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Scientists plan way-out missions to Neptune
An artist's illustration shows a nuclear-electric-powered spacecraft at Neptune, where it would release probes into the ice giant's atmosphere. The spacecraft also would send landers down to Triton, the planet's largest moon, which is seen here in the foreground. Boeing Satellite Systems
Dec. 15, 2004, 9:45 PM UTC / Source: Space.com
By By Tariq Malik
While a pair of NASA rovers explore Mars and the Cassini-Huygens mission peers close at Saturn, two research teams are targeting a more distant planetary quarry, the ice giant Neptune.
In separate studies, planetary scientists and engineers are drawing up plans to send an orbiter laden with atmospheric probes and landers to Neptune, the eighth planet from the sun. While each mission has its own way of reaching Neptune, both seek a better understanding of the planet and its surrounding 13 known moons, especially the oddball Triton.
"It's all part of the history of our solar system," Andrew Ingersoll, a study leader and planetary scientist at the California Institute of Technology, said in a telephone interview. "Neptune and Uranus are ice giants, and made mostly of heavier stuff than Jupiter or Saturn."
Ingersoll and his colleagues envision a Cassini-style mission that could use conventional rocket propulsion and gravity assists to reach Neptune.
Meanwhile, another version of the Neptune mission, which features the use of a nuclear fission reactor and ion propulsion to reach the ice giant and a timescale that spans two decades, is also under scrutiny.
"What makes Neptune unique is Triton," David Atkinson, a University of Idaho professor and the principal scientific investigator for the second study, explained in an e-mail interview. "It is speculated that Triton is actually a Kuiper Belt Object that was captured by Neptune."
Boeing Satellite Systems' Bernie Bienstock leads the second study with Atkinson.
Both Neptune mission efforts are part of NASA's Vision Mission program to develop long-term space exploration goals.
The funny thing about Neptune
Neptune sits about 2.7 billion miles (4.4 billion kilometers) from the sun. Voyager 2 swung by the planet in 1989, and Pluto, because of its orbit, periodically wanders inside Neptune's orbit.
Since Neptune is an ice giant, a dedicated mission to the planet would yield not only more about its formation and evolution, but also how such planets fit into the solar system, Atkinson said.
"The chemical makeup [of an ice giant] is different from gas giants like Jupiter," Paul Steffes, a radio scientist and member of the nuclear-electric Neptune team, told Space.com. "It's less affected by the inner solar system bodies and more representative of the primordial solar nebula."
While the same case for exploration can be made for Uranus, a fellow ice giant, the kicker is Neptune's largest moon Triton, which astronomers believe is a non-native captive of its parent planet. It circles Neptune in a retrograde orbit, in the opposite direction of Neptune's rotation. It has a gossamer-thin atmosphere where parachutes would be useless for any landing probe.
"Triton is just a really interesting object," Ingersoll said, adding that Neptune's partial ring arcs add to planetary system's draw.
Getting there sooner
Ingersoll's Neptune-bound craft would take a page from many of NASA's far-flung planetary exploration missions and rely on radioisotope thermal generators, or RTGs, a long-lasting battery fueled by plutonium, for its electric power. The Cassini orbiter currently at Saturn, for example, uses RTGs for power because the vast distance makes solar panels unpractical.
"Yes, we'd need RTGs, and yes, RTGs carry plutonium," Ingersoll said. He added that the power source can only pose a danger if it is vaporized over a city — a very unlikely case, because most launch scenarios would have them dropping into the ocean in an emergency. "There's been a lot if irrationality about nuclear power and fuels."
Ingersoll's team estimates that their spacecraft would take about 12 years to reach Neptune, but stopping once it arrives may be a challenge. His team is studying how to use aerocapture, a maneuver that allows a spacecraft to enter orbit around a planet using the atmosphere and no fuel. While NASA has experience with aerobraking, a gentler, fuel-burning maneuver, it has yet to use aerocapture in a mission.
"The most challenging thing technologically for us is to fly an aerocapture mission to Earth of Mars to demonstrate that it can be done," Ingersoll said, adding that the method occurs at higher speeds and digs deeper into a planet's atmosphere than aerobraking. It may also require a heat shield for thermal protection, he added.
Neptune's Prometheus
A nuclear-electric propulsion Neptune flight would build on NASA's plans for the Jupiter Icy Moons Orbiter mission under Project Prometheus, which is expected to use a nuclear fission reactor to power an ion engine.
The method is slow. An ion engine propelled Neptune mission launched around 2016 would take time to build up enough thrust to reach the planet, entering orbit around 2035, researchers said. But once there, the spacecraft would still have a large fuel and power supply for a long-duration stay.
"Since this mission may very well be the only mission Neptune this century, it is important the complete Neptune system be studied in detail," Atkinson said, adding that the sheer power provided by a Prometheus-type spacecraft would provide that opportunity.
But finding a way to integrate enough science instruments, detectors, cameras and other equipment, not to mention daughter spacecraft designed to separate and explore on their own, is still a large challenge in order to justify the 20-year mission, Atkinson said.
"At the present time, there is not a launch vehicle with enough capacity to launch a single Orbiter spacecraft capable of transporting Neptune Entry Probes and two Triton landers to Neptune," he added.
Probes and landers
In addition to an orbiting spacecraft that would make the rounds of the Neptunian system, NASA called for researchers to address the need for probes and landers in their respective studies.
Both teams envision sending a trio of atmospheric probes plunging into Neptune, each at different latitudes in order to provide a diverse look at the planet. Ingersoll's team favors the shotgun method, unleashing all three of its probes in one blow. Bienstock and Atkinson's study, however, plans to release the probes sequentially.
"The plan is to use identical probes ... to learn from each deployment," Steffes said.
Both studies are also looking at sending a pair of Triton landers, though setting the spacecraft down on the icy moon may be tricky. The surface is an extreme 35 degrees Kelvin (-238 degrees Celsius, or 396 degrees below zero Fahrenheit), and since Triton sports geysers and possibly seismic activity, landers would have to operate for long periods of time to monitor it.
"Landing on Triton is not trivial," Atkinson said, adding that conventional landing rockets could contaminate Triton's surface near spacecraft, so some other method is required. "The atmosphere is too thin for parachutes, and it is unlikely a rocket-controlled soft landing system can be used."
But Atkinson has ample time to find the best way to stick a Triton landing. NASA has funded his study with Bienstock, as well as Ingersoll's, until mid-2005, when their final recommendations will be submitted to the space agency.
"So it's a pretty interesting place," Ingersoll said of Neptune and its satellites. "For Voyager, Neptune was certainly the most photogenic of the ice giants."
By Tariq Malik


