text:
http://caselaw.4ipcouncil.com/german-court-decisions/lg-dusseldorf/tagivan-mpeg-la-v-huawei-district-court-landgericht-dusseldo
Notification of infringement Comparable agreements Recognised commercial practice Patent pools Obligations of SEP holder and alleged infringer (Huawei Obligations) Huawei framework Abuse of market power Willingness Relevant market Non-discrimination Implementer's counter-offer Provision of security Royalty stacking
The Claimant, Tagivan II LLC, holds a patent essential to the practice of the AVC/H.264 standard concerning the compression of video data (Standard Essential Patent, or SEP). The patent in question is subject to a FRAND commitment (FRAND stands for Fair, Reasonable and Non-Discriminatory terms and conditions) made towards the relevant standardisation body. It was included into a patent pool administered by MPEG LA LLC (MPEG LA), comprising more the 5,000 patents referring to the AVC/H.264 standard (MPEG LA pool) [1] .
The Defendant, a German subsidiary of a Chinese group of companies, sells – among other things – mobile phones in Germany that practise the AVC/H.264 standard [2] .
MPEG LA uses a standard licensing agreement, which is publicly available at its website [3] . Since 2004, MPEG-LA has signed approx. 2,000 agreements with implementers [4] , 1,400 of which are still in force [3] .
In 2009, MPEG LA and the Defendant's parent company (parent company) started discussions about a potential licence covering other standards, especially the MPEG-2 standard. On 6 September 2011, MPEG LA informed the parent company about the possibility to obtain a licence also regarding the AVC/H.264 standard, by sending PDF-copies of its standard licensing agreement to the parent company via email [5] . On 15 September 2011, the parent company suggested to arrange a call on this issue [6] . In February 2012, MPEG LA sent the pool's standard licensing agreement for the AVC/H.264 standard to the parent company also by mail [7] .
In November 2013, the discussions between MPEG LA and the parent company ended without success [8] . The parties resumed negotiations in July 2016; again, no agreement was reached [8] .
The Claimant then brought an action against the Defendant before the District Court of Düsseldorf in Germany (Court), requesting for injunctive relief, information and rendering of accounts, the destruction and the recall of infringing products as well as for a declaratory judgement confirming Defendant's liability for damages on the merits [9] .
In November 2017, during the course of the present proceedings, the Defendant made a counteroffer to the Claimant for a licence, which – in contrast to MPEG LA's standard licensing agreement – was limited to the Claimant's patent portfolio and established different royalty rates for different regions, in which the Defendant sold products [10] .
In March and September 2018 (again during the proceedings), the Defendant provided bank guarantees to the Claimant covering past and future sales of (allegedly) infringing products. The security amounts were calculated based on the Defendant's counteroffer dated November 2017 [11] . Furthermore, the Defendant made a second counteroffer to the Claimant shortly after the last oral hearing before the Court [12] .
The Court found that the patent in suit was valid [13] , standard essential [14] and infringed by the products sold by the Defendant in Germany [15] . Furthermore, the Court held that by filing the present suit the Claimant did not abuse its dominant market position in violation of Article 102 of the Treaty for the Functioning of the EU (TFEU), since it had fully complied with the conduct obligations stipulated by the Court of Justice of the EU (CJEU) in the matter Huawei v ZTE [16] (Huawei obligations or framework) with respect to dominant undertakings [17] .
The Court found that the Claimant holds a dominant market position in terms of Article 102 TFEU [18] .
The Court defined the relevant market for the assessment of dominance as the market, in which licences for any given patent are offered [19] . A dominant market position can further also exist, when the patent holder can hinder competition in downstream markets for standard-compliant products and services [19] .
The Court made clear that ownership of a SEP does not per se establish market dominance [20] . A dominant market position is given, when the use of the SEP is required for entering the market [21] . The same is true, if the patent user could not market competitive products or services, without access to the respective SEP [22] .
Based on these considerations, the Court saw no 'reasonable' doubt that the Claimant was a dominant undertaking: It was undisputed that almost all mobile phones available worldwide use the AVC/H.264 standard and that no 'realistic' alternative to the MPEG LA pool existed in the licensing market for patents essential to this standard [23] .
The Court found, however, that the Claimant did not abuse its dominant position by suing the Defendant in the present case, since its conduct was in line with the Huawei framework [24] . The Huawei framework establishes mutual conduct obligations for both SEP holders and SEP users, which need to be fulfilled step by step and one after another (meaning that each party's obligation to act arises only after the other party has fulfilled its own obligation) [25] . Subject to the Huawei framework is not only the patent holder's claim for injunctive relief, but also the claim for the destruction of infringing products [26] .
In this context, the Court pointed out that the Huawei framework applies, irrespective of whether a 'well-established' licensing practice concerning the asserted patents already existed before the CJEU delivered the Huawei judgment, or not [27] . The Claimant had argued that, in the present case, the Court should apply the (German) legal standard that preceded the Huawei framework (which was based on the so-called 'Orange-Book-Standard' ruling of the Federal Supreme Court [28] ), since with respect to the SEP in suit a 'routine' practice already existed prior to the Huawei judgement. The Court explained that the Huawei judgment does not contain either an explicit or an implicit limitation of its scope of application [29] . Furthermore, even if a 'well-established' licensing practice existed, the need to apply the Huawei framework will still be given, in order to bridge the, nevertheless, existing information gap between patent holder and implementer concerning the (potential) infringement of SEPs [30] . Finally, it would be very challenging for courts to distinguish whether a 'well-established' licensing practice excluding the application of the Huawei framework is at hand, or not [30] . Notwithstanding the above, according to the Court, the actual licensing practice of the patent holder could be of 'particular significance' when assessing the compliance of the latter with the Huawei obligations: Such practice could, for instance, serve as an indicator of the appropriateness of SEP holder's licensing offer to the implementer [31] .
The Court ruled that the Claimant had adequately notified the Defendant about the infringement of the SEP in suit through the email sent by MPEG LA to the parent company on 6 September 2011 [32] .
The fact that this email was not addressed to the Defendant, but to the parent company, did not raise any concerns as to the compatibility of the notification with the Huawei framework. The Court explained that a notification of infringement addressed only to the parent company of a group of companies is sufficient, as far as it can be assumed that the notification will be forwarded to the subsidiaries concerned [33] . The sole fact that a company belongs to a group justifies such an assumption, unless indications to the contrary exist [34] . This was, however, not the case here.
Besides that, the Court did not consider it inappropriate that the aforementioned e-mail was not sent to the parent company by the Claimant, but by MPEG LA (which is not the holder of the SEP in suit) [35] . The Court held that MPEG LA is entitled to perform legal actions in connection with the licensing of the MPEG LA pool on behalf of the Claimant. The Defendant could not contest that this was not the case, since MPEG LA's standard licensing agreement, which it is aware of, contains an indication about MPEG LA's respective capacity [36] . In addition, the Defendant's parent company was most likely aware of MPEG LA's capacity to act on behalf of the Claimant, since it had entered into direct negotiation with MPEG LA already in 2009, that is almost two years prior to the notification of infringement [37] .
The Court further ruled that, in terms of content, a notification of infringement must – at least – name the infringed patent (including the patent number) and indicate the contested embodiments as well as the (allegedly) infringing acts of use [38] . A detailed (technical and/or legal) explanation of the infringement is not required; the implementer needs just to be put in the position to assess the infringement allegations, if necessary, by seeking expert advice [38] . A notification of infringement is, therefore, not necessary, when it constitutes just a 'pointless formality' [38] . This is true, when according to the overall circumstances of the case, one can safely assume that the implementer is aware of the infringement, so that claiming that the SEP holder failed to provide adequate notification prior to the initiation of court proceedings would appear to be abusive [38] . The respective test is, however, subject to strict conditions [38] .
Based on the above considerations, the Court found that MPEG LA's email to the parent company dated 6 September 2011 should be considered – as an exception – to constitute a sufficient notification of infringement, although it did not contain the minimum information required (particularly the patent number and a reference to the specific infringing embodiments) [39] . The overall circumstances of the case (especially the fact that the parent company had been in negotiations with MPEG LA already since 2009 and, therefore, should have been aware that MPEG LA has granted licences for the AVC/H.264 standard to the implementers mentioned at its website), give rise to the assumption that the parent company had been conscious of the fact that AVC/H.264-compliant products need to be licensed [40] .
The Court held that the parent company had adequately expressed its willingness to obtain a FRAND-licence through the email sent to MPEG LA on 15 September 2011 [41] .
In the eyes of the Court, this email indicates the parent company's intention to deal with issues concerning the licensing of patents referring to the AVC/H.264 standard, especially if it is seen in the context of the negotiations between MPEG LA and the parent company that had commenced in 2009 [41] . This is sufficient under the Huawei framework: A general, informal statement suffices [42] . The implementer is not required to refer to a specific licensing agreement (on the contrary, this could be considered harmful under certain circumstances) [42] .
The Court further found that the standard licensing agreement sent by MPEG LA to the parent company in February 2012 presents an offer accountable to the Claimant which is in line with the Huawei framework in terms of both form and content [43] .
The fact that the standard licensing agreement was not tailored to the parent company but was designed for use towards a large number of (potential) licensees (the name of the licensee ought to be added in each case separately), was not criticized by the Court. MPEG-LA had made clear that the documents sent by mail in February 2012 would serve as the basis for negotiations and a future agreement with the parent company [44] .
In addition, the Court did not take an issue with the fact that the offer was addressed to the parent company and not to the Defendant, since the parties were discussing about a licensing agreement on group level and the parent company had been involved in the communications from the beginning [45] .
The Court further ruled that the Huawei requirement, according to which the SEP holder's licensing offer must specify the royalty calculation, was met, although the draft standard licensing agreement sent to the parent company did not contain a detailed explanation of the way the royalties were calculated [46] . The Court found that, in the present case, it was sufficient that the parent company was aware that the (standard) agreement presented to her had been accepted in the market by a great number of licensees [47] . In the Court's view, the explanation of the royalty calculation does not require a 'strict mathematical derivation' of the royalty; moreover, it will, as a rule, suffice to demonstrate that the (standard) royalty rates offered have been accepted in the market by presenting existing licensing agreements with third parties (comparable agreements) [48] . If a sufficient number of comparable licences is presented, then the SEP holder will usually not be required to provide further information regarding the appropriateness of its licensing offer [48] . It will need, however, to provide information on all essential comparable agreements, in order to rule out the risk that only agreements supporting the offered royalty level are presented [48] . In this context, the Court noted that it cannot be required from the SEP holder to present all comparable agreements along with the licensing offer to the implementer; a respective industry practice does not exist [49] .
Apart from the above, the Court held that the standard licensing agreement offered to the parent company was FRAND also in terms of content [50] .
According to the Court, a licensing offer cannot be considered as fair and reasonable, if the patent holder requests royalties that go significantly beyond the (hypothetical) price that would have been formed in an effectively competitive market, unless there is a commercial justification for the royalty level requested [51] . Particularly in connection with the licensing of SEPs, an offer can lie outside the FRAND-scope, if the cumulative royalty burden imposed on the implementer would not be tenable in commercial terms [51] . The Court made clear that, in this context, no exact mathematical derivation of a FRAND-conform royalty rate is required; moreover, an approximate value is to be determined based on assessments and estimations [51] . In this respect, comparable agreements can serve as an 'important indicator' of the fair and reasonable character of the offered royalty rates [51] .
Regarding to the non-discriminatory element of FRAND, the Court pointed out that it applied only to similar situated cases [52] . Even then, an unequal treatment is allowed, as long as it is objectively justified [52] . Limitations may, nevertheless, occur, especially when the implementation of the patent is necessary for entering a downstream market or when a product becomes competitive, only when it uses the patent's teachings [52] . As a rule, the burden of proof with respect to the discriminatory character of a licensing offer rests on the implementer. Since the latter will usually not be aware of the existence or the content of comparable agreements of the patent holder, it may, however, seem appropriate to request the patent holder to provide the implementer with respective details, as far as this is reasonable [53] . The information to be shared should cover all existing licensees and include which (concretely designated) company with which importance in the relevant market has obtained a licence on which conditions [53] .
Against this background, the Court found that the offer made by MPEG LA to the parent company was not discriminatory. The Defendant had argued that seeking a licence also covering sales in China violated FRAND, since not every other competitor in the Chinese market was licensed by MPEG LA [54] . The Court observed that the selective assertion of patents against only a part of the competitors in a downstream market might, in principle, be discriminatory [55] . This was, however, not the case here, because the Claimant had already sued another company active in China and was attempting to persuade other companies to obtain a licence [56] . Due to the high cost risk associated with court proceedings, the patent holder is not obliged to sue all potential infringers at once; choosing to assert its patents against larger implementers first was considered by the Court as reasonable, since a win over a large market player could motivate smaller competitors to also obtain a licence (without litigation) [57] .
Furthermore, the Court did not consider the fact that the offered standard licensing agreement contained a cap for the annual licensing fees payable to the MPEG LA pool to be discriminatory [58] . The Defendant had argued that the respective cap disproportionally favoured licensees with high volume sales which offered not only mobile phones, but also other standard compliant products in the market. The Court made, however, clear that Art. 102 TFEU does not establish a 'most-favoured-licensee' principle (meaning that the patent holder must offer the same conditions to all licensees) [59] . It is not per se discriminatory to use sale volumes as a criterion for discounts, especially if a company has managed to open up a larger market than its competitors [60] . Discounts can further hardly be discriminatory, if they are offered to every (potential) licensee under the same conditions [60] .
Besides that, the Court dismissed the Defendant's argument that MPEG LA's standard licensing agreement is discriminatory, because it is offered to both MPEG LA pool members and third licensees. The Court found that the share of the licensing income paid to pool members, who have also signed a MPEG LA licence, reflects their contribution to the pool and, therefore, does not discriminate the latter against third licensees (who have not contributed any patents to the pool) [61] . In this context, the Court also pointed out that the clauses contained in MPEG LA's standard licensing agreement, providing for deductions or instalment payments are not discriminatory, particularly because they are offered to all licensees [62] .
The Court was further not convinced that the parent company was discriminated by MPEG LA's offer, because the MPEG LA pool had refrained from requesting a licence at group level from a competitor, but had only granted a licence to a subsidiary within the respective group, instead. In the Court's eyes, the Claimant had managed to establish that this exception was objectively justified, since only the subsidiary granted a licence had activities concerning the patents included in the pool [63] .
With respect to the assessment of whether MPEG LA's offer to the parent company was also fair and reasonable, the Court placed particular emphasis on the existing licensing agreements between the MPEG-LA pool and third licensees. The Court took the view, that existing licences can establish the actual presumption that the terms offered (as well as the scope of the licence) are fair and reasonable [64] . Moreover, the fact that licences regarding the same patent portfolio have already been granted for similar products prima facie suggests that the selection of the patents included in the pool was adequate [64] .
Based on these premises, the Court found that the approx. 2,000 standard licensing agreements concluded by the MPEG LA pool provide a 'strong indication' ('erhebliche Indizwirkung') that the underlying licensing terms are fair and reasonable [65] . In the Court's view, the Defendant had failed to show sufficient facts that could rebut this indication.
In particular, the Court did not accept Defendant's claim that, as a rule, licences for products sold in the Chinese market are subject to special conditions. On the contrary, the Court found that the existing MPEG LA pool licences allow the assumption that setting worldwide uniform licence fees corresponds to industry practice [66] . Accordingly, the Court rejected Defendant's argument, that the royalties offered by MPEG LA to the parent company would hinder the Defendant from making profits with its sales in China, since the overall licensing burden (including licences needed from third parties) would be too high. The Court noted that the price level for Defendant's sales in China does not significantly differ from the price level in other regions [67] . What is more, the Defendant did not show that further licences are needed with respect to the AVC/H.264 standard [68] . The Court further did not recognise a need to apply special conditions for the Chinese market, because – compared to patents from other regions – a lower number of Chinese patents is contained in the MPEG LA pool. According to the Court, the number of patents in a specific market should not be 'overestimated' as a factor for assessing the FRAND conformity of an offer, since even a single patent can block an implementer from a market, generating, therefore, the need for obtaining a licence [69] .
Apart from the above, the Court did not criticise that MPEG LA's standard licensing agreement did not contain an adjustment clause. Such clauses can secure that the agreed licensing fees remain reasonable, in case that the number of patents contained in the pool changes during the term of the licensing agreement. They are, however, in the Court's view, not the only mean to reach this goal: Moreover, the clause contained in MPEG LA's standard licensing agreement, according to which the agreed royalties will not be adjusted either when more patents are added to the pool or when patents are withdrawn from the pool, offers an adequate balance of risk and is, therefore, FRAND compliant [70] . This assumption is also confirmed by the fact that all existing licensees have accepted this clause [71] .
In addition, the Court made clear that pool licences, as the one offered to the parent company, are, in general, appropriate under the Huawei framework. An offer for a pool licence cannot per se be seen as abusive (Article 101 TFEU) [72] . On the contrary, such licences usually serve the interest of potential licensees to be granted access to the whole standard on uniform conditions under one roof, without having to seek a licence from every single patent holder separately [72] .
An offer for a pool licence can, nevertheless, violate FRAND in 'special circumstances' [73] , for instance, if not all patents included in the pool are used by the licensee [74] . According to the Court, the fact that the Defendant – as well as mobile phone manufacturers in general – usually use only one of four available profiles of the AVC-Standard does not, however, render the standard licensing agreement offered by MPEG LA unreasonable [75] . This is particularly the case, since Defendant's products – and especially its latest smartphones – have the technical capability to implement more than one available profile [76] . Besides that, it is reasonable to offer one single licence covering all profiles, since modern products incorporate functionalities of several types of devices (e.g. smartphones offer also digital television functionalities) [76] .
In this context, the Court dismissed Defendant's arguments that the licence offered by MPEG LA was not FRAND, because it allegedly covered both standard-essential and non-essential patents. The Court recognised that the 'bundling' of essential and non-essential patents in a patent pool could, in principle, be incompatible with FRAND, if it is done with the intention to extract higher royalties from licensees by increasing the number of patents contained in the pool [77] . The Defendant failed, however, to present any reliable evidence that this was the case with the MPEG-LA pool [78] .
In the Court's eyes, the Defendant also failed to establish that the rates offered by MPEG LA would lead to an unreasonably high total burden of licensing costs ('royalty stacking') [79] . The theoretical possibility that the Defendant might need to obtain licences also for patents not included in a pool does not per se lead to royalty stacking; the Defendant would have been obliged to establish that the total amount of royalties actually paid does not allow to extract any margin from the sale of its products [80] .
The Court further pointed out that MPEG-LA's offer did not violate FRAND principles, because it referred to a licence covering all companies within the group, to which the Defendant belonged [81] . In the electronics and mobile communications industries, licences on a group level are in line with the industry practice and, therefore, FRAND-compliant [82] .
Having said that, the Court found that the Defendant failed to make a FRAND counteroffer [83] .
In particular, the counteroffer made in November 2017 after the commencement of the present proceedings violated the FRAND principles in terms of content, because it was limited to a licence covering solely the Claimant's patent portfolio and not all patents included in the MPEG LA pool [84] . Furthermore, the counteroffer established different licensing rates for different regions (especially for China) without factual justification [85] .
Furthermore, the second counteroffer made by the Defendant after the end of the last oral hearing was belated and, therefore, not FRAND. The Court held that the Claimant was not given sufficient time to respond to that counteroffer, so that there was no need for any further assessment of its content [12] . On the contrary, the Court expressed the view that the purpose of this counteroffer was most likely to delay the infringement proceedings [12] .
Since Defendant's counter-offers were not FRAND in terms of content, the Court did not have to decide, whether the security provided in form of bank guarantees was FRAND or not. The Court noted, however, that the amounts provided were insufficient, since they were calculated on basis of Defendant's counteroffer from November 2017, which itself failed to meet the FRAND requirements [86] .
[1] Tagivan (MPEG-LA) v Huawei, District Court of Düsseldorf, 9 November 2018, para. 36.
[4] Ibid, para. 453.
[9] Ibid, para. 2.
[13] Ibid, paras. 143-208.
[16] Huawei v ZTE, Court of Justice of the European Union, judgment dated 16 July 2015, Case No. C-170/13.
[17] Tagivan (MPEG-LA) v Huawei, District Court of Düsseldorf, 9 November 2018, paras. 304 et seqq.
[20] Ibid, para. 310. In this respect, the Court pointed out that – vice versa – also a non-essential patent might confer a dominant position, if the patented invention is superior in terms of technological merit and/or economical value, para. 312.
[23] Ibid, paras. 315 et seqq.
[28] Under the 'Orange-Book-Standard' regime, in order to avoid an injunction, the implementer was required to make a licensing offer to the patent holder, which the latter could not refuse without acting in an anticompetitive manner; see Federal Supreme Court (Bundesgerichtshof), judgment dated 6 May 2009, Case No. KZR 39/06.
[70] Ibid, paras. 591 et seqq., particularly para. 596.
[71] Ibid. para. 597.
[75] Ibid. paras. 511 et seqq.


