Auswahl der wissenschaftlichen Literatur zum Thema „We cannot sinn“

Background: To clarify the clinical use of sonography for differentiation of edema we tried to answer the question whether a group of doctors can differentiate lymphedema from cardiac, hepatic or venous edema just by analysing sonographic images of the edema. Patients and methods: 38 (70 ± 12 years, 22 (58 %) females) patients with lower limb edema were recruited according the clinical diagnosis: 10 (26 %) lymphedema, 16 (42 %) heart insufficiency, 6 (16 %) venous disorders, 6 (16 %) chronic hepatic disease. Edema was depicted sonographically at the most affected leg in a standardised way at distal and proximal calf. 38 sets of images were anonymised and send to 5 experienced doctors. They were asked whether they can see criteria for lymphedema: 1. anechoic gaps, 2. horizontal gaps and 3. echoic rims. Results: Accepting an edema as lymphedema if only one doctor sees at least one of the three criteria for lymphatic edema on each single image all edema would be classified as lymphatic. Accepting lymphedema only if all doctors see at least one of the three criteria on the distal image of the same patient 80 % of the patients supposed to have lymphedema are classified as such, but also the majority of cardiac, venous and hepatic edema. Accepting lymphedema only if all doctors see all three criteria on the distal image of the same patients no edema would be classified as lymphatic. In addition we separated patients by Stemmers’ sign in those with positive and negative sign. The interpretation of the images was not different between both groups. Conclusions: Our analysis shows that it is not possible to differentiate lymphedema from other lower limb edema sonographically.

The paper is devoted to an investigation of the genus of an orientable closed surface $M^{2}$ which admits $A$-endomorphisms whose nonwandering set contains a one-dimensional strictly invariant contracting repeller $\Lambda_{r}$ with a uniquely defined unstable bundle and with an admissible boundary of finite type. First, we prove that, if $M^{2}$ is a torus or a sphere, then $M^{2}$ admits such an endomorphism. We also show that, if $\Omega$ is a basic set with a uniquely defined unstable bundle of the endomorphism $f\colon M^{2}\to M^{2}$ of a closed orientable surface $M^{2}$ and $f$ is not a diffeomorphism, then $\Omega$ cannot be a Cantor type expanding attractor. At last, we prove that, if $f\colon M^{2}\to M^{2}$ is an $A$-endomorphism whose nonwandering set consists of a finite number of isolated periodic sink orbits and a one-dimensional strictly invariant contracting repeller of Cantor type $\Omega_{r}$ with a uniquely defined unstable bundle and such that the lamination consisting of stable manifolds of $\Omega_{r}$ is regular, then $M^{2}$ is a two-dimensional torus $\mathbb{T}^{2}$ or a two-dimensional sphere $\mathbb{S}^{2}$.

We investigated the wet-etching properties of SiCN films using chemical agents. Our results show that sodium hydroxide, potassium hydroxide and phosphoric acid etch SiCN films, while hydrochloric acid, sulfuric acid, acetic acid, ammonium chloride and sodium chloride cannot etch SiCN films.

Communication is the medium by which we can share our thoughts or convey the messages with other person. Nowadays we can give commands using voice recognition. But what if one absolutely cannot hear anything and eventually cannot speak. So the Sign Language is the main communicating tool for hearing impaired and mute people, and also to ensure an independent life for them, the automatic interpretation of sign language is an extensive research area. Sign language recognition (SLR) aims to interpret sign languages automatically by an application in order to help the deaf people to communicate with hearing society conveniently. Our aim is to design a system to help the Deaf and Dumb person to communicate with the rest of the world using sign language. With the use of image processing and artificial intelligence, many techniques and algorithms have been developed in this area. Every sign language recognition system is trained for recognizing the signs and converting them into required pattern. The proposed system aim to provide speech to speechless, in this paper we have introduced Sign Language Recognition using CNN for dynamic gestures to achieve faster results with high accuracy.

Neg-raising, the phenomenon whereby a negation in the main clause of a complex constructionis interpreted as if belonging to the embedded clause, has been intensivelystudied in spoken languages. The same cannot be said for sign languages. In this paper,we investigate the properties of Neg-raising constructions in three sign languages:French Sign Language, Italian Sign Language, and Sign Language of the Netherlands.We report on two syntactic tests we applied to disambiguate Neg-raising and non-Negraisingreadings, showing that Neg-raising constructions have similar properties in thethree sign languages that we studied, as well as in comparable constructions in spokenlanguages. We also discuss some intricate headshake spreading patterns we found inNeg-raising constructions in Sign Language of the Netherlands, a non-manual dominantsign language.

Based on a variable separated ODE method presented by Sirendaoreji and Sun, a modified variable separated ODE method is developed to uniformly construct the explicit exact solutions of sine-Gordon type equations by introducing a more general additional variable separated ODE. We demonstrate the effectiveness of our approach by applications to certain physically significant sine-Gordon type equations comprising the sine-Gordon equation and double sine-Gordon equation as particular examples. As a result, we cannot only recover the previously known exact solutions, but also pick up some new formal solutions for the sine-Gordon equation and double sine-Gordon equation by means of this approach.

We explore a spatially homogeneous and isotropic Friedmann–Robertson–Walker (FRW) universe that is filled with agegraphic dark energy (ADE) with mutual interaction with pressureless dark matter in the background of Brans–Dicke (BD) theory. We consider both original and a new type of ADE (NADE) and further assume that the sign of the interaction term can change during the history of the universe. We obtain the equation of the state parameter, the deceleration parameter, and the evolutionary equation for the sign-changeable interacting ADE and NADE in BD cosmology. We find that in both models, the equation of the state parameter, wD, cannot cross the phantom line, although they can predict the universe evolution from the early deceleration phase to the late time acceleration, compatible with observations. We also investigate the sound stability of these models and find out that both models cannot show a signal of stability for different model parameters.