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Grand Challenges Brazil
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Grand Challenges is a family of initiatives fostering innovation to solve key global health and development problems. Each initiative is an experiment in the use of challenges to focus innovation on making an impact. Individual challenges address some of the same problems, but from differing perspectives.
Date AwardedDate AwardedTitle (A-Z)Title (Z-A)
Tracking MRSA Evolution to Discover Important Biomarkers to Quickly Characterize Unique MRSA Clones in Hospital Bloodstream Infections
Agnes FigueiredoUniversidade Federal do Rio de JaneiroRio de Janeiro, Rio de Janeiro, Brazil
Drug Resistance Burden
The project will use molecular approaches, including genomics and phylogenomics, to find biomarkers that could indicate the location in the genetic code driving bacterial adaptation. In addition, these biomarkers could be used as a rapid method for screening predominant and high-virulency MRSA clones in hospitals, and thus quickly provide infection control committees with key data on MRSA spread and its antimicrobial resistance profile.
An Artificial Intelligence System to Strengthen Antimicrobial Prescription in a Children's Hospital: SMART-EP
Marcelo PillonettoPontifícia Universidade Católica do ParanáCuritiba, Paraná, Brazil
The idea is to develop an artificial intelligence model capable of simultaneously analyzing data from the Laboratory Information System and from the Hospital Information System. This technology aims to enable the delivery to hospital physicians of a ranked list of antimicrobials that are more suitable to treat infection by multi-resistant microorganism with a focus on newborn and young children.
Applying the Metagenomic Approach for the Detection of EsβL- and Carbapenemase-Producing Enteric Pathogens Recovered from Different Hosts
Ana GalesUniversidade Federal de São PauloSão Paulo, São Paulo, Brazil
The project will study the genetic material from environmental samples from humans (healthy and ill), cattle and their meat to estimate the proportion of E. coli and K. pneumoniae in the microbiome. The main objective is to better understand the distribution of bacteria and its resistance genes, Escherichia coli and Klebsiella pneumoniae bacteria and extended spectrum beta-lactamase (EsβL) and carbapenemases encoding genes in distinct ecological sources.
OneBR: Integrated Genomic Database for Surveillance, Diagnosis, Management and Treatment of Antimicrobial Resistance in the Human-Animal-Environment Interface
Nilton LincopanUniversidade de São PauloSão Paulo, São Paulo, Brazil
This project proposes the development of the One Health Brazilian Resistance (OneBR), a curated and integrated genomic database. OneBR will use algorithms based on artificial intelligence to conduct surveillance, diagnosis, management and treatment of antimicrobial resistance (AMR) in the human-animal-environment interface. The goal is for this platform to be used by Brazilian health professionals in diverse settings, particularly within the Unified Healthcare System (SUS).
Data Science on Drug-Resistant Tuberculosis in Brazil
Rejane PinheiroUniversidade Federal do Rio de JaneiroRio de Janeiro, Rio de Janeiro, Brazil
The researcher will use machine learning techniques and a linked database to analyze mortality from drug-resistant tuberculosis. The goal is to better understand how the flow of patients through the health services network have influenced, or not, the occurrence of resistance.
The Dynamics of Antibiotic-Resistant Microorganism Flow Between Animal Farming and Medical Hospital Assistance
Thaís SinceroUniversidade Federal de Santa CatarinaFlorianópolis, Santa Catarina, Brazil
The project proposes to characterize the resistant determinants of microbial communities from key sources in hospitals, environment and farms to model the dynamics of the flow of antibiotic resistant microorganisms. The goal is to understand how the hospital environment and animal farming affect the ecology of antibiotic resistance movement. The project will rely on a methodology that allows the analysis of genes related to antibiotic resistance in a complex microbial community derived from specific samples instead of culture based methods for AMR identification.
Plasmid Curing by an Ethiopian Barley: A Natural Food Approach to Reduce Plasmid Mediated Antibiotic Resistance
Bruno PennaUniversidade Federal FluminenseRio de Janeiro, Rio de Janeiro, Brazil
Bacterial plasmids are genetic elements that can carry genes for antibiotic resistance from one bacteria to another acting as "messengers". Plasmid transfers contribute to the appearance of multidrug resistant bacteria. This project aims to use a "kill the messenger, not the bacteria" approach to tackle the problem of increasing antibiotic resistance. The goal is to test the elimination of plasmids carrying genes for antimicrobial resistance.
Application of Low-Cost and Sustainable Solar Oxidation Treatment to Prevent Microbial Resistance in Effluents in Brazil
Camila AmaralUniversidade Federal de Minas GeraisBelo Horizonte, Minas Gerais, Brazil
This project will test a sustainable solar oxidation system as a way to remove antibiotic resistant bacteria from wastewater. The hypothesis is that this technology can enable the inactivation of antibiotic resistant bacteria and the elimination of antibiotic resistant genes from effluents in Brazil.
Monitor AMR in Community Uropathogens and Correlate Them with the Determinants of Resistance in Animal Enterobacteria Isolates
Eliana Carolina VesperoUniversidade Estadual de LondrinaLondrina, Paraná, Brazil
The project aims to monitor AMR in microorganisms of the urinary tract and correlate it with the genetic determinants of resistance in animal enterobacteria. The study results will be disseminated in order to inform potential changes to guidelines regarding selection of the appropriate antimicrobials first-line treatment for urinary tract infections (UTI).
Engineers, Pharmacists and Chemists Collaborating on the Development of an Aerobic Granular Sludge (AGS) to Remove Antibiotics from Hospital Wastewater
Leonardo MouraUniversidade Federal do Rio de JaneiroRio de Janeiro, Rio de Janeiro, Brazil
The project proposes to use an aerobic granular sludge (AGS) - a technology based on microbial community - to remove antibiotics and antimicrobial resistant genes from hospital wastewater. AGS is one of the latest innovations and it has not yet been applied for the treatment of hospital wastewater.
The Use of Low-Cost Immobilized DNA Aptamers on a Cellulose Filter to Remove Antibiotic Residues from Effluents
Tiago MendesUniversidade Federal de ViçosaViçosa, Minas Gerais, Brazil
The project will develop a cellulose filter containing immobilized DNA aptamers, molecules that bind to a specific target molecule, that act as specific and high affinity probes for the uptake and retention of antibiotic molecules present in effluents. Nowadays, the removal of antibiotic residues from effluents is mainly based on chemical processes and physical methods that require expensive technologies and costly maintenance. The success of this project will represent a wastewater treatment option that is low-cost and environment-friendly.
New Gestational Weight Gain Recommendations for the Brazilian Unified Health System (SUS)
Gilberto KacUniversidade Federal do Rio de JaneiroRio de Janeiro, Rio de Janeiro, Brazil
Data Science Approaches
Aims to validate the International Fetal and Newborn Growth Consortium for the 21st century (Intergrowth-21st) standards for gestational weight gain (GWG) and create new recommendations of GWG based on those standards for first trimester normal and overweight women to be used in the Brazilian Unified Health System (SUS). GWG recommendations currently used in SUS have not been properly tested or validated, thus the project might improve prenatal nutritional care and reduce post gestational weight retention.
Potential Pregnancy Days Lost (PPDL): An Innovative Gestational Age Measure to Assess Maternal and Child Health Interventions and Outcomes
Carmen DinizUniversidade de São PauloSão Paulo, São Paulo, Brazil
The main goal of the project is to develop and explore an innovative measure of gestational age - "potential pregnancy days lost" (PPDL) - to produce evidence of its association with maternal and child health, morbidity and mortality in the short, medium and long term. The indicator also aims to convince women and policy makers about the need to promote less interventions and "harm-free care" during pregnancy.
Early Childhood Development Friendly Index: Assessing the Enabling Environment for Nurturing Care in Brazilian Municipalities
Muriel GubertUniversidade de BrasíliaBrasília, Distrito Federal, Brazil
The study aims to develop an Early Childhood Development friendly index (ECD-FI) based on a core set of evidence-based nurturing care indicators to assess the factors contributing to enabling environments and promote ECD at the municipal level by monitoring and identifying opportunities to scale up ECD programs. The index will be created through machine learning and will run analytical models considering demographic information and risk factors at the municipal level. This disaggregated data is not available in Brazil.
How and When: Disentangling Cash and Care Effects of Conditional Cash Transfers on Birth Outcomes
Cecilia MachadoFundação Getúlio VargasRio de Janeiro, Rio de Janeiro, Brazil
Seeks to understand the impacts of the Bolsa Família conditional cash transfer on birth outcomes (e.g., birth weight, gestational weeks, etc). The proposed design will disentangle the measured effects into two components: one that is associated to the cash transfer; and another related to prenatal care assistance. Moreover, this strategy will allow the researchers to determine the window of opportunity where CCT interventions exhibit highest impacts on birth outcomes, recognizing heterogeneous impacts according to how early in the pregnancy the CCT intervention starts.
Decision-Making Support Platform Based on Visual Analytics and Machine Learning to Subsidize Public Politics Focused on Gestational Health
Tiago CarvalhoInstituto Federal de São PauloCampinas, São Paulo, Brazil
The project will develop a platform to provide services for decision-making support for neonatal death preventive actions by using data from CIDACS cohort. The platform will offer three services: cohort data visualization for decision-making support by comparative human visual analysis, prediction of risk of neonatal death based on machine learning models, and simulator of public policies impact influencing on the risk of neonatal death.
Assessing the Impact of Hospital-Based Breastfeeding Interventions on Infant Health
Cristiano BoccoliniFiocruzRio de Janeiro, Rio de Janeiro, Brazil
Aims to access all 68.3 million living births certificates from Brazil, from 1994 to 2016, and compare them with breastfeeding policies in all Brazilian hospitals to assess the impact of the initiatives on infant health. The study also plans to estimate the number of avoidable deaths during this time period, if those initiatives were adopted in Brazil.
Spatial Analysis of Child Vaccination Coverage and its Relation to Socioeconomic and Health Characteristics in Brazil
Carolina BarbieriUniversidade Católica de SantosSantos, São Paulo, Brazil
By analyzing national children vaccination coverage from spatial perspectives, the study aims to uncover insights into the traditional surveillance. This will help to identify coverage rates, regions of greater vulnerability by providing a differentiated look at the logic of equity in health. Understanding the low childhood vaccination coverage will help to guide public policies for the purpose of interventions.
Data Science to Inform the Design and Evaluation of Interventions to Improve Perinatal Outcomes: Lessons from the Mãe Coruja Program
Jailson CorreiaMunicipal Health SecretariatRecife, Pernambuco, Brazil
The study is aimed at evaluating the effectiveness of Mãe Coruja intervention in reducing low birthweight and preterm birth. By using appropriate statistical methods, the study will use the Cidacs dataset combined with the data from Mãe Coruja program to carry out the quasi-experimental study. With the support of machine learning techniques, the project will also Identify social, economic, geographic and environmental conditions that are associated with the outcomes. The researchers will also build an index of perinatal health risk to inform improvements in targeting populations and the deployment of similar strategies and programs elsewhere in Brazil.
Influenza in Pregnancy and Birth Outcomes in the Brazilian Semi-Arid Region: the INFLUEN-SA Study
Aldo LimaUniversidade Federal do CearáFortaleza, Ceará, Brazil
Studies show that seasonal influenza in Ceará, in the Northeast region of Brazil, occurs 2 to 3 months earlier than in the South and Southeast, which guides the national calendar of vaccination. By using data science approaches, the study will test if Brazil's current national policy targeting vaccination only during the months of April and May inadequately protects against the harmful maternal-fetal effects of influenza in the Semi-Arid and northern regions of Brazil. If the hypothesis confirms, the study has the potential to change policy and modify the vaccination calendar.
Using the 100M Cohort to Establish Critical Air Pollution Thresholds for Safe Childbirth in Brazil
Alexandra BrentaniUniversidade de São PauloSão Paulo, São Paulo, Brazil
Does air pollution affect the rates of stillbirths, congenital malformations and neonatal mortality? This study aims to answer this question by merging the child health data collected within the 100 Million Brazilian Cohort from Cidacs with high-resolved satellite-derived data on air pollution to establish critical ambient air pollution thresholds for preventing adverse birth outcomes and malformations based on concentrations of fine particles, PM 2.5.
Use of Interactive Infographic in the PMCP - Analysis of Indicators to Improve the Quality of Maternal and Child Health
Judith KelnerUniversidade Federal de PernambucoCaruaru, Pernambuco, Brazil
The proposal will develop a platform for the analysis and visualization of data that will allow managers, public servants and other stakeholders involved in the Mãe Coruja Program at Pernambuco state (PMCP) to extract strategic information to improve the intervention. The focus will be on the implementation and actual enforcement of public policies, considering the high gestational risk and sexually transmitted infections (STI). Currently, health databases are for consultations only. The innovation of this proposal is to create an intelligent cloud platform for the analysis and distribution of health information to improve health care of women enrolled in PMCP.
Data-Driven Risk Stratification for Preterm Birth in Brazil: Development of a Machine Learning-Based Innovation for Health Care
Erika ThomazUniversidade Federal do MaranhãoSão Luiz, Maranhão, Brazil
Identifying the preventable causes and performing early risk stratification of pregnant women are instrumental to develop strategies to prevent and reduce preterm birth (PTB). The ability to identify at-risk pregnancies and to enroll women in prevention strategies has been difficult due to complexity of associated risk factors. The study aims to combine different national level data sources to understand the main predictors of PTB and develop a machine-learning-based predictive model to conduct automated risk stratification at the point of care level, integrated with advanced data visualization for clinical decision support.
Using Geocoded Big Data to Identify Causal Links Between Infectious Diseases and Child Developmental Outcomes
Rudi RochaFundação Getúlio VargasRio de Janeiro, Rio de Janeiro, Brazil
Infectious diseases may have only transitory impacts on pregnant mothers, but they can have lasting impacts on children. Can public interventions mitigate these impacts? This project aims to identify how exposure to localized epidemiological risk factors in the fetal period influences developmental outcomes for children through the early years of life. The researchers propose to evaluate in what extent the access to primary health care and social welfare programs mitigate negative impacts in child development.
The Intergenerational Impact of Conditional Cash Transfers on Newborn Health
Andreza LucasUniversidade Federal de PernambucoCaruaru, Pernambuco, Brazil
This research aims to analyze the relationship between a conditional cash transfer program and the child's health, considering two generations of the families and using two different approaches: econometric analysis and data mining algorithms. By analyzing the long term impacts of Bolsa Familia program on future generations' health performance, the project will investigate if a child who was born in a family whose grandparents received the cash transfer is in better health conditions than a similar child born in a family whose grandparents did not receive the same benefit.
Healthy Birth: A Prospective Study to Evaluate the Implementation and Effects of an Intervention to Improve the Quality of Maternal and Neonatal Care in Brazilian Hospitals
Maria do Carmo LealFiocruzRio de Janeiro, Rio de Janeiro, Brazil
All Children Thriving
Maria do Carmo Leal from Fiocruz in Brazil will undertake a pilot "Parto Adequado" (Adequate Birth) project to evaluate whether different health care models offered by medical institutions during pregnancy and childbirth can promote healthier births, particularly by reducing the rate of unnecessary medical procedures. These include caesarean section without clinical indication, which occur frequently in Brazil and can have negative consequences. They have selected 23 geographically dispersed hospitals for the pilot study, which will involve around 16,000 mothers. To promote good practices, they have developed three health care models that combine different numbers and types of medical staff (i.e., Doctors and nurses-midwives) to be involved at specific stages from pregnancy to birth. These will be offered to hospitals for implementation over 18 months. They will then analyse the degree of implementation of the models, and their effects on the type of birth, adoption of good practices, and hospital costs after two and three years. They will also interview the mothers and health care workers to evaluate acceptability of the different models.
PrePARE - Preterm Birth Reduction by Improvements in the Quality of Care to Patients with Preeclampsia
Marcos Augusto Bastos DiasFiocruzRio de Janeiro, Rio de Janeiro, Brazil
Marcos Augusto Bastos Dias from Fiocruz in Brazil in collaboration with the Global Pregnancy Collaboration (CoLab) will test a new approach for managing women in Brazil with preeclampsia in order to reduce unnecessary preterm births. Preeclampsia is characterized by high blood pressure and impaired organ function during pregnancy and can cause severe complications or even death for mother and child. The only cure is delivery, but preterm births are also high risk. In Brazil preeclampsia accounts for far more preterm deliveries than in higher income countries who more readily choose medication to reduce the severity of the disease, and help delay delivery. The study includes seven geographically diverse hospitals with 23 satellite community health centres over four years. They will train staff to adopt the WHO guidelines for preventing preeclampsia and introduce a method for identifying low-risk women whose pregnancies can be safely prolonged. The study will also generate data and biological samples that can be used to help better stratify risk and understand the disease, which could further improve clinical management and lead to new treatments.
Monitoring Child Development Indicators in Vaccination Campaigns: A Tool for Planning and Evaluating Intersectoral Actions
Sonya Isoyama VenancioInstituto de SaúdeSão Paulo, São Paulo, Brazil
Sonia Isoyama Venancio from the Instituto de Saúde in Brazil will implement a program for monitoring the development of children less than five years of age during vaccination campaigns in the municipalities, to help identify risk factors, raise awareness, and support healthy development. They will design and pilot test a questionnaire that can be easily applied during a vaccination procedure to carefully query the health and behavior of the child, as well as their family environment and access to health services and education. To promote implementation of the program, they will recruit and train interviewers, and partner with Universities to recruit health-care students for collecting the data and entering them into a custom built web application. They will validate their approach for identifying children with developmental problems, and analyze the data for potential causes such as socioeconomic conditions and quality of health care.
Maternal Neuropsychiatric Disorders During Pregnancy and Postpartum Period: Early Detection and Intervention, and its Impact on Family Triads
Ricardo Tavares PinheiroUniversidade Católica de PelotasPelotas, Rio Grande do Sul, Brazil
Ricardo Tavares Pinheiro from the Universidade Católica de Pelotas in Brazil will identify factors that are associated with gestational depression, and determine whether they influence their response to treatment and ultimately the healthy development of the child. Gestational and postpartum anxiety and depression affect 15-25% of mothers and can alter the emotional, social and cognitive development of the child. They are likely caused by a complex combination of genetic, hormonal, psychological and social/environmental factors. Only a handful of risk factors, including the levels of proinflammatory molecules, have been identified. The study will involve around 1250 pregnant women who will be evaluated by psychologists to ascertain their mental state. Blood and buccal cell samples will be collected to analyze the presence of candidate risk markers (specific proteins and microRNAs) and genetic polymorphisms (specific DNA sequences) to identify those associated with depression. They will also determine the relationship between these psychological and physiological factors and the subsequent motor and neurocognitive development of the born children. Clinical studies will also evaluate the efficacy of several modified therapeutic approaches centered on cognitive behavioral therapy, which involves guiding the patient to modify any distorted thinking and can be effective in depressed mothers.