text:
\section*{References}

\section{Acknowledgement}
\label{sec:Acknowledgement}

The authors are indebted to Dr. S. Yennello for attention to the work and permanent support and to Dr. Lee Sobotka for reading the draft, for valuable comments and the discussion.
This work was supported in part by the Russian Science Foundation [grant number 17-12-01367].

Authors also acknowledge financial support from the Nazarbayev University [small grant
number 090118FD5346] and the Ministry of Education and Science of the Republic of
Kazakhstan [state-targeted program number BR05236454].

This work was supported by the U.S. Department of Energy, Office of Science, Office of Nuclear Science [award number DE-FG02-93ER40773] and by National Nuclear Security Administration through the Center for Excellence in Nuclear Training and University Based Research (CENTAUR)[grant number DE-NA0003841].
G.V.R. is also acknowledge the support of the Welch Foundation [grant number A-1853].

\section{Conclusion}
\label{sec:Conclusion}

We performed the first measurements of the excitation function for the ${}^{13}\mathrm{C}(\alpha,n)$ reaction at 180${}^\circ$ $c.m.$ using TTIK method.
The excitation function was obtained in the $c.m.$ energy interval 1.7-2.6~MeV with energy resolution of $\sim$60~keV which is mainly defined by the width of the cyclotron beam burst and the neutron detector resolution.
The obtained excitation function is in general agreement with an old measurement in the backward hemisphere \cite{WALTON1957}.
However, the present results are in evident disagreement with a comprehensive fit \cite{HEIL2008} used to predict the ${}^{13}\mathrm{C}(\alpha,n)$  reaction rate needed for astrophysics.
We believe that the simplicity and high efficiency of the present approach will result in various applications.
In particular, it can be used for detection of $\gamma$-rays distributed in time according to resonant interaction of low energy heavy ions moving in extended target.

\section{Discussion}
\label{sec:Discussion}

The present work shows that the energy resolution in the measurements of the excitation function for ${}^{13}\mathrm{C}(\alpha,n)$ reaction by the TTIK approach depends mainly upon the time width of the beam bunch (at the chamber) and on the time resolution of the neutron detector.
Both factors can be improved and we are planning on doing so.
We believe an energy resolution of $\sim$30 keV is achievable.
However, it is the high efficiency of this new approach that is most noteworthy.
The counting statistics in the observed peaks was well over $10^5$ counts.
These data resulted from only 30 hours measurement with a beam intensity of a few nA.

The present measurements, planned as a test, revealed an interesting result.
Evidently, the new result is related with the unusual geometry.
Obtaining equivalent data with the conventional approach would require neutron measurement at angles close to 180${}^\circ$, a difficult measurement.
The physical basis of the observed discrepancy likely resides in an unaccounted for interference of one or more broad (low spin) level(s) of opposite parity.
A manifestation of such levels, if they are broad, might be attributed to a background in an analysis of forward angle data.

If this is the case, the unaccounted levels might influence the calculations for the lower excitation energy region important for astrophysics.
However, a comprehensive analysis, like that in Ref.~\cite{HEIL2008} is needed to make a reliable conclusion.

It is not easy to predict the eventual applications of the specific TTIK approach described in the present work for the first time.
(This was also the case in the original TTIK work \cite{ARTEMOV199052}.)
One might imagine that the TTIK technique described here could be used to study  ($\alpha$,n) reactions on gas targets, many of which have not been thoroughly investigated.
This is largely due to experimental difficulties of working with gas targets in the conventional geometry.
The simplicity of the TTIK approach is attractive, even more so when the reactions are induced by low-intensity secondary beams.
In such cases, each beam particle would be tracked, removing a significant source of the ultimate center-of-mass energy uncertainty.
As a final point, measurements of resonant gamma rays delayed by a movement of low-energy heavy ions in an extended target seem interesting.
For such studies $\mathrm{LaBr_3}$ gamma, with their excellent (respectable) time (energy) resolution would be a good choice for these measurements.
As the first test gamma decays accompanying neutron (or proton) decays of the resonances to an excited state of a daughter nuclei might be selected because of the expected high yield.

\section{Experiment}
\label{sec:Experiment}

The experiment was performed at the DC-60 heavy-ion cyclotron in Nur-Sultan (Kazakhstan) using beam energies of 13.0 and 14.3~MeV.
The cyclotron parameters were tuned to provide a beam bunch with optimal time resolution at the expense of beam intensity.
The beam width was about 2 ns with $\sim$0.2\% energy resolution  at a beam intensity of a few nA.
The beam parameters were controlled by monitor detectors, described below.
The experimental setup is presented on Fig.~\ref{fig:expSetup}.
The cylindrically shaped scattering chamber (15.5 cm diameter and 53.0 cm length) was made of stainless steel with a wall thickness of 0.25 cm and filled with helium of 99.99\% purity.

\begin{figure}[htbp]
\centering
\includegraphics[width=0.8\linewidth]{figures/FIG1-expSetup.pdf}
\caption{Experimental layout.}
\label{fig:expSetup}
\end{figure}

The ${}^{13}\mathrm{C}$ beam from the cyclotron entered the scattering chamber through a thin entrance window made of 1.9~$\mu$m Ti foil.
Four monitor Si detectors were mounted on a ring-shaped holder inside the chamber in order and detected the ions elastically scattered from the entrance window.
The energy of the beam decreases as it proceeds through the gas.
While in most TTIK applications the unreacted beam is stopped in the gas, in this case, to increase the travel time of heavy ions between the resonances we used lower pressure than needed to range out the beam.
At the pressure of 25 torr, the beam ions deposit about 25\% of their energy in the gas and stop in a back  flange of the scattering chamber.
If the ${}^{13}\mathrm{C}(\alpha,n)$ reaction occurs, a neutron flying forward at near $0^\circ$ will pass through the solid angle subtended by a neutron detector  36~cm downstream, behind the back flange.

