Complexity As A Shock Absorder: The Belgian Social Cube

Throughout its history, Belgium has been a complex political and social entity. The King of the Belgians was told in an official report that \u27there are no Belgians.\u2

Complejidad Como Un Amortiguador: El Cubo Social Belga

En toda su historia, B61gica ha sido una entidad compleja politicamente y socialmente

Flight Data Analysis of HyShot 2

The development of scramjet propulsion for alternative launch and payload delivery capabilities has comprised largely of ground experiments for the last 40 years. With the goal of validating the use of short duration ground test facilities, the University of Queensland, supported by a large international contingency, devised a ballistic re-entry vehicle experiment called HyShot to achieve supersonic combustion in flight above Mach 7.5. It consisted of a double wedge intake and two back-to-back constant area combustors; one supplied with hydrogen fuel at an equivalence ratio of 0.33 and the other un-fueled. Following a first launch failure on October 30th 2001, the University of Queensland conducted a successful second launch on July 30th, 2002. Post-flight data analysis of the second launch confirmed the presence of supersonic combustion during the approximately 3 second test window at altitudes between 35 and 29 km. Reasonable correlation between flight and some pre-flight shock tunnel tests was observed

Aging and Equity in the Greater Portland Metropolitan Region

Aging and Equity in the Greater Portland Metropolitan Region discusses the opportunities and needs created by the increase in older adults in the region. The 65 and older population is expected to more than double over the next two decades, to over half a million people. Planning for the inevitable and unprecedented aging of our population provides an opportunity to improve our environments while becoming a leader in the push to create sustainable, equitable, and age-friendly communities

THE LANDSCAPE: A GOOD OF CULTURE, IDENTIFICATION AND RICHNESS

The adoption of a systematic in geography has helped to "revolutionize" and in the same time to complete the notion of landscape that, until the half '900, has mastered the international geographic research. We are passed from definitions of the landscape like complex of the sensible features of a region of landscape like theatre etc. to that of landscape as structured system, where the natural and anthropic component are melt in a system which complexity is given by the inextricability of their relations as seen in a historical perspective. Already L. Gambi, however, in 1964 had adopted a first interpretative approach to the complexity of the landscape, looking no more at the man in the nature, according to Biasutti's point of view, but putting the "man in history" near the nature who, exploiting his kind of life contributes at the constitution of the "Anthropogeographic landscape". The centrality of the history in the processes of complexification of the landscape has been put, most recently, in evidence by Paola Sereno (2001): the landscape is composed of elements that belong to the various processes of territorialization, then at more territorial systems that the history produces, transmit some components that, changing even meaning and function, are reunited in a new system, establish new connections with other elements inside of new processes of territorialization. Not exist however a true "past" of the landscape if not in the whole of the continuous morphogenetic processes that had characterized it. In this perspective the landscape's tutelage not is immediately connected at the tutelage of a cultural, architectonic or monumental good that would be, because the same landscape configure itself as the historical - geographical context that the single object inside it get meaning; a context complex, however, because not only the simple union of elements, but the architecture of the nexus that tie them. The landscape configure itself as a whole of signs imprinted by the community to the own territory; it become then expression of belonging that consents to the men of recognize and identify themselves in the "places". Every landscape then has strong individualizing characters that consent the emersion of the deep roots of the realities that constitute the identity of the human groups that in time have established themselves in the territory. (Mautone, 1999). It is uncovered then an ambivalence that, according to M.C. Zerbi (1999) constitute the very essence of the complexity of the notion of landscape: from a side the landscape as visible, external, objective reality, that the observer can see, on the other side the mental image that the observer build for himself, the subjective dimension that is more strictly connect to the notion of cultural landscape. In particular Zerbi see how in the contemporary geographic research, the notion of landscape is seen in three different aspects that presuppose various uses. The first aspect concern The notion of cultural landscape, to whom geography has dedicate much time, as landscape modified by human work. Is derived a large meaning of this term, because the human work -directly or indirectly- manifests itself in a great number of landscapes. Is, however, according Zerbi, a good starting point to pick the past and present dynamics through an approach at the same time ecologic and historical - geographical. When then some elements of the cultural landscape stand out which are particularly appraised or are perceived as menaced in their own existence, it comes out the concept of landscape as patrimonial heritage. Is a more selective concept than previous, which concerns a reality full of values: archaeological sites, traditional agrarian cultivations, ancient houses become a heritage to protect and maintain more than to hand down. The historical gardens and parks too find place in this concept, becoming a planning object. There is even, according M.C. Zerbi, a third notion of cultural landscape that, this time, consider the landscape not only a objective reality, but a subjective interpretation of elements held in the ambient to which various human groups attribute different meanings and values. 228 Landscape then as way to see that surrounds us. At first sight it could seem an abstract approach, less responding to reality; is, instead, an approach that has validity even on the operative plane when is needed to know the values of the insiders, to make them aware of the planning of their complex of life