Continuous Global Early Intervention Program for Preterm Infants Performed by their Families
Rita de Cássia SilveiraHospital de Clínicas de Porto AlegrePorto Alegre, Rio Grande do Sul, Brazil
Rita de Cássia Silveira from Hospital de Clínicas de Porto Alegre in Brazil will develop and test a program for families with preterm infants to follow at home to improve the child's cognitive, motor and social development. Preterm infants (those born with less than 37 weeks of gestation) can suffer a variety of complications due to incomplete brain, lung and eye development, which can cause long-term problems. They have shown that careful baby massage, alongside the standard skin-to-skin care by the mother, in the hospital after birth can improve the child's neurological development at two years of age. Here they will perform a randomized study of around 80 mothers of preterm infants, and teach one group to perform the massage technique and instruct them to administer it at home for the child's first 12 months of life, which will be carefully monitored. The effects on motor and neurodevelopment will be assessed at regular intervals up to 24 months of age and compared to a control group performing only skin-to-skin care.
Infant Sleep Hygiene Counseling: A Randomized Controlled Trial
Iná da Silva dos SantosUniversidade Federal de PelotasPelotas, Rio Grande do Sul, Brazil
Iná da Silva dos Santos from the Universidade Federal de Pelotas in Brazil will develop a simple, low-cost strategy targeting mothers to ensure young children get enough sleep. Inadequate sleep is more common in children from low-resource households, and can negatively impact their physical and mental health, including their cognitive development. Children can be encouraged to sleep well by creating a restful environment and helping them learn to get to sleep by themselves. They will perform a randomized controlled study with around 500 mothers of infants aged three months. One group of mothers will be taught about normal sleep behavior during the first year of life and how to encourage their child to sleep. The effect of this intervention on sleep duration, growth and neurodevelopment will be analyzed over a 24-month period. Sleep duration will be monitored by actigraphy to ensure accuracy.
Evaluating the Impact of Social Factors and Interventions on Healthy Growth and Development: the 80 Million Brazilian Cohort
Mauricio Lima BarretoFiocruzRio de Janeiro, Rio de Janeiro, Brazil
Mauricio Lima Barreto from Fiocruz in Brazil will evaluate the impact of social and economic inequalities, and the national family allowance program (Bolsa Familia), on healthy births and early childhood health and development. They will setup a cohort, which will be derived from a central database of named households created to support Brazil's social programs, and a data center for the analysis. They will use a variety of demographic, economic and social data on families, as well as information on births and childhood deaths, and child growth. The impact of receiving family allowance, and the effect of its value and duration, on outcomes such as birth weight, prematurity, fetal death, and early childhood growth will also be measured. This approach will generate evidence to help maximize the value of the social program and inform future related policies.
Testing PIXA(3): An Innovative Way to Measure Growth Easily, Frequently and Precisely
Guilherme Vanoni PolanczykUniversidade de São PauloSão Paulo, São Paulo, Brazil
Guilherme Vanoni Polanczyk from Universidade de São Paulo in Brazil will test their new method Pixel Averages for Auxological Assessment (PIXA3) that enables parents at home to frequently and precisely measure height during early childhood to help better detect and monitor growth defects in low-resource settings. The current standard for accurately measuring height requires specialized equipment and trained staff, and is thus unsuitable for frequent application. Their new method involves using a smartphone to take multiple photographs of an individual next to an internal standard of known size, and doesn't require cross-sectional population norms, which have complicated current methods of longitudinally assessing growth. They will perform a randomized controlled trial in São Paulo to test the feasibility of their method and determine how accurate it is compared to traditional growth measures taken at a health clinic.
Mother and Teacher Support Programs to Improve Cognitive, Social and Communication Skills of Pre-School Children, to Improve the Mother's Quality of Life and to Decrease Domestic Violence Levels
Maria Conceicao do RosárioUniversidade Federal de São PauloSão Paulo, São Paulo, Brazil
Maria Conceicao do Rosário from Universidade Federal de São Paulo in Brazil will assess the effect of mother and teacher support programs in pre-schools in poor districts of São Paulo on the physical and emotional well-being of families, and on early childhood development. Many poor communities in Brazil suffer from high levels of urban violence and adult mental illness that affect the healthy development and well-being of children. Brazil has pledged that all children aged 4-6 will be in pre-school by 2016, presenting an opportunity to improve the quality of pre-school teaching to impact childhood development. They will recruit around 900 mothers to evaluate a mother support program, which will involve weekly group meetings for around 12 weeks to discuss issues including parenting methods and healthy child development. They will also implement a teacher support program to increase their knowledge on childhood health and development, and assess the impact on their attitudes and practices.
Use of Metabolomics for the Identification and Validation of Clinical Biomarkers for Preterm Birth
José Guilherme CecattiUniversidade Estadual de CampinasCampinas, São Paulo, Brazil
Preterm Birth Burden
José Guilherme Cecatti from the Universidade Estadual de Campinas in Brazil will develop a predictive algorithm to identify early in pregnancy those at increased risk of preterm birth so that if possible they can be treated. There are likely to be many causes of preterm birth, and it is a major cause of both short and long term life-threatening complications for infants. They will use existing data from 6,000 pregnancies that resulted in both term and preterm births, and perform three complementary mass spectrometry-based methods on blood taken early (around 15 weeks) in those pregnancies to identify a panel of biomarkers that can predict preterm birth. This will be combined with sociodemographic and physical data including economic status and age to generate a predictive algorithm. They will then evaluate this algorithm in a cohort of 1,150 low risk pregnant Brazilian women for its ability to identify those that go on to give birth prematurely.
Pessary Plus Progesterone to Prevent Preterm Delivery in Women With Short Cervical Length
Rodolfo de Carvalho PacagnellaUniversidade Estadual de CampinasCampinas, São Paulo, Brazil
Rodolfo de Carvalho Pacagnella from the Universidade Estadual de Campinas in Brazil will perform two randomized clinical trials across 15 obstetric clinics in Brazil to evaluate treatment with progesterone in the presence or absence of a cervical pessary for preventing spontaneous preterm birth. Both cervical pessary and progesterone are individually considered to be effective preventative treatments for preterm birth, which is one of the most common complications seen in pregnancy and can cause severe complications for the premature infant. The causes of preterm birth are mostly unknown, although incidence does increase with cervical shortening during the mid stages of pregnancy. They will also analyze the prevalence of a short cervix in Brazilian pregnant women, and determine how well it predicts preterm birth. Their approach to screen for cervix length and then treat high-risk individuals with the combination therapy will also be evaluated for cost-effectiveness.
Influence of the Vaginal Microbiome and Vaginal Metabolites on Cervical Remodeling and Preterm Parturition
Antonio Fernandes MoronUniversidade Federal de São PauloSão Paulo, São Paulo, Brazil
Antonio Fernandes Moron from the Universidade Federal de São Paulo in Brazil will investigate whether the presence of specific bacterial populations in the vagina can predict preterm birth, which could form part of an inexpensive test suitable for low resource settings. Preterm birth leads to major short- and long-term health problems for the child. The causes are largely unknown, making it hard to identify pregnant women at increased risk who need monitoring and might benefit from treatment. They hypothesize that bacterial infections in the vagina during pregnancy can alter the length, elasticity and/or thickness of the cervix, thereby triggering preterm birth. To test this, they will analyze vaginal samples from 400 pregnant women located at four urban care centers throughout Brazil to identify bacteria and selected proteins that associate with specific cervical alterations detectable by ultrasound, and determine their association with preterm birth.
Senses of Birth: Effects of an Interactive Exhibit in Changing the Perception About Labor and Birth With Community Mobilization for Reducing Excessive Caesarean Sections and Iatrogenic Prematurity In Brazil
Bernardo Jefferson de OliveiraUniversidade Federal de Minas GeraisBelo Horizonte, Minas Gerais, Brazil
Bernardo Jefferson de Oliveira from the Universidade Federal de Minas Gerais in Brazil will develop an interactive exhibit including images, audio, games, and theatre to encourage natural childbirth and perform a pilot study to evaluate its effect on changing public perception of labor and birth. They aim to reduce unnecessary cesarean sections in Brazil where the incidence of preterm births, which can cause severe disabilities, has been increasing. This is thought to be due in part to the negative perception of normal birth and the assumption that cesarean sections are safer and more convenient. The exhibit will focus on producing sensations and emotions to teach participants about the experience, risks and benefits of both cesarean section and natural childbirth. They will present the exhibit over 12 months in three major cities, which should reach around 30,000 people, and use interviews and questionnaires before and after participants visit the exhibit to measure its effect on knowledge and attitudes.
Breastfeeding in Premature Infants: Impact of Bfhi in Neonatal Units
Carmen Gracinda Silvan ScochiUniversidade de São PauloSão Paulo, São Paulo, Brazil
Carmen Gracinda Silvan Scochi from the Universidade de São Paulo in Brazil will encourage mothers of preterm infants in Brazil to exclusively breastfeed them for the first six months to better protect them against infections and optimize their growth and neurodevelopment. The incidence of preterm births in Brazil is increasing, and causes multiple short and long-term complications. Exclusive breastfeeding can limit some of these complications but is particularly challenging with preterm infants due to their incomplete development and the need for hospitalization, as well as there being practical and emotional difficulties for the mother. The existing WHO/UNICEF global program for promoting exclusive breastfeeding has been adapted specifically for preterm infants and involves better educating medical staff so that they provide the practical and emotional support to encourage exclusive breastfeeding. They will establish the program in 10 hospitals/maternity units across Brazil and evaluate its effect on the numbers of preterm infants being exclusively breastfed.
A Randomized Clinical Trial With Oral Magnesium Supplementation in Pregnancy
Joao Guilherme Bezerra AlvesInstituto de Medicina Integral Professor Fernando FigueiraRecife, Pernambuco, Brazil
Joao Guilherme Bezerra Alves from the Instituto de Medicina Integral Professor Fernando Figueira in Brazil will perform a randomized controlled trial to assess whether a daily oral supplement of magnesium citrate can prevent placental vascular disease, which can lead to preterm birth. Placental vascular disease restricts the flow of nutrients to the fetus and can cause growth restriction and maternal hypertensive disorders. Magnesium is known to promote placental vascular flow, and magnesium citrate is safe, inexpensive and easily absorbed in the body. They will perform a clinical trial in two large hospitals in Brazil in which 3,000 pregnant women will be offered a daily magnesium supplement or a placebo control starting from up to 20 weeks of gestation and continuing until birth. The effect on various outcomes including placental function, preterm labor, and mother and child health will be evaluated.
Quarenta Semana: Innovative Intervention in the Prenatal Care for Reduction of Prematurity
Jose Maria de Andrade LopesInstituto Fernandes Figueira - FiocruzRio de Janeiro, Rio de Janeiro, Brazil
Jose Maria de Andrade Lopes of the Instituto Fernandes Figueira - Fiocruz in Brazil will conduct a randomized study to evaluate "Quarenta Semana," which is a program designed to remove risk factors associated with preterm births in Rio de Janeiro. The preterm birth rate in Brazil is amongst the highest globally. Some known risk factors for preterm birth include limited access to healthcare services, maternal social and health factors such as diabetes, and the quality of prenatal care. They will train pregnant women to act as health advocates who encourage women to seek prenatal care in their first trimester. They will also establish social support groups to help reduce stress and offer support throughout pregnancy, and implement a checklist for providers and patients to increase the quality of prenatal care. The effect of these approaches on preterm birth rates will be evaluated.
Elaboration of a Lyophilized Human Milk Concentrate To Be Used To Feed Very Low Birth Weight Preterm Newborns
José Simon CameloUniversidade Federal de São PauloSão Paulo, São Paulo, Brazil
Jose Simon Camelo Junior from the Universidade Federal de São Paulo in Brazil will test a method for producing a lyophilized human milk concentrate for feeding very low birth weight newborns that can be implemented in developing countries. Very small premature babies of less than 1,500 grams require large quantities of proteins, calories, minerals, micronutrients and electrolytes to survive and thrive. However, breast milk alone is not concentrated enough. Supplements derived from cow's milk have been used but appear to inhibit particularly the immunological quality of human breast milk, which helps block infection. Human milk additives have now also been tested and show promising results, but they are prohibitively expensive to produce in developing countries. They will use a simple method involving evaporation, centrifugation and lyophilization to produce a concentrated form of human milk that can be implemented in Brazilian milk banks. The milk product will be evaluated for stability and safety and for nutritional content to ensure it contains adequate concentrations of essential nutrients within manageable volumes to support very low weight newborns.
Improved Method of Screening for Preeclampsia
Renato Luis da Silveira XimenesUniversidade Federal de São PauloSão Paulo, São Paulo, Brazil
Renato Luis da Silveira Ximenes of Universidade Federal de São Paulo in Brazil will conduct a randomized controlled trial to evaluate whether a daily low dose of aspirin taken from early in pregnancy can prevent preeclampsia and thereby reduce the rate of preterm birth. Preterm birth is a leading cause of neonatal morbidity and mortality, and preeclampsia is a major cause of maternal death. The combination of several biomarkers such as serum levels of placental growth factor and biophysical measurements such as mean arterial pressure can now quite well identify women at higher risk of developing preeclampsia already at 11-14 weeks gestation, providing an early window of opportunity to treat them. And a recent meta-analysis suggested that the administration of low dose aspirin before 16 weeks could reduce the rate of preeclampsia by fifty percent. They hypothesize that the earlier treatment is started, the more effective it will be. They will screen pregnant Brazilian women at 11–14 weeks to identify those at risk of developing early preeclampsia and test whether low dose aspirin can prevent it.
Premature Births in São Paulo: A Spatial Approach
Silvia Regina Dias Medici SaldivaInstituto de SaúdeSão Paulo, São Paulo, Brazil
Silvia Regina Dias Medici Saldiva from the Instituto de Saúde in Brazil will determine whether and which physical, social and cultural aspects of urban environments can increase the incidence of preterm birth. Prematurity is a major cause of childhood mortality and disability, and levels are high in Brazil. Preterm birth is likely caused by combinations of factors that, particularly in urban locales, might include environmental factors such as the quality of housing, proximity to health facilities and pollution levels, which then interact with social and cultural factors. They will identify spatial clusters of premature births from 2012 in the city of São Paulo to define suitable regions for performing case-control studies. The studies will involve face-to-face interviews at selected households by trained interviewers to assess environmental and social factors such as income, education, health and sanitation. These data will be supplemented with available or modeled meterological and pollutant data, and data from tree rings, which can provide climate information as well as levels of toxins. They will then perform hierarchical modeling to identify environmental factors associated with preterm births.
ABC Transporters in Pregnancy and Preterm Labor
Tania Maria Ruffoni OrtigaUniversidade Federal do Rio de JaneiroRio de Janeiro, Rio de Janeiro, Brazil
Tania Maria Ruffoni Ortiga from the Universidade Federal do Rio de Janeiro in Brazil will measure the levels of so-called ABC transporters throughout pregnancy, and during normal and preterm labor, and how they are influenced by infections such as malaria and influenza, to determine whether they might increase the risk of preterm labor. ABC transporters sit in the outer membranes of cells and actively transport drugs, toxins and immune signaling molecules out of them. In this way, they regulate the immune response, hormonal signaling and the activity of drugs such as antibiotics, which become particularly important during pregnancy and labor. They will collect human intrauterine tissue at different time points during pregnancy and during cesarean delivery from hospitals in Brazil and Canada, and investigate the distribution of ABC transporters and the association with infection. They will also use a mouse model of malaria to evaluate the effect on the levels and activity of the transporters.
Association Among Fetal Microbiota, Prematurity and Preterm Morbidities
Renato Soibelmann ProcianoyUniversidade Federal do Rio Grande do SulPorto Alegre, Rio Grande do Sul, Brazil
Renato Soibelmann Procianoy from the Universidade Federal do Rio Grande do Sul in Brazil will analyze the association between bacterial populations in the vagina and gut of mothers in their third trimester and in the meconium of very preterm newborns, with risk of preterm delivery. It was previously assumed that microbes from the mother are first transferred to the fetus during delivery. However, it was recently shown that this could happen already in the uterus, triggering a possible immune response by the fetus that may lead to premature birth, which is a leading cause of infant morbidity and mortality. They will use 16S rRNA-based bacterial sequencing technology on around 600 samples to compare the types of bacteria present in preterm infants with that in healthy term infants in a neonatal unit in the Clinicas Hospital in Porto Alegre. They will also track the changes in bacterial composition in healthy and sick newborns during their hospital stay, to identify types of bacteria associated with specific diseases such as diarrhea. All samples will be stored in a repository for future case-controlled studies.
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HAMILTON STAR NIK WALKER CALLED HEINEN'S A SECRET GEM ON TWITTER. IF HE'S LOOKING FOR GOOD PLACES TO BUY FOOD, I'D SUGGEST A CERTAIN PLACE ON WEST 25TH FILLED WITH FRESH FRUITS AND VEGETABLES AND PLENTY OF VENDORS!
THE UPCOMING EIGHTH SEASON OF AMERICAN HORROR STORY WAS ANNOUNCED AS 'APOCOLYPSE'. THE SEASON KICKS OFF ON SEPTEMBER 12TH ON FX. RYAN MURPHY, CREATOR OF AMERICAN HORROR STORY ALSO CREATED THIS MUSICAL COMEDY-DRAMA ABOUT A SHOW CHOIR TEAM IN LIMA, OHIO.
SPEAKING OF THE SEA, IT'S OFFICIALLY SHARK WEEK! DISCOVERY WILL BE AIRING 22 SPECIALS ABOUT SHARKS ALL THIS WEEK FOR THEIR 30TH EDITION OF SHARK WEEK. NOW…THE HIGHEST GROSSING MOVIE ABOUT SHARKS IS OBVIOUSLY JAWS, GROSSING 470 MILLION. BUT WHAT'S THE SECOND HIGHEST MOVIE? SHARK TALE? DEEP BLUE SEA? OR JAWS 2?
MATT GROENING, CREATOR OF THE SIMPSONS, HAS A NEW SHOW COMING NEXT MONTH TO NETFLIX, IT'S A CARTOON CALLED DISENCHATMENT AND WILL BE ABOUT A PRINCESS IN A MIDDLE EARTH TYPE SETTING. THIS SHOW WILL BE MATT GROENING'S THIRD SERIES, THE FIRST BEING THE SIMPSONS. WHAT IS THE SECOND SHOW? IS IT BRICKLEBERRY? FUTURAMA? FAMILY GUY?
TIM SAYS HE 'CANNOT FIND' THE CHOCOLATE HUMMUS EVEN THOUGH EVERYONE ELSE IN CLEVELAND CAN. SOUNDS A LITTLE CONVIENENT TO ME! THE QUESTION REVOLVES ANOTHER CHARACTER, GEORGE COSTANZA FROM SEINFELD, WHO GOT IN TROUBLE BY DOING WHAT WITH HIS CHIP AND DIP?