The neutron detector was a stilbene crystal of cylindrical shape (8 cm diameter, 5 cm thickness) optically coupled with Photonis XP 4312/B photomultiplier.
Stilbene has an excellent n-$\gamma$ separation ability which is exploited using standard pulse-shape discrimination (PSD) techniques.
The amplitude calibration was made with ${}^{60}\mathrm{Co}$ and ${}^{137}\mathrm{Cs}$ $\gamma$-sources.
Time resolution for amplitudes exceeding 0.5~MeV (equivalent electron energy) was better than 0.5~ns (FWHM).
Fig.~\ref{fig:NeutrGamPulseShape} demonstrates the quality of PSD made with MPD-4 module (Mesytec), where the horizontal axis shows the amplitude in recoil proton energy scale.
(Conversion from the electron to recoil proton scale  bases on the data of Ref.~\cite{ZHANG2013}.)
Following Ref.~\cite{ZHANG2013}, the amplitude of 0.5~MeV in electron scale corresponds to about $\sim$2.5~MeV in proton scale.

\begin{figure}[htbp]
\centering
\includegraphics[width=0.7\linewidth]{figures/FIG2-NeutrGamPulseShape.pdf}
\caption{n-$\gamma$ pulse shape discrimination.}
\label{fig:NeutrGamPulseShape}
\end{figure}

A neutron detector spectrum is shown in Fig.~\ref{fig:NeutrAmplvsTime}.
The horizontal axis shows the neutron registration time relative to cyclotron RF and the vertical axis shows the amplitude in recoil proton energy scale.
The left (right) edge corresponds to the interaction of ${}^{13}\mathrm{C}$ near the entrance window (downstream end of the chamber).
The counts outside this interval cannot originate from the $\alpha-{}^{13}\mathrm{C}$ interaction and provide a measure of background.

\begin{figure}[htb]
\centering
\includegraphics[width=0.7\linewidth]{figures/FIG3-NeutrAmplvsTime.pdf}
\caption{(a) two dimensional $E_{p}$-T excitation function for $^{13}\mathrm{C}(\alpha,n)$ reaction and (b) projection of (a) spectrum on the X axis (see the text for explanations).}
\label{fig:NeutrAmplvsTime}
\end{figure}

In order to consider all the factors that influence the precision of the excitation function, a complete simulation of the experiment in GEANT4 toolkit was constructed.

However before employing these simulations, it is instructive to obtain qualitative estimations of the time (energy) resolution using simple considerations.
Figures \ref{fig:ElasticEandT} and \ref{fig:LowHiEnergDiff} are provided to aid in this initial effort.
One of these elementary considerations is the time dispersion of the beam ions as they reach the chamber.
This dispersion is due to the initial energy spread of ions in the beam bunch and the flight path of 10~m between extraction from the cyclotron and the scattering chamber.
Fig.~\ref{fig:ElasticEandT} shows the energy-time (E-T) spectrum of the ions scattered from the entrance window observed in a monitor detector.
It is seen in Fig.~\ref{fig:ElasticEandT} that high-energy ions reach the detector earlier than the low-energy ions.
The time difference of approximately 2~ns is in agreement with a conventional cyclotron energy resolution ($\pm$~0.25\%) and the 10~m flight path.
The energy spread of the beam after passing through the window foil, calculated from the monitor detector spectrum, should be approximately 450~keV.
The main contribution to this spread is due to the thickness nonuniformity of the entrance window, estimated to be 9\%.
\begin{figure}[htb]
\centering
\includegraphics[width=0.9\linewidth]{figures/FIG4-ElasticEandT.pdf}
\caption{Energy-time (E-T) spectrum of the ions scattered from the entrance window.}
\label{fig:ElasticEandT}
\end{figure}
For reference, and to revert to time, beam ions lose approximately 0.45~MeV in 5.5~cm of gas and they need about 4.1~ns to travel this 5.5~cm distance.
The low-energy ions of the beam reach a resonance energy earlier, while the high-energy ions need to travel a longer distance (about 5.5~cm) and deposit an extra 0.45~MeV to reach the resonance energy.
Therefore, the neutrons from the decay of the narrow resonance in the ${}^{13}\mathrm{C}(\alpha,n)$ reaction will originate with a time spread of $\sim$~(4.1 -- 2.0)~ns, with the low-energy part of the beam reaching the resonance earlier.

Finally, the neutrons from the lowest energy part should travel 5.5~cm more than those from the high-energy part to the detector at zero degrees.
This difference amounts to about 1.6~ns.
(The neutron velocities are 2.5 higher than these of the heavy ions).
Summing up these effects: The faster ions from the machine get to the chamber sooner (about 2~ns), but they have to travel further (taking about 4.1~ns more) partially compensated by the reduced neutron flight time to the $0^\circ$ detector (about 1.6~ns).
The largely compensating effects lead to only an expected 0.5~ns time spread in the Time-of-Flight (ToF) of detected neutrons from the extreme ends of the initial energy distribution.
To evaluate the overall time resolution, we should also take into account the original width of beam bunch ($\sim$2~ns), and the neutron detector resolution of $\sim$1.6~ns (mainly from the finite thickness of the neutron detector).
Considering all three as independent factors yields 2.5~ns (FWHM).
This corresponds to a center-of-mass energy resolution of $\sim$60~keV.

\begin{figure}[htbp]
\centering
\includegraphics[width=0.7\linewidth]{figures/FIG5-LowHiEnergDiff.pdf}
\caption{
Diagram of the development of time spread of neutrons from (a) (see the text for explanations) 1(2) high (low) energy ions in the bunch, (a) 1 is ahead of 2 at the entrance to the scattering chamber, (b) resonance place for 2; (b') resonance place for 1, (c) 2 is ahead of 1 in the neutron detector (see the text for additional explanations)
}
\label{fig:LowHiEnergDiff}
\end{figure}

Fig.~\ref{fig:ExtFunction180} demonstrates a combined spectrum using both the 13.0 and 14.3~MeV ${}^{13}\mathrm{C}$ measurements.
The energy resolution estimated by the FWHM resolution for the peak at 2.15~MeV $c.m.$ energy is $\sim$60~keV.
The solid line in Fig.~\ref{fig:ExtFunction180} shows R-matrix calculations with the parameters of Ref.~\cite{HEIL2008}.
The disagreement between these calculations and our measurements is evident.
Finding no obvious mistakes in either our work or that of the comprehensive work of \cite{HEIL2008}, we looked to older experimental data for additional insight.
The very old work by Walton et al. \cite{WALTON1957}, did in fact provide some insight.
These old excitation functions for the ${}^{13}\mathrm{C}(\alpha,n)$ reaction at symmetric forward and backward angles (31${}^\circ$ and 149${}^\circ$) together with R-matrix calculations with contemporary parameters~\cite{HEIL2008} are shown in Fig.~\ref{fig:ExtFunction149}.
Fair agreement is found at the forward angles but not at backward angles where the character of the disagreement is similar to that shown in Fig.~\ref{fig:ExtFunction180}.

\begin{figure}[htp]
\centering
\includegraphics[width=0.7\linewidth]{figures/FIG6-ExtFunction180.pdf}
\caption{The excitation function for the ${}^{13}\mathrm{C}(\alpha,n)$ reaction at 180${}^\circ$ c.m.
The bold curve is R-matrix calculations with parameters of Ref. \cite{HEIL2008}.}
\label{fig:ExtFunction180}
\end{figure}

\begin{figure}[!htp]
\captionsetup[subfloat]{position=bottom}
\centering
\subfloat[]{\includegraphics[width=0.7\linewidth]{figures/FIG7-ExtFunction31.pdf}}
\vfill
\subfloat[]{\includegraphics[width=0.7\linewidth]{figures/FIG7-ExtFunction149.pdf}}
\caption{The excitation functions for the ${}^{13}\mathrm{C}(\alpha,n)$ reaction at 31${}^\circ$ and 149${}^\circ$ from Ref.~\cite{WALTON1957}.
The bold curves are R-matrix calculations with parameters of Ref.~\cite{HEIL2008}.}
\label{fig:ExtFunction149}
\end{figure}

\section{Introduction}
\label{sec:intro}
About thirty years ago, one of us (V.Z.G.) proposed the Thick Target Inverse Kinematics (TTIK) method to search for $\alpha$-cluster states as scattering resonances in the interactions of heavy ions with  ${}^4\mathrm{He}$ \cite{ARTEMOV199052}.
In the TTIK technique, a beam of heavy ions is slowed in an extended helium gas target.
The light recoils, ($\alpha$-particles) are detected from a scattering event.
These recoils emerge from the beam ions-helium interaction and hit a Si detector array located at forward angles.
The beam ions are stopped in the gas, while the $\alpha$-particles, having smaller energy losses, are not.
Thus, measurement of ($\alpha$) recoil energies provides for a continuous excitation function of elastic scattering.
Due to inverse kinematics, zero degrees measurements correspond to 180${}^{\circ}$ $c.m.$ and it is at this angle that the best energy resolution can be achieved.
(In other studies, 25~keV $c.m.$ has been achieved \cite{NURMUKHANBETOVA2017125}).
Differences between the TTIK method and the classical approach are notable.
In the classical approach, using beams with well-defined energies and very thin targets, one can yield energy resolution less than 1~keV \cite{TOMPSON198042}.
However, the classical approach makes systematic fine step (commensurate the energy resolution) infeasible.
While the TTIK approach cannot compete with the classical approach in terms of energy resolution, it can provide the systematic excitation functions, which are impractical to obtain in the standard approach.
Initially, the TTIK approach has been proposed in experiments with stable beams, however, its greatest potential is for the investigations of resonance scattering induced by rare, exotic beams \cite{GOLDBERG2010307}.