A prospective adaptive utility trial to validate performance of a novel urine exosome gene expression assay to predict high-grade prostate cancer in patients with prostate-specific antigen 2-10ng/ml at initial biopsy

BACKGROUND: Discriminating indolent from clinically significant prostate cancer (PCa) in the initial biopsy setting remains an important issue. Prospectively evaluated diagnostic assays are necessary to ensure efficacy and clinical adoption. OBJECTIVE: Performance and utility assessment of ExoDx Prostate (IntelliScore) (EPI) urine exosome gene expression assay versus standard clinical parameters for discriminating Grade Group (GG) ≥2 PCa from GG1 PCa and benign disease on initial biopsy. DESIGN, SETTING, AND PARTICIPANTS: A two-phase adaptive clinical utility study (NCT03031418) comparing EPI results with biopsy outcomes in men, with age ≥50 yr and prostate-specific antigen (PSA) 2-10ng/ml, scheduled for initial prostate biopsy. After EPI performance assessment during phase I, a clinical implementation document (ie, CarePath) was developed for utilizing the EPI test in phase II, where the biopsy decision is uncertain. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Performance evaluation of the EPI test in patients enrolled in phase I and publication of a consensus CarePath for phase II. RESULTS AND LIMITATIONS: In a total of 503 patients, with median age of 64 yr, median PSA 5.4ng/ml, 14% African American, 70% Caucasian, 53% positive biopsy rate (22% GG1, 17% GG2, and 15% ≥ GG3), EPI was superior to an optimized model of standard clinical parameters with an area under the curve (AUC) 0.70 versus 0.62, respectively, comparable with previously published results (n=519 patients, EPI AUC 0.71). Validated cut-point 15.6 would avoid 26% of unnecessary prostate biopsies and 20% of total biopsies, with negative predictive value (NPV) 89% and missing 7% of ≥GG2 PCa. Alternative cut-point 20 would avoid 40% of unnecessary biopsies and 31% of total biopsies, with NPV 89% and missing 11% of ≥GG2 PCa. The clinical investigators reached consensus recommending use of the 15.6 cut-point for phase II. Outcome of the decision impact cohort in phase II will be reported separately. CONCLUSIONS: EPI is a noninvasive, easy-to-use, gene expression urine assay, which has now been successfully validated in over 1000 patients across two prospective validation trials to stratify risk of ≥GG2 from GG1 cancer and benign disease. The test improves identification of patients with higher grade disease and would reduce the total number of unnecessary biopsies. PATIENT SUMMARY: It is challenging to predict which men are likely to have high-grade prostate cancer (PCa) at initial biopsy with prostate-specific antigen 2-10ng/ml. This study further demonstrates that the ExoDx Prostate (IntelliScore) test can predict ≥GG2 PCa at initial biopsy and defer unnecessary biopsies better than existing risk calculator\u27s and standard clinical data

Radio frequency component and method of making same

An electrical component and a method of constructing it are disclosed. The component includes a hollow tubular structure. The structure includes a series of axially spaced apart rings and at least one outer perimeter housing member. The housing member interconnects the rings for defining an internal configuration of the hollow tubular structure for electrical purposes. The rings and the housing member each include inter-engageable elements for helping secure mechanically the rings and housing member together to facilitate final assembly of the electrical component

The Effect of Race and Chronic Obstructive Pulmonary Disease on Long-Term Survival after Coronary Artery Bypass Grafting

Background: Chronic obstructive pulmonary disease (COPD) is a known predictor of decreased long-term survival after coronary artery bypass grafting (CABG). Differences in survival by race have not been examined. Methods: A retrospective cohort study was conducted of CABG patients between 2002 and 2011. Long-term survival was compared in patients with and without COPD and stratified by race. Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model. Results: A total of 984 (20%) patients had COPD (black n = 182; white n = 802) at the time of CABG (N = 4,801). The median follow-up for study participants was 4.4 years. COPD was observed to be a statistically significant predictor of decreased survival independent of race following CABG (no COPD: HR = 1.0; white COPD: adjusted HR = 1.9, 95% CI = 1.7–2.3; black COPD: adjusted HR = 1.6, 95% CI = 1.1–2.2). Conclusion: Contrary to the expected increased risk of mortality among black COPD patients in the general population, a similar survival disadvantage was not observed in our CABG population