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grilled seasoned chicken breast with onions, green peppers and tomatoes in a grilled flour tortilla with cheddar and jack cheeses. served with sour cream and salsa.
grilled seasoned steak with onions, green peppers and tomatoes in a grilled flour tortilla with cheddar and jack cheeses. served with sour cream and salsa.
all our favorites. monster mozza sticks, onion rings and crispy chicken strips. served with honey mustard and marinara sauces.
garden greens topped with diced crispy-fried chicken, tomatoes, crispy bacon, jack and cheddar cheeses and a hard boiled egg. tossed with honey mustard dressing and served with garlic bread. also available with grilled chicken.
roast turkey, crispy bacon, cheddar cheese, sliced tomatoes, lettuce and mayonnaise on a grilled roll.
a great double-decker with six strips of crispy bacon, lettuce, tomato and mayonnaise on white toast.
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a juicy, grilled chicken breast with melted provolone cheese, oven roasted tomatoes, lettuce and sun-dried tomato pesto on a grilled romano-parmesan bun.
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a thick, juicy, bacon 'n beef burger with cheddar cheese on a romano-parmesan bun with lettuce, tomato and red onion.
a thick, juicy, bacon 'n beef burger topped with cheddar cheese, crispy bacon and one egg over medium on a romano-parmesan bun with lettuce, tomato and red onion.
a thick, juicy, bacon 'n beef burger with cheddar cheese and two strips of crispy bacon on a romano-parmesan bun with lettuce, tomato and red onion.
a thick, juicy, bacon 'n beef burger with grilled mushrooms crowned with swiss cheese. served on a romano-parmesan bun with lettuce, tomato and red onion.
two thick, juicy bacon 'n beef burger patties smothered in american and provolone cheeses on a romano-parmesan bun with lettuce, tomato and red onion.
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seasoned tilapia, grilled to perfection then topped with sauteed mushrooms, onions, diced tomatoes, balsamic glaze and a lemon wedge. served with steamed broccoli and a house salad with reduced-fat italian dressing.
light crunchy golden fried shrimp, served with steamed broccoli, seasoned red skin potatoes and pineapple island glaze.
two seared chicken breasts marinated with rosemary, garlic and lemon. served with seasoned red skin potatoes and steamed broccoli hollandaise.
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Groupon has verified that the customer actually visited International House of Pancakes.