The difference in the specific energy loss of a heavy ion beam and the recoils is a very important issue for the implementation of the TTIK approach.
The larger the difference, the better the resolution potentially achievable for the measurement of the excitation function.
As neutrons have no direct ionization loses, the application of the TTIK method to cases with neutrons in a final state is tantalizing.

The present work is the first application of TTIK method to measurements of excitation function of ${}^{13}\mathrm{C}(\alpha,n)$ reaction.
We used Time-of-Flight (ToF) technique (neutron detector time relative to the RF of the beam) for neutron energy measurements.
The choice of the reaction was based on the fact that the excitation functions for the ${}^{13}\mathrm{C}(\alpha,n)$ reaction have been studied at a broad range of $\alpha$-particle energies and because of the importance of this reaction for the nucleosynthetic s-process \cite{GALLINO1998}.
Additionally, our new results can be compared to a very comprehensive and recent analysis of the data relevant to this reaction, made by the Notre Dame University group \cite{HEIL2008}.
(This reference also contains a comprehensive review of previous studies.)

redpajama_set_name: RedPajamaArXiv


The behind-the-back play isn't unusual in baseball -- for infielders. But what about hitters?
The whole swing-really-hard-and-spin-in-a-circle thing isn't new for Park Suk-Min, as he's exhibited throughout his career. Like this time in 2013.
It's great to see such a strong relationship between a slugger and his bat.


The robotics market continues to experience a profound and significant restructuring as the traditional industrial robotics sector shrinks as an overall percentage of the total robotics industry. According to recent estimates from Tractica, non-industrial robots represented 70% of the $39.3 billion robotics market globally in 2017, growing from a 64% share in 2016. Most of this growth is being driven by new and expanding use cases in segments like agriculture, autonomous vehicles, consumer unmanned aerial vehicles (UAVs), warehousing, logistics, military robotics, and personal assistant robots.
Tractica's analysis indicates that there are currently 110 real-world use cases that compose the total robotics market, a significant diversification of robot applications compared to just a few years ago.
Sanders adds that the result is that the number of non-industrial robots for professional and consumer use cases is expected to more than double in the next 5 years.
Tractica's report, "Robotics Use Cases", covers 110 use cases for robotics, with examples and descriptions including consumer robots, enterprise robots, industrial robots, healthcare robots, military robots, UAVs, and autonomous vehicles. These categories are segmented into 15 robot application markets. Market data within the report includes revenue forecasts for each segment. The forecast period for this report extends from 2017 through 2025. An Executive Summary of the report is available for free download on the firm's website.
Tractica, an Informa business, is a market intelligence firm that focuses on emerging technologies. Tractica's global market research and consulting services combine qualitative and quantitative research methodologies to provide a comprehensive view of the emerging market opportunities surrounding Artificial Intelligence, Robotics, User Interface Technologies, Advanced Computing, Connected & Autonomous Vehicles, and Wearables & Digital Health. For more information, visit www.tractica.com or call +1.303.248.3000.


