Transfer Options Research Articles

Functional Outcome and Quality of Life After Hypoglossal-Facial Jump Nerve Suture.

Background: To evaluate the face-specific quality of life after hypoglossal-facial jump nerve suture for patients with long-term facial paralysis.Methods: A single-center retrospective cohort study was performed. Forty-one adults (46% women; median age: 55 years) received a hypoglossal-facial jump nerve suture. Sunnybrook and eFACE grading was performed before surgery and at a median time of 42 months after surgery. The Facial Clinimetric Evaluation (FaCE) survey and the Facial Disability Index (FDI) were used to quantify face-specific quality of life after surgery.Results: Hypoglossal-facial jump nerve suture was successful in all cases without tongue dysfunction. After surgery, the median FaCE Total score was 60 and the median FDI Total score was 76.3. Most Sunnybrook and eFACE grading subscores improved significantly after surgery. Younger age was the only consistent independent predictor for better FaCE outcome. Additional upper eyelid weight loading further improved the FaCE Eye comfort subscore. Sunnybrook grading showed a better correlation to FaCE assessment than the eFACE. Neither Sunnybrook nor eFACE grading correlated to the FDI assessment.Conclusion: The hypoglossal-facial jump nerve suture is a good option for nerve transfer to reanimate the facial muscles to improve facial motor function and face-specific quality of life.

Defining flood risk management strategies: A systems approach

Recent years have seen a growing recognition of and attention to strengthening community flood resilience as a key leverage for achieving sustainable flood risk management. The literature on the success of focusing on ex-post responses to flood events shows poor outcomes in mitigating flood risks across the board. Here, we employ systems thinking to conceptualise the dynamics underlying interactions among endogenous characteristics of the flood-prone community, and apply this, as a case study example, to the regional township of Roma in inland Queensland, Australia—a location that has experienced significant flooding in recent decades. Our results show that current flood mitigation policies are likely to be maladaptive due to unintended consequences that ultimately undermine the effectiveness of the interventions in the longer term. Based on our analysis, we conclude that integrated flood risk management, effected through well-targeted proactive investments—such as investment in infrastructure; technology advances; capacity improvements; shifts in systems, management practices and behaviour—and risk transfer (insurance) options, provide opportunities for reducing future relief and recovery costs and increasing fiscal stability and the long term well-being of communities in the face of increasing climate variability and flood risk under climate change. Conceptualisation and visualisation of the flood risk system, as exemplified in this paper, provides insights which might help to guide more cost-effective and sustainable flood risk mitigation investment in flood-prone communities.

Should we transfer poor quality embryos?

BackgroundTo evaluate if it is safe and effective to transfer poor quality embryos.MethodsIt was a retrospective analysis using individual patient data with positive controls. All patients undergoing embryo transfers of poor quality embryos on day 3 or on day 5 as part of fresh In Vitro Fertilization (IVF) cycles performed between 2012 and 2016. This study assessed a total of 738 poor quality embryos from 488 IVF programs. 261 embryo transfers were performed on day 3 (402 embryos were transferred) and 227 on day 5 (336 embryos were transferred). Control group consisted of 9893 fair and good quality embryos from 5994 IVF programs. Outcome rates were compared with two-tailed Fisher exact test using fisher.test function in R software. 95% confidence intervals for proportions were calculated using the Clopper-Pearson method with binom.test function in R. The groups of patients with poor vs. good and fair quality embryos were compared by age, body mass index(BMI), number of oocytes, female and male main diagnosis, cycle type, controlled ovarian stimulation (COS) protocol, the starting day of gonadotropin administration, the starting dose of gonadotropins, the total dose of gonadotropins, the total number of days of gonadotropins administration, the starting day of gonadotropin-releasing hormone (GnRH) agonist administration, the total number of ampoules of GnRH-agonist used, day of the trigger of ovulation administration and the type of the trigger of ovulation using the Student’s t-test for interval variables and with the chi-square test for nominal variables.ResultsNo significant differences in the implantation rate, clinical pregnancy rate, miscarriage rate, live births, and the number of children born were found between the groups of poor quality embryos transferred on day 3 and day 5. Though the implantation rate was lower for the group of poor quality embryos, than for the control (13.9% vs 37.2%), statistically significant differences between the proportion of implanted embryos which resulted in clinical pregnancies and live births in both groups were not observed (72% vs 78.2 and 55.8% vs 62.0% respectively).ConclusionTransfer of poor quality embryos at either day 3 or day 5 have a low potential for implantation, though those embryos which successfully implanted have the same potential for live birth as the embryos of fair and good quality. This study supports that it is safe to transfer poor quality embryos when they are the only option for fresh embryo transfer (ET).