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Fair board happy with turnout
By Daniel Winningham
Those attending the annual Macoupin County fair are typically used to visiting the event on hot, sweltering days in late July.
However, earlier this year, the fair opted to hold the fair in June, and the early signs have been pretty positive.
"As far as the board goes, we're very happy with how the fair went with moving it up," said fair board president Mark Dugger said. "With people coming out, about 99 percent of the comments were very positive. Things worked out pretty well in spite of mother nature."
According to weather data from Weather Underground, which collects information on Sumner Street in Carlinville, the high temperature climbed past 90° on just three of the seven days from June 23-29, and for the fair's final night at the demolition derby many were wearing jackets and long-sleeve shirts as the temperature was below 73° after 6:30 p.m.
Grandstand attendance was down some earlier in the week but picked up the last three nights, according to Dugger.
"The first few nights were a little lighter than what we usually receive," Dugger said. "Folks really started to flock out there for the motor sports."
This year, the grandstand entertainment included mud drags June 27, tractor/truck pulls June 28 and the demolition derby June 29.
"The carnival was very positive," Dugger said. "It seems like that was very well received."
Dugger admitted there were a couple of "minor hiccups" with a ride one evening but was fixed after operators made a few repairs.
"Trinity Amusements did a great job," Dugger said. "We're really pleased with how things turned out with them."
Asked if the board is locked into holding the fair in late June in future years, Dugger said, "As of right now, yes."
"The vendors had very positive responses to the earlier date," Dugger said. "There's a lot less competition from other fairs since it's before the July 4 weekend."
To read more of this story, see our e-edition. Check out our gallery for lots of fair photos!
3872 02:35PM 0 Community, Events, Macoupin County Fair 2019 Tags: 2013, ends, macoupin county fair, success, wrap up