text:
Publication Date 01/07/2014 Volume. 6 No. 6
ASMI Media Releases
NPS Media Releases
PSA Media Releases
From the desk of the editor
Welcome to the July 2014 homepage edition of i2P (Information to Pharmacists) E-Magazine.
At the commencement of 2014 i2P focused on the need for the entire profession of pharmacy and its associated industry supports to undergo a renewal and regeneration.
We are now half-way through this year and it is quite apparent that pharmacy leaders do not yet have a cohesive and clear sense of direction.
Maybe the new initiative by Woolworths to deliver clinical service through young pharmacists and nurses may sharpen their focus.
If not, community pharmacy can look forward to losing a substantial and profitable market share of the clinical services market.
Who would you blame when that happens?
But I have to admit there is some effort, even though the results are but meagre.
In this edition of i2P we focus on the need for research about community pharmacy, the lack of activity from practicing pharmacists and when some research is delivered, a disconnect appears in its interpretation and implementation.
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Loretta Marron OAM BSc: Health Watch | open full screen
Barry Urquhart: Marketing Focus | open full screen
Harvey Mackay: Strategic Thinking | open full screen
Mark Neuenschwander: I`ve been thinking about... | open full screen
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i2P Archives
Baz Bardoe: 'Marketing Based Medicine' – how bad is it? | open full screen
Staff Writer: Academics on the payroll: the advertising you don't see | open full screen
Staff Writer: Explainer: what is peer review? | open full screen
Click here for a list of epublications
Newsflash Updates for July 2014
Newsflash Updates
Regular weekly updates that supplement the regular monthly homepage edition of i2P.
Access and click on the title links that are illustrated
Feature Contribution
Woolworths Pharmacy - Getting One Stage Closer
Neil Johnston
It started with "tablet" computers deployed on shelves inside the retailer Coles, specifically to provide information to consumers relating to pain management and the sale of strong analgesics.
This development was reported in i2P under the title "Coles Pharmacy Expansion and the Arid PGA Landscape"
In that article we reported that qualified information was a missing link that had come out of Coles market research as the reason to why it had not succeeded in dominating the pain market.
Of course, Woolworths was working on the same problem at the same time and had come up with a better solution - real people with good information.
Intensive Exposition without crossing over with a supermarket
Fiona Sartoretto Verna AIAPP
Editor's Note: The understanding of a pharmacy's presentation through the research that goes into the design of fixtures and fittings that highlight displays, is a never-ending component of pharmacy marketing.
Over the past decade, Australian pharmacy shop presentations have fallen behind in standards of excellence.
It does not take rocket science - you just have to open your eyes.
Recently, our two major supermarkets, Woolworths and Coles, have entered into the field of drug and condition information provision - right into the heartland of Australian Pharmacy.
Pharmedia Commentary
The sure way to drive business away
Gerald Quigley
I attended the Pregnancy, Baby and Children's Expo in Brisbane recently.
What an eye and ear opening event that was!
Young Mums, mature Mums, partners of all ages, grandparents and friends……...many asking about health issues and seeking reassurances that they were doing the right thing.
'Marketing Based Medicine' – how bad is it?
Baz Bardoe
It should be the scandal of the century.
It potentially affects the health of almost everyone.
Healthcare providers and consumers alike should be up in arms. But apart from coverage in a few credible news sources the problem of 'Marketing Based Medicine,' as psychiatrist Dr Peter Parry terms it, hasn't as yet generated the kind of universal outrage one might expect.
Community Pharmacy Research - Are You Involved?
Mark Coleman
Government funding is always scarce and restricted.
If you are ever going to be a recipient of government funds you will need to fortify any application with evidence.
From a government perspective, this minimises risk.
I must admit that while I see evidence of research projects being managed by the PGA, I rarely see community pharmacists individually and actively engaged in the type of research that would further their own aims and objectives (and survival).
Organisational Amnesia and the Lack of a Curator Inhibits Cultural Progress
Most of us leave a tremendous impact on pharmacies we work for (as proprietors, managers, contractors or employees)—in ways we're not even aware of.
But organisational memories are often all too short, and without a central way to record that impact and capture the knowledge and individual contributions, they become lost to time.
It is ironic that technology has provided us with phenomenal tools for communication and connection, but much of it has also sped up our work lives and made knowledge and memory at work much more ephemeral.
Academics on the payroll: the advertising you don't see
This article was first published in The Conversation and was written by Wendy Lipworth, University of Sydney and Ian Kerridge, University of Sydney
In the endless drive to get people's attention, advertising is going 'native', creeping in to places formerly reserved for editorial content. In this Native Advertising series we find out what it looks like, if readers can tell the difference, and more importantly, whether they care.
i2P has republished the article as it supports our own independent and ongoing investigations on how drug companies are involved in marketing-based medicine rather than evidence-based medicine.
I've been thinking about admitting wrong.
Mark Neuenschwander
Editor's Note: This is an early article by Mark Neuenschwander we have republished after the soul-searching surrounding a recent Australian dispensing error involving methotrexate.
Hmm. There's more than one way you could take that, huh? Like Someday when I get around to it (I'm not sure) I may admit that I was wrong about something. Actually, I've been thinking about the concept of admitting wrong. So don't get your hopes up. No juicy confessions this month except that I wish it were easier for me to admit when I have been wrong or made a mistake.
Brian Goldman, an ER physician from Toronto, is host of the award-winning White Coat, Black Art on CBC Radio and slated to deliver the keynote at The unSUMMIT for Bedside Barcoding in Anaheim this May. His TED lecture, entitled, "Doctors make mistakes. Can we talk about it?" had already been viewed by 386,072 others before I watched it last week.
Dispensing errors – a ripple effect of damage
Kay Dunkley - BPharm, Grad Dip Hosp Pharm, Grad Dip Health Admin, MPS, MSHPA
Most readers will be aware of recent publicity relating to dispensing errors and in particular to deaths caused by methotrexate being incorrectly packed in dose administration aids.
The Pharmacy Board of Australia (PBA), in its Communique of 13 June 2014, described a methotrexate packing error leading to the death of a patient and noted "extra vigilance is required to be exercised by pharmacists with these drugs".
This same case was reported by A Current Affair (ACA) in its program on Friday 20 June http://aca.ninemsn.com.au/article/8863098/prescription-drug-warning
Take a vacation from your vocation
Have you ever had one of those days when all you could think was, "Gosh, do I need a vacation."
Of course you have – because all work and no play aren't good for anyone.
A vacation doesn't have to be two weeks on a tropical island, or even a long weekend at the beach.
A vacation just means taking a break from your everyday activities.
A change of pace.
It doesn't matter where.
Everyone needs a vacation to rejuvenate mentally and physically.
But did you also know that you can help boost our economy by taking some days off?
Call it your personal stimulus package.
Explainer: what is peer review?
This article was first published in the Conversation. It caught our eye because "peer review" it is one of the standards for evidence-based medicines that has also been corrupted by global pharma.
The article is republished by i2P as part of its ongoing investigation into scientific fraud and was writtenby Andre Spicer, City University London and Thomas Roulet, University of Oxford
We've all heard the phrase "peer review" as giving credence to research and scholarly papers, but what does it actually mean?
Peer review is one of the gold standards of science. It's a process where scientists ("peers") evaluate the quality of other scientists' work. By doing this, they aim to ensure the work is rigorous, coherent, uses past research and adds to what we already knew.
Most scientific journals, conferences and grant applications have some sort of peer review system. In most cases it is "double blind" peer review. This means evaluators do not know the author(s), and the author(s) do not know the identity of the evaluators.
The intention behind this system is to ensure evaluation is not biased.
The more prestigious the journal, conference, or grant, the more demanding will be the review process, and the more likely the rejection. This prestige is why these papers tend to be more read and more cited.
Dentists from the dark side?
Loretta Marron OAM BSc
While dining out with an elderly friend, I noticed that he kept his false tooth plate in his shirt pocket. He had recently had seven amalgam-filled teeth removed, because he believed that their toxins were making him sick; but his new plate was uncomfortable. He had been treated by an 'holistic dentist'. Claiming to offer a "safe and healthier alternative" to conventional dentistry, are they committed to our overall health and wellbeing or are they promoting unjustified fear, unnecessarily extracting teeth and wasting our money?
Planning for Profit in 2015 – Your key to Business Success
We are now entering a new financial year and it's a great time to reflect on last year and highlight those things that went well and those that may have impacted negatively in the pursuit of your goals.
It's also a great to spend some time re-evaluating your personal and business short, medium and long term goals in the light of events over the last year.
The achievement of your goals will in many cases be dependent on setting and aspiring to specific financial targets. It's important that recognise that many of your personal goals will require you to generate sufficient business profits to fund those aspirations
ReWalk™ Personal Exoskeleton System Cleared by FDA for Home Use
Exoskeleton leader ReWalk Robotics announced today that the U.S. Food and Drug Administration has cleared the company's ReWalk Personal System for use at home and in the community.
ReWalk is a wearable robotic exoskeleton that provides powered hip and knee motion to enable individuals with Spinal Cord Injury (SCI) to stand upright and walk.
ReWalk, the only exoskeleton with FDA clearance via clinical studies and extensive performance testing for personal use, is now available throughout the United States.
Attracting and Retaining Great People
Barry Urquhart
Welcome to the new financial year in Australia.
For many in business the past year has been described as a challenging period.
Adjectives are a key feature of the English language. In the business lexicon their use can be, and often is evocative and stimulate creative images. But they can also contribute to inexact, emotional perceptions.
Throughout the financial pages of newspapers and business magazines adjectives abound.
References to "hot" money draw attention and comment. The recent wave of funds from Chinese investors, keen to remove their wealth from the jurisdiction and control of government regulations is creating a potential property bubble in Australia.
Updating Your Values - Extending Your Culture
Pharmacy culture is dormant.
Being comprised of values, unless each value is continually addressed, updated or deleted, entire organisations can stagnate (or entire professions such as the pharmacy profession).
Good values offer a strong sense of security, knowing that if you operate within the boundaries of your values, you will succeed in your endeavours.
Evidence-based medicine is broken. Why we need data and technology to fix it
The following article is reprinted from The Conversation and forms up part of our library collection on evidence-based medicines.
At i2P we also believe that the current model of evidence is so fractured it will never be able to be repaired.
All that can happen is that health professionals should independently test and verify through their own investigations what evidence exists to prescribe a medicine of any potency.
Health professionals that have patients (such as pharmacists) are ideally placed to observe and record the efficacy for medicines.
All else should confine their criticisms to their evidence of the actual evidence published.
If there are holes in it then share that evidence with the rest of the world.
Otherwise, do not be in such a hurry to criticise professions that have good experience and judgement to make a good choice on behalf of their patients, simply because good evidence has not caught up with reality.