Risk Transfer for Populations in Precarious Urban Environments

This study explores risk transfer options that precarious and marginal urban communities could use to protect themselves from future damages and losses generated by socio-natural hazards and disasters at the individual and community levels. The design is framed within an evidence-based disaster risk reduction (DRR) strategy and follows the case study research approach. We analyze the 2018 Neighborhood Approach for DRR programming evaluation carried out in four Latin American cities’ informal settlements and review relevant risk transfer experiences aimed at vulnerable populations. We calculate the pure risk premium for the four cases selected, using a previous catastrophe risk assessment for earthquakes and landslides. We propose three risk transfer options based on our analysis: (1) voluntary collective insurance; (2) structural reinforcement with a comprehensive housing insurance; and (3) hybrid parametric insurance. Risk transfer mechanisms conventionally focus on residual risk management. Here, due to the precariousness of the analyzed urban settings, the proposed alternatives go beyond the management of just residual risk to positively impact the beneficiaries’ quality of life and the reduction of the built environment’s physical vulnerability in the short and medium terms. Our study proposes a prospective estimation of future risk despite the limitations of data availability. This study opens a window to new approaches and proposes a systematic process to design DRR policy aimed at the poor and vulnerable strata of society.

Syntrophus conductive pili demonstrate that common hydrogen-donating syntrophs can have a direct electron transfer option.

Syntrophic interspecies electron exchange is essential for the stable functioning of diverse anaerobic microbial communities. Hydrogen/formate interspecies electron transfer (HFIT), in which H2 and/or formate function as diffusible electron carriers, has been considered to be the primary mechanism for electron transfer because most common syntrophs were thought to lack biochemical components, such as electrically conductive pili (e-pili), necessary for direct interspecies electron transfer (DIET). Here we report that Syntrophus aciditrophicus, one of the most intensively studied microbial models for HFIT, produces e-pili and can grow via DIET. Heterologous expression of the putative S. aciditrophicus type IV pilin gene in Geobacter sulfurreducens yielded conductive pili of the same diameter (4 nm) and conductance of the native S. aciditrophicus pili and enabled long-range electron transport in G. sulfurreducens. S. aciditrophicus lacked abundant c-type cytochromes often associated with DIET. Pilin genes likely to yield e-pili were found in other genera of hydrogen/formate-producing syntrophs. The finding that DIET is a likely option for diverse syntrophs that are abundant in many anaerobic environments necessitates a reexamination of the paradigm that HFIT is the predominant mechanism for syntrophic electron exchange within anaerobic microbial communities of biogeochemical and practical significance.

Cashless Policy and the Nigerian Payment System

Before the introduction of the cashless policy by the Central Bank of Nigeria in 2011, the Nigerian economy was heavily cash-oriented in its transaction of goods and services contrary to the global trends. With the aid of paired data samples between 2007 and 2017, this study evaluates the impact of cashless policy on the Nigerian payment system. The operations of a cashless economy were assessed based on the use of Cheques, funds transfer channels and Automated Teller Machines (ATMs). Analysis of data showed that the volume and usage of cheques as a means of financial settlement has failed and was partially replaced by electronic payment systems. Banks are getting more involved in the use of interbank fund transfers rather than a cash settlement. It was also ascertained that the use of ATM’s as a means of financial intermediation is increasing. It is anticipated that the use of ATMs will become even more popular in Nigeria in the near future. To some extent, the outcome of the study has justified the implementation of the cashless policy initiative in Nigeria. However, the innovation and operations of the policy are not without its related limitations. There are various challenges associated with its practice, ranging from poor infrastructural facilities and difficulty in imbibing the e-payment culture due to illiteracy. Other socio-cultural factors that constitute an impediment include celebrations like weddings, birthdays and festivals. On such occasions, Nigerians prefer to ”display or spray raw cash’’ rather than issuing cheques. Thus, more effort needs to be put in place by the regulatory authority to re-orientate the masses and to encourage the use of E–payments channels, cheques, funds transfer options and, owning/ operating of bank accounts. This will give a further boost to the development of the Nigerian payment system.

