1998. Levels of agreement between teacher assessments and test results were remarkably consistent across all years and all subject areas. In all subject areas, teacher assessments were more likely to be lower than corresponding test results for pupils with SEN compared to their peers. Other pupil characteristics demonstrated only weak associations with extent of agreement. There was evidence that schools have become more similar over time with regard to patterns of differences between teacher assessments and test results. This is suggestive of increased consistency amongst teachers in the way that they interpret and apply the Key Stage assessment levels.

(2000). English Learners Reading English: What We Know, What We Need to Know. Theory Into Practice: Vol. 39, Children and Languages at School, pp. 237-247.

The present research focuses on opening activities in two bilingual Spanish immersion Kindergarten classrooms in northern California, Creekside and Seaside, in which similar numbers of native Spanish speakers and native English speakers were instructed primarily through Spanish. This study analyzes ways in which teachers structured opening activities to ensure comprehension and participation by children when the youngsters had little or no knowledge of the language of instruction, Spanish. Routines are analyzed in terms of scaffolding provided, with the concept of multiple embedded scaffolds proposed to explain how native English speakers are supported in language acquisition and content learning through a language that is new to them. Analysis revealed specific communication strategies such as functional repetition and the use of non-verbal cues to meaning that scaffolded comprehension. In addition, the teachers modeled language use themselves and structured events so that native Spanish speaker...