Laropiprant is the Bad One; Niacin is/was/will always be the Good One
Orthomolecular Medicine News Service, July 25, 2014
by W. Todd Penberthy, PhD
(OMNS July 25, 2014) Niacin has been used for over 60 years in tens of thousands of patients with tremendously favorable therapeutic benefit (Carlson 2005).
In the first-person NY Times best seller, "8 Weeks to a Cure for Cholesterol," the author describes his journey from being a walking heart attack time bomb to a becoming a healthy individual.
He hails high-dose niacin as the one treatment that did more to correct his poor lipid profile than any other (Kowalski 2001).
Culture Drive & Pharmacy Renewal
Deep within all of us we have a core set of values and beliefs that create the standards of behaviour that we align with when we set a particular direction in life.
Directions may change many times over a lifetime, but with life experiences and maturity values may increase in number or gain greater depth.
All of this is embraced under one word – "culture".
When a business is born it will only develop if it has a sound culture, and the values that comprise that culture are initially inherent in the business founder.
A sound business culture equates to a successful business and that success is often expressed in the term "goodwill" which can be eventually translated to a dollar value.
Pharmacy 2014 - Pharmacy Management Conference
The brave new world of health and wellness is not the enemy of Pharmacy, it is its champion.
Australian futurist, Morris Miselowski, one of the world's leading business visionaries, will present the Opening Keynote address on Pharmacy's Future in the new Health and Wellness Landscape at 2.00pm on Wednesday July 30.
Morris believes the key to better health care could already be in your pocket, with doctors soon set to prescribe iPhone apps, instead of pills.
Technology will revolutionise the health industry - a paradigm shift from healthcare to personal wellness.
Health and wellness applications on smartphones are already big news, and are dramatically changing the way we manage our personal health and everyday wellness.
Generation and Application of Community Pharmacy Research
Editor's Note: We have had a number of articles in this issue relating to pharmacy research.
The PGA has conducted a number of research initiatives over the years, including one recently reported in Pharmacy News that resulted from an analysis of the QCPP Patient Questionnaire.
Pharmacy Guild president, George Tambassis, appears to have authored the article following, and there also appears to be a disconnect between the survey report and its target audience illustrated by one of the respondent comments published.
I have asked Mark Coleman to follow through, elaborate and comment:
Rollo Manning
articles by this author...
Rollo Manning has experienced pharmacy practice from all sectors of the industry – retail, administrative, policy and remote Aboriginal practice. He spent 10 years with Glaxo Australia and was the first Director of Public Relations at the Pharmacy Guild National Secretariat in Canberra.
He has also held the position of Pharmacy Policy Officer for Territory Health Services in Darwin.
Rollo is currently a Consultant working in his own practice with remote Aboriginal communities, in Northern Australia.
"Hey – don't forget us – we were here first!"
Remote Aboriginals left out of inclusion agenda
Remote living Aboriginals and the cycles of disadvantage which place them at the bottom of the socio economic ladder in Australia must get special treatment from a new Government in Canberra. The fact that Australia's first people are still living in "Third World" conditions in one of the wealthiest countries of the World is a shameful situation and only special treatment will raise their standards to a point where they can be considered "included" in Australian society.
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The "social inclusion agenda" of the Rudd Labor Government said that it was a means of "building a nation in which all Australians have the opportunity and support they need to participate fully in the nation's economic and community life, develop their own potential and be treated with dignity and respect."
These words are admirable except that there is a need for an Action Plan to ensure it is followed through in reality. The population cohort of 150,000 Aboriginal people living in remote communities across the north of the country and in the central and western desert regions – are at present living in a constant state of "exclusion".
The National Social Inclusion Board has been asked to take immediate steps to arrest the slide that has been happening since the introduction of "self government" and welfare dependency in 1970s. These are:
A "Third World" classification is given by Government to remote communities that are home to Aboriginal people across the north of Australia and in the central and western desert. This is said to be essential for the rebuilding of social capital and economic prosperity to a standard required by the inhabitants to contribute to the Australian Society.
The Aboriginal people themselves must be involved in identifying their own social priorities of need and establishing measures to alleviate these with funding available to initiate micro economic enterprises that will provide the incentive to work and shake off welfare dependence.
The payment of money to individuals should cease on a universal basis when a clan or tribe group present a solid business plan for social and economic reform. Universal welfare payments have failed and worked against social inclusion. "Cashed out" Centrelink payments should be possible to put the same amount of money into targeted assistance packages and economic development.
The life expectancy of remote living Aboriginal Australians should be expressed separately in order to show the difference between urban and remote.
An acceptance of the fact that to educate young women between the age of 16 to 24 years will assist them and enable them to pass down to their children the need for an education and work ethic. Without this another generation will be lost to welfare dependency.
Remote living Aboriginals are a unique cohort whose life style and life outcomes are clearly delineated through statistical measurements. Nowhere near is enough use made of this information in planning change. This is "Third World" country and has to be recognised as such. Some input from AusAid might be more useful for framing policy than bureaucrats used to dealing with mainstream populations living in communities with a wide range of services available in settings with already strong social capital. The remote living Aboriginal has none of these "luxuries".
The cycles of disadvantage
The numerous cycles of disadvantage in remote Aboriginal communities are interrelated and synergistic in their effect on the individual. More research needs to be done to identify the priorities of need (as seen by the community) in attacking each one. Too often the cry goes out that it is "too hard" and nothing is done. The people themselves must be drawn into a conversation on the social priorities and needs for their communities. In this way moves towards building social capital can be commenced through social and economic development.
The main cycles are:
o A denial of the human rights of the child such that abuse of those rights becomes the norm and is accepted by new generations. Housing, nutrition, education and leisure opportunities are lacking and this leads to a child frustrated from inactivity, opportunities to show creativity and exercise initiative. The overcrowded house is under estimated in the minds of government policy makers as a prime influence on this fact and each of those following. The overcrowded house brings with it immense unsafety, insecurity, a lack of food security, own space to reflect, household facilities that do not work because they were never built for so many persons living in the house. This absolutely hopeless situation is still evident with no real action to make an immediate response to this devastating influence on the ability to feel included in a social setting filled with joy and harmony. It is disgraceful that the policy makers allow a town of 2,200 people (Galiwin'ku) to have 152 houses while another in the white man's world (Boorowa NSW) to have 857 for the same population. Galiwin'ku has five retail outlets against 15 in Boorowa – how much more serious can a lack of social inclusion get when people are denied choices, job opportunities but receive money for doing nothing and have little choices of what to spend it on.
o Poor literacy and numeracy stems from an inability of children to understand why this is needed when all they see is adults sitting around doing nothing and no role models from their parents or carers who do not work. Creating work opportunities should be an essential part of the mix and is not receiving nearly enough attention at the local level. Unemployment is the norm and this becomes the key in removing welfare dependence. Much bolder mechanisms must be tried at the local level to encourage economic activities and employment opportunities such as "cashing out" Centrelink payments within a community or Clan group in a community. The writer is in the process of obtaining from Centrelink the stats on the quantum of money going into communities to ascertain how much would be available if people decided to "cash out". The principle involved here relates to the social justice in paying money to individuals rather than to communities for economic and social development.
Substance abuse leads to violence and both are symptoms of a community without direction. The fact that substance abuse (alcohol and Marijuana or Gunja) is so widespread means that children are exposed to it at an early age and peer pressure may result in consuming drugs (marijuana) by age 10 years. This rules against any possible development of social dreams, hopes and ambitions. Future planning is absent and few children have any idea of what they want to do in a future life apart from nothing which carries with it distinct boredom and further substance abuse. The flow on is arguments, fighting, stealing for money to sustain the habit and prosecution. It is well recognised that recidivism for Aboriginal prison inmates is high following its acceptance as being "part of life". The cyclical nature of family violence is strong, despite the resource of domestic violence orders which seem useless in alcohol and drug charged family disputes. Men and women seem to ignore the rights of the individual to lead a peaceful life free of torment, danger, uncertainty and stress. Mental health problems surge to the front of "health" problems and the resulting stress is a dampener on many a discussion regarding future hope. It is the survival of "today" that is the prime motivator not consideration of a peaceful future and how that can be attained. The definition of poverty given by Muhammad Yunus in an Interview with Andrew Denton describes the situation admirably:
"Poverty, is almost, you can describe is a living in a box, all with the thick wall, no window, no door, no light, so you don't know what's coming next, you have no idea of new day starting in different way, you repeat the same thing over and over again. No hope, basically. So you try to survive the day in very uncertain conditions. So that's poverty, you have no control over your life, that's total, that's it." (ABC-TV 07/12/09)
Health, nutrition and physical activity – the cycle of poor nutrition and reduced physical activity leading to poor health has been gaining momentum since 1975. This has lead to a situation where all people born after 1975 have lived their entire life in a community with the health status on the decline. The child fed a breakfast of black tea with noodles thinks that is normal. The two takeaway shops in town (two of the five retail outlets at Galiwin'ku) selling death through cigarettes, high fat content foods and sugar loaded soft drinks are making huge profits by selling sickness. The businesses of the two takeaways are owned by Darwin based syndicates and staffed by Asian workers on "457" Visas. And we allow this to happen to the most under privileged Australians who were here for 40,000 years before colonial British settlement. Social justice? Hardly. Social inclusion? No attempt. Only recently has there been evidence of organised sport for young people with the major emphasis having been on adult age football and basketball. The scope for athletics, swimming sports, junior football and basketball is immense and such activities could include the entire family.
The end result is the early death – and at a much earlier age than the National average depicts – let's get real and respect the huge differences where the median age at death for men is 43 years and for women 53 years. That is a lot of adults taken out of a community at a young age and this then becomes the norm in people's minds as if this is the way it has to be.
It does not have to be this way and a concerted effort under the banner of social inclusion which has with it a "bottoms up" approach to a social revolution might help to reduce the intensity of these cycles.