Workshop: Bringing economics, health and migration together: a mutual learning experiment

Abstract Acknowledging the role of economic arguments in political discourses and decision-making, researchers have begun to pay more attention to the fiscal implications of different health policy options for migrants. As yet, empirical evidence on economic effects of policy responses to migration and the societal costs or cost-effectiveness of competing strategies to address migrants’ health needs is scarce. Methodological challenges such as limited availability and accessibility of decent data often impede the generation of robust evidence. Further, little is known as to how evidence can effectively be moved into policy; e.g., the actual clout of economic arguments in migration policies debates, as opposed to other evidence- or value-based arguments, hitherto remains unclear. In other social policy domains such as educational and labour market integration, economic evaluations have become routine components of policy assessments. And under the title of, e.g., knowledge translation, strategies for the introduction of research evidence into political decision-making processes have been developed. The combination of similar goals and challenges suggests that there are opportunities to build bridges across sectors and disciplines - e.g., public health, social epidemiology, economics, social policy, data science - as well as across research-practice-divides, for the purposes of mutual learning and the joint improvement of research outcomes. The goal of this workshop is to start such learning processes by bringing together researchers and professionals from different fields, by sharing existing knowledge, and by jointly exploring the following questions: What are the thematic intersections, tensions and synergies between the different disciplines? What are common goals and questions? Which kinds of different knowledge complement each other towards those goals?Where are options for mutual learning, methodological transfer and/or synthesis? How can they help to overcome current challenges in estimating the costs of divergent migrant health policies?What can be learnt from existing knowledge translation strategies as regards the role of research for migrant health policy making?What challenges and open questions remain? The workshop will start with a brief introduction of key concepts and objectives. The first presentation will use three case studies to reflect on the potential of economic evaluation for improving health screening and assessment policies for asylum seekers in Germany. The second presentation will provide input from seminal research on public policy in migration contexts. A third presentation will summarize previous activities and insights of the work group “Economic arguments in migrant health policy making”. The following discussion will examine the above noted questions by tapping into the presenters’ expertise and the audience’s experience. The workshop will be closed with a summary of lessons learnt and directions for future research. Key messages Economic arguments play a central role in policy-making; but economic analyses of different migrant health policy options are hampered by various methodological challenges and tensions. Seminal research in other social policy domains offers potential for mutual learning, toward the end of generating valid economic evidence on the cost-benefits of migrants’ greater in-/exclusion.

Potential Launch Opportunities for a SmallSat Mission around the Moon Injected during a Lunar Flyby En Route to Mars

In this work, the concept of a multipurpose mission that can explore both the Moon and Mars with a single launch is proposed, and potential launch opportunities are analyzed to establish an early-phase trajectory concept. The proposed mission applies the concept of a piggyback ride to a small-sized lunar probe, i.e., the daughtership, of the main Mars orbiter, i.e., the mothership. For the trajectory design, the Earth-Moon-Mars gravity assist (EMMGA) trajectory is adopted for the mothership to reach Mars, and the daughtership is assumed to be released from the mothership during lunar flyby. To investigate the early-phase feasibility of the proposed mission, the launch windows have been analyzed and the associated delta-Vs have been directly compared with the solutions obtained for typical Earth-Mars direct (EMD) transfer options. The identified launch windows (in the years 2031 and 2045) could be the strongest candidates for the proposed conceptual mission. Under the current assumptions, up to approximately 15% (in 2031) and 9% (in 2045), more dry mass is expected to be delivered to Mars by appropriately selecting one of the currently available launch vehicles, regardless of whether the EMMGA transfer option is used. For missions around the Moon using a SmallSat in 2031, the feasibility of a lunar orbiter case and an impactor case is briefly analyzed based on the delta-Vs required to divert the SmallSat from the mothership. Although the current work is performed under numerous assumptions for a simplified problem, the narrowed candidate launch window from the current work represents a good starting point for more detailed trajectory design optimization and analysis to realize the proposed conceptual mission.