THIS MONTH WE WILL BE MAKING CROPPED ANIMAL PORTRAITS. STUDENTS WILL USE THE GRID DRAWING METHOD TO ENLARGE A PHOTO ONTO CANVAS BOARD. WE WILL THEN BEGIN LEARNING ABOUT ACRYLIC PAINT AND USE IT TO FINISH OUR PORTRAITS. FINISHED ARTWORK WILL BE 14" X 18".


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I have always loved helping and supporting others. I was particularly interested in working with children, having grown up in a large family with over thirty cousins. I started to learn about social work because my auntie was a foster carer. I built relationships with the children she cared for and I was able to get an insight to what social work was from a young age.
Despite this, I was often told I wasn't good enough and that I wouldn't make it past my GCSEs, but these comments only made me more determined. I'm one of those people, if someone says I can't do something I want to do it even more. I wanted to prove them wrong. I knuckled down and revised as much as possible to get in to college and then university. During this time, I went through many transitions and experienced friendship breakdowns.
In 2017, I was assaulted and this led to my mental health deteriorating, which meant I had more challenges to face. Mental health was something I struggled with for many years and I wasn't really sure how to deal with it to begin with. I kept it quiet for so long, but people had started picking up on signs, especially within my cohort.
Before I struggled with mental health, I didn't really understand what it was. When I was diagnosed with an eating disorder, I was terrified of the stigmatisation around mental health. My cohort were amazing and were always empowering me, which made me stronger and more confident. One of the social work values is about being honest, speaking up and asking people how they are and that's what my cohort did. It made me more confident to speak about it and they didn't judge me for it.
I began to fight back and speak openly about mental health. I think when you speak out and say that you want to recover, it makes you more determined to succeed. I learnt what resilience really was and how important self-respect is. It only made me more passionate about helping others and I was able to use my own experiences to do this.
This year, I recovered from mental health and as a thanks to those who helped me, I did a skydive for Mind and was able to raise nearly £500. It was scary but I did it to give back to those who enabled me to get better.
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Home / Department of Public Health and Primary Care / Primary Care Unit / GP News / PCU Profile: Dr Yasar Khan, first generation medic
PCU Profile: Dr Yasar Khan, first generation medic
Dr Yasar Khan joined the GP Education Group (GPEG) at the Primary Care Unit in 2017. GPEG teaches hundreds of medical students every year – delivering 21% of the Cambridge clinical curriculum and teaching everything from dermatology to primary care paediatrics. Dr Khan is an Assistant Director with the team. He is a GP and medical educator who is also pursuing his Masters in Medical Education at the University of Bedfordshire.
How did you become interested in medicine?
"There was no single defining moment. In fact I struggle to recollect the exact narrative that led to being part of this great profession. I always found learning of the science subjects particularly intellectually invigorating. My experience of the medical profession revealed people who were compassionate and valued. I wanted to apply to train to be a doctor! I remember being asked why? My answer was always why not?"
So you were the first member of your family to study medicine? What were the barriers that you overcame to get into medical school? And what helped you?
"I did not have personal access to a member of the medical profession. On reflection this made it difficult to organise relevant work experience. I hand delivered a personal written letter to all the local GP surgeries requesting work experience but was unsuccessful. In the end I visited the voluntary services department at the Luton and Dunstable Hospital and a lady called Mrs Liz Bagshaw took pity on me. As it transpired, I had the most educationally valuable work experience shadowing a variety of professionals and speaking to patients. Without this experience I think it would have been impossible to gain entry into medical school."
What was it like studying medicine?
"I went to Norwich Medical School. It was intellectually vigorous but thoroughly enjoyable. It surpassed my expectations."
How did your interest in GP develop?
"From the time I was in medical school I wanted to be a GP. A GP is the first port of call and often the last port of call for a patient. They are the medical advocate for their patients from the cradle to the coffin. The demand for formulating a specific management plan that encompasses a patient's physical, mental, social and spiritual needs in ten minutes albeit without prior knowledge of the reason for the consultation is intellectually stimulating and thus appealing."
I am enthused by all the specialities in medicine. Being a GP involves keeping up to date in all areas: we use a great breadth of skills to meet the needs of a patient, who can present to their GP with any condition."
– Dr Yasar Khan
And your interest in medical education?
"I wanted to be involved in medical education to play a part in developing, educating and influencing the future generations of medical doctors. It is a rewarding to work with their unbounded enthusiasm, intellectual curiosity and open mindedness.
I work as an Assistant Director in the General Practice Education Group (GPEG), Primary Care Unit at the University of Cambridge and I also teach early career GPs in the Luton GP Training scheme. I used to be a Training Programme Director for the Luton GP Training scheme and I am an examiner for the GP School entrance exam. Also, I work as Clinical Educator at the University of Bedfordshire involved in the learning of allied health professionals."
Special interests in medicine?
"My special interest within medical education involves the use of Virtual Reality Technology in General Practice education."
Can you describe a day in your life at PCU?
Cambridge students on placement in a GP surgery. Credit: Nick Saffell
Dr Khan's days at PCU are varied: he explained that a recent day included:
– Meeting with colleagues on formulating the medical student clinical exams
– Analysing the content of the medical student teaching
– Planning an outreach event with colleagues to inform teenagers of the nature of a career in medicine
– Visiting a GP surgery interested in teaching medical students to explain the medical curriculum and determining whether the students can be placed at that surgery.
Return tickets will be available on the door at our Cambridge Science Festival event: 'Do YOU want to be a doctor?'. Sunday 25th March at 11.15 – 12 noon on Cambridge Biomedical Campus.
For young people who want to try out their diagnostic skills. With Dr Alex Davidson, Dr Kinnary Martin and Dr Ruwani Siriwardena and 'patients' in our on-stage GP 'Surgery.' Free stethoscopes for most promising future GPs. See more
About the GP Education Group at the Primary Care Unit
Top image: Dr Jon Ferdinand for the Primary Care Unit
Filed Under: GP News, PCU Updates, Student News Tagged With: GP, meded, PCU profiles, Yasar Khan
Best software tools to help researchers conduct systematic reviews in healthcare research identified in new study
Public support for a policy can be increased by communicating evidence of its effectiveness
Improving care by using patients' feedback in the NHS: NIHR research review features Primary Care Unit research
Prize-winning thesis by University Lecturer Anna Spathis tackles cancer-related fatigue amongst children and young adults
St Luke's Hospice PhD studentship, 6 Jan 2020 deadline


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È il padre dello scrittore Jonathan Littell. Attualmente vive in Francia.

Littell ha scritto diversi romanzi, specializzandosi in spy-story ove affronta tematiche legate alla CIA ed all'Unione Sovietica. Nel 2009 ha pubblicato il romanzo L'epigramma a Stalin, dedicato al poeta russo Osip Ėmil'evič Mandel'štam, morto nel 1938 in Siberia durante le purghe staliniste.