Better health is not about building better health clinics and employing more clinical staff – it is about the relationship the dominant culture has with the people to enhance their understanding of the risks associated with lifestyle choices and the opportunities they create to reduce stress and lead a useful life. This was well expressed by Professor Fiona Stanley who said:
"..the real gains in reducing disease and improving health will come from the social and economic circumstances operating in families, communities and the wider society. That is that the most effective preventive strategies lie OUTSIDE the traditional areas of the health professions." (National Press Club. August 2003.)
The entrapment of cycles of disadvantage
People are born into these communities and have no option when their families have lived there for generations and their ancestors respected and owned the land for thousands of years. There is an affinity to the land which is unique. It is the heritage a child takes on from its predecessors.
It is very important that when there are people who want to break out of the cycle of disadvantage that they are helped 100% in a quest to do so. If someone puts up there hand and says "I want to lead a better life" there must be the facility to make that happen. To follow the lead of overseas efforts in Third World countries it will be the young women who are targeted for improvement. Educate a girl and you educate a future family. We must put sexist attitudes aside and decide to concentrate on young women between the ages of (say) 16-24 years old. If nothing is done to help these young women there will be no role models coming forward to show the younger ones that good is a better choice in life than bad. Is it any wonder there are no persons from remote communities attending university? – there is simply not enough done to make it happen. The fault is not with the person but with the system that seems intent on having these people continue a life of poverty.
Mutual obligation has to work both ways
An example can be given of a 21 year old woman from a remote community who came to Darwin to "make good" and was shuffled between Centrelink and Job Services Australia (JSA) agencies for three months. All she got was appointments or on three occasions cancelled appointments that did not suit the JSA agent. So much for mutual obligation! The Prime Minister during the recent election campaign claimed a get tough policy on the unemployed who did not turn up for appointments. The same should apply to JSA agents who fail to meet appointments and more importantly fail to provide a training program. Sure excuses will be made as to how hard this is but regrettably no excuses should be accepted. It is imperative we return the obligation for to leave a person in a city like Darwin with all the distractions for three months with no work, no training and no future is just asking them to continue the exclusion.
What do the authorities planning this transition from welfare to work expect people to do with their idle time? Or are they so used to people that do not want anything to happen (like find a job) that when a person wanting to do better comes along they cannot handle the positive nature of the inquiry. It appears that the entire system is geared to mediocrity and the Centrelink and job finding agencies are so used to people that don't want to work that they have no strategy to help those few that want to make good. There could be no bigger turn off for anyone than to be left in front of a TV all day waiting for the next appointment when what they really want is to learn and find work that suits their ambitions.
The problem of "disengaged youth" is attracting a lot of attention from Government programs and in the work of Non Government Organisations (NGOs). And yet little is being done to prevent young people from becoming "disengaged" when they really want to be more engaged. There are youths (aged 16-24yo) who want to be included in the world—not excluded like so many of their peers that end up in prison or on diversion programs.
In Darwin there is an 800 bed prison, Berrimah Gaol, costing $80 million a year for people who have chosen to be bad. The young Aboriginal inmate – and that is 90% of the prison population – is probably in there for some anti social behavior fuelled by alcohol and Gunja – will receive tuition in literacy and numeracy and computer skills.
Upon release they will be remanded to a formal rehabilitation program in a beautiful garden setting hostel style accommodation with all meals and training provided for a further 12 weeks.
Oh for such a facility for those those who want to do "good" – and not just for those who choose to do "bad".
Government programs exist—the Job Services Australia network; Language, Literacy and Numeric Program; Step-Up; WELL; Youth Connect; the Indigenous Youth Mobility Program; Youth in Communities and the exalted Youth Attainment and Transitions program - BUT there is no co-ordination and each program is delivered by a contracted provider that once having gained the contract has little competition leaving mediocrity to reign.
Glossy websites and publications mean nothing if the product is not being delivered. The so-called "mutual obligation" means equal commitment from all parties and yet Governments seem to think their obligation is finished with the appointment of an agency to deliver programs. If the government funded agency fails to perform there seems to be no obligation but if the client does not arrive at an appointment the welfare payment can be stopped. This begs the question of why it is so hard to co-ordinate the efforts of these similar government funded programs with the same goals so that the clients get what they want. An element of "discretionary funding" must be made available for use at the local level to stimulate initiatives and help to fund the work needed to build plans to a point of applying for funding.
Breaking out of cycles of disadvantage
Control of ones own life is an important element in building social capital. The principles that were espoused in the Australian Assistance Plan of the Labor Government in 1972-75 were said to be ahead of their times but maybe the time is NOW for Aboriginal communities to receive an Aboriginal Assistance Plan along the same lines that could involve the people in determining their social needs and priorities. This would also make micro loans available to seed new ventures that would create training, employment, independence from welfare and a purpose for rising every morning and getting the children to school.
The time is now when it comes to building stronger social capital in remote Aboriginal communities and this is well reflected in the words of Nobel Laureate Chilean born Gabriel Mistral who said of the needs of children:
Many things we need can wait, the child cannot. Now is the time his bones are being formed, his blood is being made, his mind is being developed. To him we cannot say tomorrow, his name is today.
There must come a time when the policy makers shed the shroud of fear about matters such as "paternalism", "stolen generations" and "separatism". In decrying paternalism self determination was brought in and it has now been recognised that has been a failure. The basic ability and understanding is simply not there for these Aboriginal people to negotiate the machinations for moving ahead in the western world. There does need to be considerable mentoring, guidance and fostering of confidence which can still be done in a facilitative way without being labelled as paternalistic. To wait until the people are ready for change could be to wait another one or two generations – a prospect that no Australian would feel comfortable in accepting. If there is tutoring and mentoring to be done we must do it in a vigorous manner and not just pay lip service to it against a backdrop of centralist policies and program development.
With respect to the stolen generation - there is no doubt the forced removal of children from their parents in previous generations was despicable. However this was forced removal. To suggest that an Aboriginal child may be assisted by attending a boarding school in another state is not forced removal. The paranoia that surrounds suggestions of moving must be diminished by examples of well being fostered from such experiences. Research should be done to demonstrate the long term benefit in voluntary removal to allay these fears. Even the "dormitory" style living and mentoring and caring for children who are disengaged would be better than the nomadic existence so many young children have to undertake when abandoned by their natural mother or father.
Separatism was a sensitive issue in the world in the early 1970s with vivid memories of the tour of the Springbok Rugby Team in 1971 still vivid in the minds of those of us around at the time. The apartheid movement in South Africa has finished and should never be seen again. It was the forced separation of one race of people from another with harsh penalties for anyone who crossed the line. However in decrying apartheid it should be acknowledged that there will be situations where one race of people may decide that it does not want to live in the same way as another. At no time in the history of the Aboriginal survival efforts have they been given the opportunity to decide the way they want to live. The Aboriginal men from remote communities seem unable to embrace a mainstream culture and legal constraints while for the women there are those that simply see themselves as "community girls" with no intention of even trying to live the mainstream lifestyle. If we do accept that assimilation failed and that self determination has failed then we need another word that will describe a phase whereby Aboriginal people are given the resources to develop a world of their own that takes what they want from the western world and allows them to remain in their own country.
Personal choice should play a part
Choices are made on a basis of knowledge so that the costs and benefits of a situation can be weighed up critically to choose a path. In the situation under review the people involved do not have an education or awareness of a logical framework in thinking that allows to them to participate in an analysis of choices. The educated mainstream person does not appreciate the manner in which their upbringing in a culture that has thousands of years of development through many "revolutions" that have embraced invention to move that culture ahead in a manner that is "mind boggling" to a person from a culture that subsisted in the desert for thousands of years without even knowing what a wheel could do. It was not until the arrival of ships from foreign countries such as Holland and Indonesia (Macassans) in the 16th and 17th century that these people learned what metal was. The power of logical thinking that comes with an ability to manage a situation, prioritise things, file away messages and thoughts in the brain to a later date are all practices that come naturally to the educated dominant culture person in Australia. This value was highlighted during a recent visit to Australia of the Somalia born women's activist Ayaan Hirsi Ali who said:
"We can learn from you and your centuries of critical thinking. You Westerners come to Africa with your money but you can keep your money - we want to share with you your values. The most important value – the value of critical thinking – questioning authority – no matter who it is – question why things are the way they are and why they cannot be done better." (Interview with Monica Attard – Slow TV – August 2010)
To expect Aboriginal people to think through their options for survival in a world that none of them has grown up in is a tall order and the resolution needs a lot more talk and research to find the best path ahead. In 2005 the present Co-ordinator General for Remote Service Delivery in the NT, Mr. Bob Beadman wrote a paper in which he lamented the fact that something had taken away the ability for Indigenous people to have dreams for their future. He wrote:
"I am looking at human detritus right here in Darwin, and wonder what dreams they might have once had for themselves. What dreams they might have had for their children? What dreams their children might have had for themselves? I wonder if people have abandoned those dreams, what caused them to give up, what is it about the world that surrounds us all that makes them think that their dreams are unachievable." (Do Indigenous youth have a dream Menzies Research Centre, Canberra, 2004).
Work is needed to ascertain how many young people would like to see a better life and this needs to be carefully structured. The target population is not English speaking, does not understand concepts of space and time and is not confident in working with the dominant culture. The young people must be encouraged to question why the situation is the way it is and not to simply accept as normal or necessary for it to stay the same.
Somehow the minds of the young have to be engaged in wanting to see an improved life ahead for their children – the next generation and social inclusion could be the agenda through which to make this happen.
Published in Information to Pharmacists , 01/09/2010, Volume 2, No. 8
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Quartet - 2006 - Malvern Theatre Company Inc.
> History 1999 to . . .
Cast: Shirley Cattunar, David Perkins, Ron Paddon and Genevieve Ryan.
Season ran from 24th February to 11th March, 2006.
David Perkins, Shirley Cattunar, Genevieve Ryan and Ron Paddon.