The Versatility of the Superficial Circumflex Iliac Artery Perforator Flap: A Single Surgeon's 16-Year Experience for Limb Reconstruction and a Systematic Review.

The superficial circumflex iliac artery perforator (SCIP) flap is a versatile option of free tissue transfer for small to large defects. In this study, we examine the advantages of the SCIP flap, its cadaveric anatomy, and clinical subtypes. Ten cadavers were dissected and the corresponding pedicles of the SCIP and groin flaps were identified. A retrospective review of 20 clinical cases of free SCIP flap reconstruction was undertaken. The indication for reconstruction, flap dimensions, and survival were analyzed. A systematic literature review was conducted including articles that have previously reported the use of the SCIP flap. The SCIP pedicle was present in all our cadaveric dissections. The starting point of its pedicle ranged from 1.5 to 4.5 cm along the superficial circumflex iliac artery. The median diameter of the perforator and its concomitant vein was 1mm (range 0.8-2 mm). A cutaneous vein (1.3-2.3 mm) could be included in the flap if the concomitant vein was too small. Twenty consecutive patients had free SCIP flaps between 2002 and 2018. The indications were for finger defects (n = 8), thumb reconstruction (n = 1), lower limb compound fractures (n = 3), iatrogenic wounds (n = 2), upper limb large defects (n = 2), and scar contractures (n = 4). Flap dimensions ranged from 2 × 4 cm to 14 × 25cm, and the longest pedicle was 8cm. All flaps survived. The systematic literature review identified 34 previous reports using the SCIP flaps, most of these published by Asian units. The SCIP flap is useful for reconstruction throughout the body due to its ease of dissection, thinness, adjustable pedicle length, and flap dimension ranging from tiny to large, as well as the feasibility of raising a compound flap incorporating an adipofascial or vascularized bone component if necessary.This is a level of evidence therapeutic IV study.

Looking past the appearance: a comprehensive description of the clinical contribution of poor-quality blastocysts to increase live birth rates during cycles with aneuploidy testing.