Opere

Romanzi
 The Defection of A. J. Lewinter (1973)
 L'inutile gioco, Garzanti, 1974
 Sweet Reason (1974)
 The October Circle (1975)
 Mother Russia (1978)
 The Debriefing (1979)
 The Amateur (1981)
 The Sisters (1986)
 La scuola del vasaio, Mondadori, 1987
 The Revolutionist (1988)
 Il rivoluzionario, Mondadori, 1989
 The Once and Future Spy (1990)
 La spia dai due volti, Sperling & Kupfer, 1992
 An Agent in Place (1991)
 The Visiting Professor (1994)
 Walking Back the Cat (1997)
 The Company (2002)
 The Company, Mondadori, 2004
 Legends (2005)
 L'oligarca, Fanucci, 2009
 Vicious Circle (2006)
 I figli di Abramo, Fanucci, 2011
 The Stalin Epigram (2009)
 L'epigramma a Stalin, Fanucci, 2010
 Young Philby (2011)
 Il giovane Philby, Fanucci, 2012
 A nasty piece of work (2013)
 Una sporca faccenda, Timecrime, 2014

Note

Altri progetti

Collegamenti esterni

redpajama_set_name: RedPajamaWikipedia


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Immigrants, particularly men and youth, have been disproportionately hit by the global economic crisis that began in fall 2008 and now confront a reality of dwindling budgets for public services and immigrant integration programs, this report prepared for the BBC World Service reveals. The report, which has a particular focus on five North Atlantic countries—Germany, Ireland, Spain, the United Kingdom, and United States—finds that the unemployment gap between immigrant and native workers has widened in many places. It offers analysis of a number of trends, including the fact that some immigrant-destination countries that historically have been countries of emigration such as Ireland, Greece, and Portugal, may be reverting to earlier trends.
Overall immigration to developed countries has slowed sharply as a result of the economic crisis, bringing to a virtual halt the rapid growth in foreign-born populations over the past three decades. The number of foreign workers caught attempting to enter illegally at EU maritime borders fell by over 40 percent from 2008, 2009, and 2010, while apprehensions at the U.S.-Mexico border since 2007 have declined by almost the same magnitude.


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Last Updated: Thursday, 18 August 2005, 20:33 GMT 21:33 UK
Malaysia's Anwar wins libel case
By Jonathan Kent
BBC News, Kuala Lumpur
Mr Anwar also won damages recently for a prison beating
Malaysia's High Court has awarded former deputy leader Anwar Ibrahim $1.2m in damages over a pamphlet that hastened his downfall in 1998.
The pamphlet, Fifty Reasons Why Anwar Ibrahim Cannot Be Prime Minister, included allegations that Mr Anwar was corrupt and a homosexual.
When Mr Anwar launched this libel suit he was still deputy prime minister.
In the time it's taken to settle the case, he was sacked, and imprisoned for six years for corruption and sodomy.
The latter conviction was eventually overturned and he was released from jail a year ago.
After seven years, the High Court has finally ruled that the claims in the pamphlet were very vicious and very serious.
The damages, said the judge, Hishamuddin Yunus, were unusually high to reflect the gravity of the allegations and the lack of an apology.
Hand strengthened
The author, Khalid Jafri, is critically ill in a Kuala Lumpur hospital.
He is currently on bail pending his appeal against a one-year jail term for writing the leaflet.
The pamphlet was widely circulated at the height of the political and economic turmoil that gripped Malaysia in 1998, just as some of Mr Anwar's supporters started to press for him to replace the then premier, Dr Mahathir Mohamad.
The allegations were seized on by Mr Anwar's opponents and are believed to have contributed to his arrest and prosecution.
Mr Anwar is currently barred from holding office until 2008 but this ruling can only strengthen his hand.
Anwar wins apology for beating
03 Aug 05 | Asia-Pacific
Malaysia opposition backs Anwar
03 Jun 05 | Asia-Pacific
Malaysia's Anwar Ibrahim set free
02 Sep 04 | Asia-Pacific
Country profile: Malaysia
14 Jan 05 | Country profiles
Malaysian government


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Bayern Munich vs AC Milan Preview and Line Up Prediction: Draw 1-1 at 15/2
Bayern Munich and AC Milan will play in the International Champions Cup at the Shenzhen Universiade Sports Centre on Saturday,…
AC Milan vs Borussia Dortmund Preview and Line Up Prediction: Draw 1-1 at 6/1
AC Milan and Borussia Dortmund will play in the International Champions Cup at the University Town Main Stadium on Tuesday,…
AC Milan vs Chelsea Preview and Line Up Prediction: Draw 1-1 at 11/2
AC Milan and Chelsea will play a friendly match as part of the International Champions Cup at the U.S. Bank…
Bayern Munich and AC Milan will play an International Friendly match at Soldier Field, Chicago on Thursday, 28th July. Match…
AC Milan vs Juventus Preview and Line Up Prediction: Juventus to Win 1-0 at 4/1
AC Milan and Juventus will play in the Coppa Italia Final at the Stadio Olimpico on Saturday, 21st May. Match…
NBCSN to Broadcast Champions Cup And Preseason Football Matches From US Soil
Later this month fans of Liverpool and Manchester United football teams will have the opportunity to watch these Premier league…
Champions League Betting Trends
Football fans and particularly those who enjoy betting on the Champions League will be interested in some trends which have…
Europe's Clubs Closing Last Deals, Arsenal Makes Stunning Offer for Mesut Özil Before Transfer Window Ends
Transfer Rumors: A moment before the window closes, and with 2 transfers only for this summer, both of free players,…
Madrid Sells Benzema, Özil and di María to Afford Bale and Suárez, Manchester Pushes to £28M for Fellaini
Transfer Rumors: Sold for Bale money? The Daily Mail reports that Real Madrid seems to be having a pre-bale player…
Modri?, Baines and Fellaini Transfer to Manchester United for £55 Million, Arsenal Gets Benzema for £40 Million
Transfer Rumors: According to La Parisian, PSG is still interested in Nani and will try to rush negotiations for the…


DETROIT -- Picking up right where they left off, Donald Trump, Ted Cruz and Marco Rubio barked out fresh insults at each other in a Republican presidential debate Thursday night that also featured a crude sexual reference from Trump -- and a healthy dose of policy, too.
Cruz and Rubio, who earlier had devoted considerable debate time to throwing sharp elbows at one another, were relentless in training their fire on Trump.
Rubio justified his attacks on Trump by saying the billionaire businessman had "basically mocked everybody" over the past year. Trump countered with a feint, saying he'd called Rubio a "lightweight" in the past but "he's really not that much of a lightweight."
Trump then noted that Rubio had mocked his hands as small, widely viewed as an insult about Trump's sexual prowess. Holding his hands up to the audience, Trump declared, "I guarantee you, there's no problem" in that area.
It was a jaw-dropping moment in a campaign that's been full of surprises from the beginning.
For all of the criticism and ill will, Cruz, Rubio and Kasich all said they would support Trump if he is the Republican nominee. He, too, said he would support whoever wins.
There was plenty of policy, too, as Rubio and Cruz pressed Trump aggressively on his conservative credentials, his business practices and shifting policy positions.
Trump, in short order, acknowledged his willingness to deal and be flexible when it suits his needs.
He said it was fine that Rubio had negotiated with other lawmakers on immigration policy.
He said he had changed his own mind to support admitting more highly skilled workers from overseas, saying matter-of-factly, "I'm changing. I'm changing. We need highly skilled people in this country."
And he also was matter of fact about providing campaign contributions to leading Democrats, including 10 checks to Hillary Clinton, reviled by many conservatives.
Trump said it was simply business.
"I've supported Democrats and I've supported Republicans, and as a businessman I owed that to my company, to my family, to my workers, to everybody to get along," he said.
When moderator Megyn Kelly told Trump his shifts caused some people to question his core, Trump insisted: "I have a very strong core. I have a very strong core. But I've never seen a successful person who wasn't flexible, who didn't have a certain degree of flexibility."
John Kasich sought to turn Trump's statement on the value of "flexibility" into a character question. When the Ohio governor meets with voters, he said, "you know what they really want to know? If somebody tells them something, can they believe it?
The bad blood among the candidates flowed freely.
Cruz, poking fun at Trump for interrupting, told the businessman, "Breathe, breathe, breathe."
Rubio chimed in, "When they're done with the yoga, can I answer a question?"
In one particularly sharp exchange, Rubio renewed his criticisms of Trump University, which charged students $1,495 each for seminars that would teach them the billionaire's secrets to making it big in real estate. A lawsuit filed by the New York attorney general claims the classes fell so short of promises that it amounted to fraud.
"He's trying to do to the American voters what he did to the people that signed up for this course," Rubio declared. "He's trying to con people into giving him their vote just as he conned those people."
Cruz, tag-teaming on the issue, saying, "If we nominate Donald, we're going to spend the fall and the summer with the Republican nominee facing a fraud trial,"
Trump was dismissive, saying: "It's a minor civil case. Give me a break."
And he turned the tables, saying Rubio is "the real con artist." He said the first-term senator "scammed the people of Florida" by skipping a high number of votes while running for president.
In another exchange, Rubio faulted Trump's businesses for manufacturing clothing in China and Mexico rather than the U.S.
Trump retorted, "This little guy has lied so much about my record."
Asked when he would start making more clothes in the U.S., Trump said that would happen when currency valuations weren't biased against manufacturing garments in America.
Cruz, too, took the fight to Trump, accusing him of being "someone who has used government power for private gain."
"For 40 years, Donald has been part of the corruption in Washington" that people are angry about, Cruz said, citing Trump's campaign contributions to leading Democrats, including then-Sen. Clinton.
Trump piled more insults, too, on the party's 2012 presidential nominee, Mitt Romney, who earlier Thursday made a rare public appearance to denounce Trump as "a phony" who is "playing the American public for suckers."
Trump dismissed Romney as "a failed candidate" and an "embarrassment."
"Obviously, he wants to be relevant," Trump said dismissively.
Thursday's debate was the first time he faced questioning from Kelly since the two clashed in the first primary debate. That's when Kelly's tough questioning about Trump's treatment of women blew up into a running argument between Fox and the candidate.
Trump signaled he was ready for a truce. When Kelly posed her first question to him, Trump told her "you're looking well. You're looking well."
With Ben Carson's exit from the race this week, the field of Republican candidates has now been narrowed to four, but any number of predictions that GOP voters would unite behind one anti-Trump candidate have come and gone without a change in the overall dynamic.
Trump, with 10 state victories, leads the field with 329 delegates. Cruz has 231, Rubio 110 and Kasich 25. It takes 1,237 delegates to win the Republican nomination for president.
-- Benac reported from Washington.