Earthquakes in the San Francisco Bay Region result from the accumulation of energy as the Pacific Plate slides past the North American Plate. The fact that a devastating earthquake occurred in 1906 — the San Francisco earthquake — is common knowledge. Larger earthquakes generally affect larger areas; the 1906 earthquake caused extensive damage in San Francisco, Oakland, San Jose and Santa Rosa. More recently, the 1989 Loma Prieta earthquake caused extensive damage in the Santa Cruz Mountains, as well as in Oakland and San Francisco tens of miles away. But many moderate to great earthquakes (over magnitude 6.0) have affected the Bay Area; 22 such events have occurred in the last 160 years — for an average of one every seven years, and future large earthquakes are a certainty. Learn more.
This map shows the composite shaking hazard across the Bay Area based on all earthquake scenarios and likelihood information using the Modified Mercalli Intensity (MMI) scale.
Liquefaction happens when loosely packed sandy or silty materials saturated with water are shaken hard enough to lose strength and stiffness. Liquefied soils behave like a liquid and are responsible for tremendous damage in an earthquake, causing pipes to leak, roads and airport runways to buckle, and building foundations to be damaged.
These maps are State regulatory maps that show "Zones of Required Investigation" for liquefaction (and landslide) hazard. They do not depict different degrees of hazard, rather they identify zones within which site-specific studies will be required for new construction. Sellers of properties within a "Zone of Required Investigation" must disclose that fact to prospective buyers.
Mapping Approach – This map shows areas with water-saturated sandy and silty materials that are susceptible to liquefaction if shaken hard enough. This map is not a substitute for a site-specific investigation by a licensed geologist or geotechnical engineer.
The map predicts the approximate percentage of each designated area that will liquefy and show surface manifestations of liquefaction such as sand boils and ground cracking.
Faults are weaknesses in the earth's crust that allow plates to slide past each other. Earthquakes occur when forces underground cause the faults beneath us to rupture and suddenly slip. If the rupture extends to the surface, we see movement on a fault (surface rupture). Because faults are weaknesses in the rock, earthquakes tend to occur over and over on these same faults. Strong earthquakes can occur when the fault rupture does not extend to the surface, and fault-related damage is rare when compared to shaking-related damage.
Source: California Geological Survey from CD-ROM 2001-04 (2001), Official Map of Alquist-Priolo Earthquake Fault Zones.
The California Geological Survey publishes maps of the active faults in the Bay Area that reach the surface as part of its work to implement the requirements of the Alquist-Priolo Earthquake Fault Zone Act. These maps show not only the most comprehensive depiction of fault traces that can rupture the surface but also the zones in which cities and counties must require special geologic studies to prevent the building of structures intended for human occupancy and in which the surface rupture hazard must be disclosed in real estate transactions.
Earthquakes can trigger landslides on hillsides that can result in significant property damage, injury and loss of life. The only way to know for certain if you home is on an active landslide is for a geotechnical engineer to perform an assessment.
This map is derived from State-mandated regulatory maps that show "Zones of Required Investigation" for landslide (and liquefaction) hazard. They do not depict different degrees of hazard, rather they identify zones within which site-specific studies will be required for new construction. These zone maps also are used in real estate transactions – sellers of properties within a "Zone of Required Investigation" must disclose that fact to prospective buyers.