Which are the clinical benefits and risks of including poor-quality blastocysts (PQBs) in the cohort of biopsied embryos during a cycle with preimplantation genetic testing for aneuploidies (PGT-A)? PQBs show a worse prognosis with respect to sibling non-PQBs, but their clinical use allows an overall 2.6% increase in the number of live births (LBs) achievable after PGT-A. PQBs (<BB according to Gardner and Schoolcraft's classification) are generally disregarded for clinical use and/or research purposes. Therefore, limited data exist in literature to estimate the benefits and risks deriving from the transfer of a PQB. In Italy, the law imposes the transfer or cryopreservation of all embryos, unless proven not viable. This regulation has allowed the production of a large amount of data regarding poor-quality embryos. Previous reports outlined a lower chance of euploidy and implantation for PQBs. Yet, a comprehensive picture of their real clinical contribution is missing. This observational cohort study including 2757 oocyte retrievals for PGT-A (mean maternal age, 39.6 ± 3.3years) conducted at a private IVF centre between April 2013 and May 2018. A total of 1497 PQBs were obtained and their embryological, chromosomal and clinical features were compared to 5250 non-PQBs (≥BB according to Gardner and Schoolcraft's classification) and adjusted for all significant confounders. After defining the overall increase in LBs due to PQBs, we outlined the population of patients who might benefit the most from their clinical use. ICSI cycles, involving ovarian stimulation, blastocyst culture, trophectoderm biopsy, vitrification, comprehensive chromosome testing and vitrified-warmed euploid single embryo transfers (SETs), were conducted. Overall analyses and sub-analyses in populations of patients clustered according to maternal age at retrieval and size of the cohort of sibling non-PQBs were performed. Finally, the risk of miscarriage and the chance of LB per biopsied PQB and non-PQB were estimated. PQBs allowed a 12.4% increase in the cycles where ≥1 blastocyst was biopsied. To date, we report a concurrent 2.6% increase in the cycles resulting in ≥1 LB. On average 0.7 ± 0.9 (range, 0-9) PQBs were obtained per cycle for biopsy, including 0.2 ± 0.4 (range, 0-5) euploid PQBs. Maternal age solely correlates with the prevalence of PQBs from both overall and cycle-based analyses. Indeed, the patients who benefit the most from these embryos (i.e. 18 women achieving their only LBs thanks to PQBs) cluster among women older than 42years and/or those with no or few sibling non-PQBs (1.1 ± 1.1; range, 0-3). The 1497 PQBs compared to the 5250 non-PQBs showed slower development (Day 5, 10.1% versus 43.9%; Day 6, 60.5% versus 50.8%; Day 7, 29.4% versus 5.2%) and lower euploidy rates (23.5% versus 51%; adjusted OR, 0.36). Among the 195 and 1697 transferred euploid PQBs and non-PQBs, the former involved a lower implantation rate (16.9% versus 52.3%) and a higher miscarriage rate per clinical pregnancy (36.4% versus 13.9%), therefore resulting in a lower LB rate (LBR, 10.8% versus 44.6%; adjusted OR, 0.22). Based on these rates, we estimated an overall 1.5% risk of miscarriage and 2.6% chance of LB after euploid vitrified-warmed SET per each biopsied PQB. The same estimates for non-PQBs were 3.7% and 22.8%. The clinical benefit of PQBs is underestimated since they are the last option for transfer and this analysis entailed only the first LB. The higher miscarriage rate per clinical pregnancy here reported might be the consequence of a population of patients of poorer prognosis undergoing the SET of euploid PQBs, an option that requires further investigation. Finally, a cost-benefit analysis is needed in a prospective non-selection fashion. PQBs show higher aneuploidy rates. If to be included, PGT-A is recommended. When selected against aneuploid-PQBs, euploid ones could still involve a worse prognosis, yet, their LBR is not negligible. Women should be informed that a poor morphology does not define a non-viable embryo per se, although PQBs show a reduced chance of resulting in an LB. No external funding was used for this study. The authors have no conflict of interest related to this study. N/A.

Dual-hub connectivity: a case study on China Eastern Airlines in Shanghai

To deal with slot constraints and insufficient capacity, emerging multi-airport systems have been under construction in China. This paper chose China Eastern Airlines as a case study, evaluating its hub connectivity under a dual-hub circumstance in Shanghai. The paper detected that the biggest constraint of China Eastern Airlines’ dual-hub situation lied in Shanghai’s location and the restricted transfer options on international routes. Contributions from alliance partners were assessed and benchmarked with China Eastern Airlines. With China Southern Airlines quit SkyTeam alliance, China Eastern Airlines faced more challenges on the domestic market. The empirical study also pointed out the shortcoming of operating at two hubs in the same catchment area, where the quality of connectivity of inter-hub connections cannot be maintained as high as a single-hub transfer. However, the market potential of inter-hub connections in Shanghai was identified with a considerable amount of viable connections.

Tendon transfers for rotator cuff pathologies

Irreparable rotator cuff tears remain one of the most challenging pathologies faced by shoulder surgeons. In both irreparable anterior (subscapularis) and posterosuperior (supraspinatus and infraspinatus) tears, patients experience marked shoulder dysfunction and pain. In this article, we review the surgical considerations for treating patients with these tears, as well as the tendon transfer options. Irreparable rotator cuff tears are associated with advanced fatty infiltration, tendon retraction, and loss of tendon length. Although there are multiple reconstructive options, most are limited to small series with short-term follow-up. Tendon transfers have emerged as very promising reconstructive options for these patients. When considering the ideal tendon transfer, it is critical to consider the four-tendon transfer principles, as well as the ability of patients to retrain the new transfer to perform a different function. The historical option for posterosuperior tears involved a latissimus dorsi transfer, while the lower trapezius transfer emerged in recent years. The historical transfer for irreparable subscapularis tears was the pectoralis major transfer, while the latissimus dorsi emerged in recent years. Further comparative trials with large patient numbers and longer follow-up are needed to better understand the indications for each of these transfers to treat these difficult pathologies.