Full-service event marketing and public relations agency mdg has been purchased by Freeman, an international brand experience company with headquarters in Dallas, Texas. The acquisition is part of an overarching strategy that allows Freeman to serve its clients more holistically and streamlines the customer journey, from pre-event marketing, to the onsite user experience, to post-show communications based on data-informed insights.
mdg will continue operating as its own independent business unit within Freeman, giving the agency the freedom and autonomy to serve all event organizers, regardless of their existing relationship to Freeman. Over the next several months, however, integration specialists will begin building processes and service offerings that will facilitate the delivery of messaging, content and experiences based on online and onsite behavioral insights. These processes include the unification of strategic planning with campaign performance modeling, benchmarking, optimization and reporting.


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Nová sladovna je minipivovar a restaurace v opavském nákupním centru Breda & Weinstein. Pivovar byl slavnostně otevřen 13. prosince 2013 a navazuje na dlouholetou tradici opavského pivovaru. Ve stálé nabídce zde zákazníci najdou tři druhy piva a výběr pivních koktejlů, při různých příležitostech jsou k dostání také speciální druhy piv.

Pivo se zde vaří výhradně z českých surovin (žateckého chmele a místní vody), bez umělých náhražek.

Druhy piva

Stálá nabídka

 Opavský Škopek 10°
 Opavský Zlaťák 12° – světlý
 Opavský Čert 12° – tmavý

Odkazy

Reference

Externí odkazy
 Oficiální stránky pivovaru
 Historie pivovaru Nová Sladovna
 Katalog pivních tácků pivovaru Nová Sladovna

Nová Sladovna
České pivovary
Firmy v Opavě
Firmy založené roku 2013
Stavby ve Městě (Opava)


Canadians want action on climate change. We agree that we need to do more. We know that we must quickly lower our greenhouse gas emissions (GHGs). And there is general consent that pricing carbon is the best way to reduce Canada's GHGs. Putting a price on pollution should be a no-brainer.
And so, why are governments that impose a price on carbon under fire? And why will carbon pricing be a hot issue in this year's federal election? The many myths about carbon pricing may be one of the problems as shown in the following video.
According to the EcoFiscal Commission, "carbon pricing is a practical, meaningful and fair way to reduce the pollution that is destabilizing our climate and threatening our health." But there are a lot of myths about carbon pricing. Here's more on the top 3 myths.
Myth #1: Carbon pricing will cost Canadian families.
Fact: People pay attention to prices every day. Carbon pricing will make it more expensive to pollute. And if you pollute more, you'll pay more. That's fair. But it's only half the story. Governments are using the revenues to make the transition to a cleaner economy affordable. For example, some governments are returning money directly to households.
Myth #2: Carbon pricing hurts jobs.
Fact: Carbon pricing changes what we buy, and this changes the kinds of jobs we need, not the number of jobs we have. Governments are helping with training programs for people to transition into this cleaner economy—like Alberta has done with coal communities.
Myth #3: Big polluters are getting a big break.
Fact: Like households, large emitters pay a carbon price on their emissions. This gives them a strong incentive to innovate and shrink their footprint. They also get support, which is designed to protect jobs and investment. Our economy will get cleaner, not smaller. And putting a price on carbon has many advantages. It should be a key part of Canada's efforts to address climate change.


This beauty makes a great addition to your kitchen or bathroom while also being functional and sustainable. Iconic colorblocking complements the beauty of any home while window shows when soap or lotion is low.
Hand Wash: Products like this do best with a thorough wash in warm, soapy water. Just let it dry thoroughly before using and you'll be ready to go.


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League Cup: Aubameyang scores hat-trick as Arsenal thrash West Brom 6-0
Arsenal's Gabonese striker Pierre-Emerick Aubameyang celebrates scoring his team's first goal during the English Premier League football match between Bournemouth and Arsenal at the Vitality Stadium in Bournemouth. Photo: AFP
Pierre-Emerick Aubameyang hit a hat-trick to lift the gloom around troubled Arsenal in a 6-0 rout of West Bromwich Albion in the League Cup second round on Wednesday.
Beaten by Brentford and Chelsea in their first two Premier League games, Arsenal arrived at the Hawthorns in turmoil after their worst ever start to a season.
Mikel Arteta's side were booed off following Sunday's 2-0 home defeat against Chelsea, with a group of supporters surrounding the Arsenal manager's car and chanting for him to quit as he drove away from the stadium.
Against that miserable backdrop, Arteta could not afford a defeat against Championship promotion chasers West Brom, who rested their entire first team and fielded a side with seven debutants.
Fortunately for Arteta, Aubameyang was able to make his first start this season after recovering from the coronavirus.
Aubameyang scored Arsenal's first two goals of the campaign before Nicolas Pepe and Bukayo Saka netted.
The Gabon forward completed his treble just after the hour and Alexandre Lacazette added the sixth.
It won't buy Arteta much breathing space however as this weekend they face a daunting trip to Premier League champions Manchester City, where Arteta worked as Pep Guardiola's assistant before joining Arsenal.
Losing to City would pile more pressure on Arteta, who has pleaded with Arsenal's fans to back the team during a difficult period he describes as "unprecedented" in the club's history.
Amid reports former Inter Milan boss Antonio Conte is being lined up to replace Arteta if results don't improve in the next five games, he desperately needed a morale-boosting victory against Albion.
There was no lack of support for Arteta from Arsenal's sizeable support in the midlands and, for once, his players delivered as well.
– Dynamic Aubameyang –
Having failed to qualify for Europe, Arsenal were forced to enter the League Cup in the second round for the first time since 1995.
The north Londoners hadn't suffered a second round defeat in the competition since 1978 and they kept that run intact.
Tottenham vs Arsenal: London derby postponed as COVID-19 hits Gunners' squad
AFCON: Arsenal's Aubameyang misses Gabon vs Ghana over heart issues
Arsenal's Lacazette wins Premier League Goal of the Month award
Arsenal looked vulnerable early on and it took a fine save from Aaron Ramsdale, making his debut after his move from Sheffield United, to keep out Taylor Gardner-Hickman's low strike.
Adam Reach fired narrowly wide of the far post from the resulting corner, but Arsenal were gifted the lead in the 17th minute.
Woeful Albion defending on the edge of their own area presented the ball to Saka and when his stinging effort was pushed out by Alex Palmer, Aubameyang was on hand to tap into the empty net.
Arsenal had too much experience for Albion's callow youngsters and their captain struck again in the 45th minute.
Pepe beat the offside trap and when his shot hit the post, Aubameyang was waiting to slot home from close-range.
Pepe bagged Arsenal's third seconds before the interval, the Ivory Coast winger stretching to score from four yards after Aubameyang's shot was saved.
Saka made it four in the 50th minute with a sweeping finish from Martin Odegaard's backheeled pass.
Aubameyang sealed his third Arsenal hat-trick in the 62nd minute when he curled into the far corner from the edge of the area.
Lacazette came on for his first appearance this season and rifled home from Pepe's 69th minute cross.
Southampton crushed fourth tier Newport 8-0, with Mohamed Elyounoussi scoring a hat-trick in the biggest away win in the club's 136-year history.
Burnley beat Newcastle 4-3 on penalties after a 0-0 draw at St James' Park.
Tags: Arsenal League Cup


The International Society for Magnetic Resonance in Medicine (ISMRM) is a multi-disciplinary nonprofit association that promotes innovation, development, and application of magnetic resonance techniques in medicine and biology throughout the world. We are a community made up of clinicians, physicists, engineers, biochemists, and technologists- professionals united by a common interest in the ongoing dialogue between the scientific and clinical communities.
Our colleagues, Prof. Destrieux and Dr. Zemmoura (Team Imaging, Biomarkers, Therapy) showed their collaborative research project with Prof. Poupon (Neurospin/CEA) on Post-mortem mapping of cortical layers using combined multicompartmental relaxometry and diffusometry at ultra-high field (7T and 11.7T): The human cerebral cortex has a laminar structure presenting distinct cell organization and myelination. In this work, we compare the lamination observed from multicompartmental quantitative relaxometry- or diffusometry-based microstructural ultra-high field MRI on a post-mortem human brain visual cortex sample. This study reveals that the quantitative intra-neuritic volume fraction map provides a better delineation of the line of Gennari in the primary visual cortex whereas multicompartment T1 relaxometry provides a better segmentation of the superfical layers. Thus, this study strongly plays in favour of a combination of relaxometry and diffusometry methods to robustly map the cortex lamination in humans.


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Lean Six Sigma Green Belt methodology is used to solve complex business problems in a streamlined and efficient manner. Many different professions utilize this method to improve their processes and overall business performance. Our noncredit certificate program presents the five elements of the DMAIC model in detail – Define, Measure, Analyze, Improve, and Control – and concludes with a series of competency exams.
Students who successfully complete the program are eligible to transition to BMGI Consulting, an international Six Sigma Consulting firm, to complete the Green Belt Certification process .
Students who successfully complete our Lean Six Sigma Green Belt Certificate Program (noncredit) can transition to BMGI, an international Six Sigma consulting firm, to complete the Green Belt certification process .