Soft Tissue Microvascular Reconstruction of Orbital Exenteration Defects

The main goal of head and neck reconstruction is the restoration of form and function. Oncologic surgery makes this process more complex, as the preplanned defect can be very different from its intraoperative counterpart. This emphasizes the role of preoperative planning and a diverse reconstructive "tool box" that can accommodate a variety of complicated defects. The other reconstructive goals are determined by the patient with the aid of an interdisciplinary team. While multiple local and regional reconstructive options are available, free tissue transfer provides a versatile and reliable option for reconstruction-especially for complex orbital defects. Here the authors discuss free soft tissue transfer options for orbital exenteration. This review will catalog the advantages and disadvantages of the radial forearm, rectus abdominis, latissimus, and anterolateral thigh.

Mosaic embryos are not the only option for transfer in 90% of PGT-A cases

Objectives The increased sensitivity of NGS for routine PGT-A has allowed the accurate classification of embryo biopsies as mosaic. Correspondingly, there is now a proportion of clinical cases in which there are no euploid embryos and at least one other mosaic for transfer consideration. This presents unique challenges to clinical decision makers about whether to transfer mosaic embryos. An increasing number of studies report normal live births after the transfer of mosaic embryos, but nonetheless, the issue of knowingly transferring an embryo with a detected abnormality is an ethically fraught issue. To the best of our knowledge however no studies have yet, in a sufficiently large cohort, audited the extent to which clinicians encounter this predicament and the extent to which it is related to maternal age. The objective of this study was therefore to address these two questions. Method Retrospective analysis of whole genome NGS PGT-A cases (Dec2015-Oct2017, Cooper Genomics). Re-biopsy, gender only and donor egg (age unknown) cases were excluded. Results 6,615 cases involving 27,396 biopsies were reviewed (table below) with the above categories in mind and in 4 age categories. The no euploid (1 or more mosaic) group constitutes 10.8% of the total and does not change significantly with maternal age. The one euploid (1 or more mosaic) group constitutes 10.1% of the total and reduces with maternal age, from 11.43% of cases associated with maternal age below 35, down to 6.10% of cases of patients over 40. Conclusions We found that 10-11% of cases only have a mosaic embryo available for transfer, and a further 10% of cases only have 1 euploid embryo and a further mosaic embryo available for double embryo transfer or a subsequent frozen embryo transfer. In these cases, clinical and genetic counselling involvement would be required to aid in decision making as to whether a mosaic embryo is to be transferred. Conversely, 80% of cases wouldn't present such a predicament with, 21% of cases only having aneuploid embryos reported and 59% of cases having one or more euploid embryos available (excl. our 1 euploid and 1 or more mosaic group). While the incidence of overall euploidy vs aneuploidy is clearly an age-related phenomenon on both an individual embryo and per case basis, the incidence of our two sub groups (each 10-11% of the total) does not appear to vary significantly with age with the possible exception of the “1 euploid and at least 1 mosaic” category in the over 40 age group. This suggests that the frequency of our two sub groups in question are more related to errors of mitosis (post-zygotic) than meiosis. It is important that we continue to monitor pregnancies and live birth outcomes where mosaic embryos are transferred to gather more information regarding those which are more likely to result in live births and low levels of pregnancy loss.

Procedures for systematic capture and management of analytical data in academia

Data management in universities is a challenging endeavor in particular due to the diverse infrastructure of devices and software in combination with limited budget. Nevertheless, in particular the analytical measurements and data sets need to be stored if possible digitally and in a well-organized manner. This manuscript describes how scientists can achieve a data management workflow focusing on data capture and storage by small adaptions to commonly used systems. The presented method includes data transfer options from ubiquitous devices like NMR instruments, GC (MS) or LC (MS), IR and Raman, or mass spectrometers to a central server and the visualization of the available data files in an electronic lab notebook (ELN). The given instruments were chosen according to the needs of synthetic chemists, in particular devices needed in organic, inorganic and polymer chemistry where single data files in the range of several megabytes per data set are produced. Altogether, three different data transfer systems were elaborated to allow a flexible handling of different devices running with different proprietary software: The first procedure allows data capture via the use of a mail server as data exchange point. With the second procedure, data are automatically mirrored from a local file folder to a central storage server where new files are monitored and processed. The third procedure was designed to transfer data with manual support to a central server which is supervised to register new information. All components that are necessary to install and use the herein elaborated functions are available as Open Source and the designed workflows are described step by step to facilitate the adaption of procedures in other universities accordingly if desired.

An investigation of route-choice in integrated public transport networks by risk-averse users

Globally, transport agencies are implementing integrated public transport systems to increase ridership. Transfers are a key component of such integrated systems; they facilitate connectivity among modes, allowing the system to function in unison. It is well known that transfers can cause users to feel anxious, due to the possibility of missed connections. The public transport network in Auckland, New Zealand, is undergoing a transformation into an integrated system, which means more routes with transfers are replacing direct routes. This study examines the route choice of public transport users when faced with multiple routes involving transfers. Four sub-models are developed to create the Route Choice Model. One of the contributions of the present study is the development of the Risk-Aversion sub-model, which provides a straight-forward representation of users’ risk profiles for route-choice associated with transfers. These four sub-models are applied to a proposed integrated public transport network to determine the ridership of the new routes involving transfers. The socio-economic characteristics included in this study are gender and age. The findings show that females are more risk-averse than male users, and that users aged 40 or over are more risk-averse than those under 40. Overall, users who are more risk-averse prefer the transfer options if the service is reliable, and the transfer waiting time is relatively short in proportion to the overall journey time. Future research is encouraged to investigate the effects of other socio-economic characteristics on users’ decisions to make transfers, using the findings to make further improvements to the network.

Pharyngeal Reconstruction with Microvascular Free Tissue Transfer.

Reconstruction of pharyngoesophageal defects after total laryngectomies and extirpation of hypopharyngeal and upper esophageal carcinomas presents a challenging task. Goals of reconstruction include adequate voice rehabilitation and restoration of normal swallowing. The reconstructive armamentarium contains many options for reconstruction and creation of a new upper digestive tract. This review article focuses on the most commonly used free tissue transfer options for the reconstruction of these defects, with an assessment of their advantages and disadvantages.

Technology transfer for development in Nigeria: patterns, problems and prospects

Technology is critical to industrialization and economic development of every country. The disparity in income gap between countries is largely explained by the differences in technological generation, application and diffusion. For quite sometimes now, Nigeria has continued inordinately to occupy an unenviable position in the technological development ladder. Consequently, it is contended that the time is ripe for Nigeria to properly articulate and harness opportunities offered by the technology transfer. Such technology transfer arrangements can be accomplished through carefully formulated and implemented policies that not only emphasize the optimization of the transfer options but also foster the deepening of the national absorptive capacity and innovation capability, bearing in mind the inextricable linkage between research results from academic and research institutions and industries.

Queueing analysis of DTN protocols in deep-space communications

Delay/disruption tolerant networking (DTN) [1] is proposed as an internetworking architecture for reliable data delivery despite a long propagation delay and/or lengthy link disruptions. DTN targets challenging networking environments where traditional networking protocols such as the terrestrial Transmission Control Protocol/Internet Protocol (TCP/IP) typically do not work effectively. The challenging problem of mission control and data delivery in space communications is a typical application scenario of the DTN technology. Reliable and highly efficient data delivery of DTN relies heavily on the bundle protocol (BP) [2]. BP is intended to establish an overlay network that is able to withstand intermittent data link connectivity in the delivery of DTN data units, termed bundles. BP adopts a store-and-forward mechanism and a custody transfer option for transmission reliability.

To re-biopsy or not? results from trophectoderm re-biopsy of embryos with an inconclusve result increase transfer options

To re-biopsy or not? results from trophectoderm re-biopsy of embryos with an inconclusve result increase transfer options