The birth of modern aesthetics cannot be separated from the emergence of a new, non-dogmatic conception of religion and theology. Friedrich Schlegel advocated ‘art as new religion’ while Friedrich Schleiermacher developed a vision on religion as a deeply aesthetic experience. In this rich intellectual context, one author stands out as deeply steeped in this field of innovative dialogues between philosophy, religion and art (against the backdrop of profound historical transformations) and as a singular figure beckoning towards a future (and a future language) that was still to come: Friedrich Hölderlin. In his later work, Hölderlin’s poetic voice retreats into a process of meticulous reading and writing, a complex score of traces and signs that articulate difference, not-yet-presence and potentiality, which is nothing other than the experience of finite time. In doing so, Hölderlin retraces the divine in history and in human existence: its retreat and expected arrival. In this article, we present readings and interpretations of Hölderlin’s later poetry, with a specific focus on the Winke or hints of the gods, and the vocabulary of nods and signs (Zeichen) signifying the experience of time’s passing as the announcement of an unthinkable future. By involving Jean-Luc Nancy’s rethinking of the Winke as intersections of the divinity of humanity and the humanity of divinity, we will arrive at a new understanding of Hölderlin’s emblematic figures of modernity: the stranger and the passer-by as receivers and transmitters of these Winke.

As sign language is used by deaf and dumb but the non-sign-language speaker cannot understand there sign language to overcome the problem we proposed this system using python. In this first we taken the some of the hand gestures are captured using the web camera. The image is pre-processed and then feature are extracted from the captured image .comparing the feature extracted image with the reference image. If matched decision is taken the displayed as a text. This helps the non-sign-language members to recognize easily by using Convolutional neural network layer (CNN) with tensor flow

We consider the Aslamazov-Larkin term in the Hall conductivity near Tc, and find that the sign of this term is determined by ∂Tc/∂μ, where μ is Fermi level. We show that the AL term cannot explain the sign change of the Hall conductivity in high temperature superconductors. We also show that weak damping helicon waves exist in classical weak magnetic field due to the very strong increasing of AL term near Tc.

The problem of how to understand the personal language Paul uses to describe s/Sin is introduced. Literary personification is distinguished from what we might call “person-identification” by an element of self-conscious fiction that recognizes a gap between the personal language deployed and the “actual state of affairs.” The problem is that, for readers of Paul, his construal of the “actual state of affairs” is precisely what is at issue. Three emphases in the history of scholarship are considered: Bultmann’s focus on the sins of the individual; Käsemann’s focus on Sin as a cosmic power; and the liberationists’ focus on social sin. Each school demonstrates that the interpreter’s sense of the “actual state of affairs” cannot be removed from the process of interpretation. This sets the stage for careful consideration of our own readerly sense of how individual, social, and cosmic realities might coexist and interact.

Philosophers draw a distinction between ontology and epistemology: a distinction between what is and what we know. What counts as evidence of causation will be fixed by our choice of methods of discovery, and our choice of methods will be fixed by what we take causation to be. Nevertheless, causation cannot be identified with its methods of discovery. Hume argued that causation was not directly observable. If this is the case, we need methods that can reliably latch on to the signs of causation. But we cannot automatically judge there to be no causation if we find no sign of it.

we know to tell many lies that sound like truth,but we know to sing reality, when we will.Hesiod, Theogony 27–28 (trans. M. L. West)Human cooperation and development are underwritten by a practice of information sharing. Given our limited lifespan and point of view, we are dependent on information acquired from others. Our limitations concern both the world and the minds of others. No one can investigate every corner of the universe, or even of their own neighborhood, and we cannot always tell what someone is thinking just by looking at their face. We depend on others to share information with us both about the world and their thoughts. By far, most of the information we acquire from others we acquire from testimony. Language is our best tool for sharing information. This system of using language to overcome our cognitive limitations relies fundamentally on sincerity. In the most ordinary case ...

We have all had the experience of being unable to explain an idea to someone else or, to put it in reverse, the experience of another person being unable to understand something we understand well. It’s always tempting to dismiss the other as the one at fault in a misunderstanding, but this can be a sign of our own arrogance since the fault may lie in our inability to communicate well. Yet after repeated sincere attempts at mutual understanding, sometimes we reluctantly conclude that the two of us simply can’t understand each other....

This chapter has two objectives. The first is to argue for the fact of meta-ethical pluralism. In other words, the chapter argues that the recent empirical scholarship suggesting that people are both realists and anti-realists cannot be simply dismissed on the basis of being philosophically inadequate because even when we increase the level of clarity and rigor, the pluralism remains. The second is to argue for the function of meta-ethical pluralism. In other words, the chapter argues against the view that this pluralism in people’s meta-ethical commitments is incoherent or a sign of confusion and puts forth the view that, instead, it serves a pragmatic function—namely, that it promotes civility and aids in the individual and collective navigation of normative space within a morally imperfect world.

Pulmonary hypertension is a haemodynamic and pathophysiological condition defined as an increase in the mean pulmonary arterial pressure of ≥25 mmHg at rest, as assessed by right heart catheterization. In fact, while transthoracic echocardiography may provide clues on the presence of pulmonary hypertension, the haemodynamic evaluation offers a more precise and comprehensive assessment. Pulmonary hypertension is heterogeneous from a pathophysiological point of view, and the diversity is reflected in the haemodynamic definitions. The different haemodynamic forms of pulmonary hypertension can be found in multiple clinical conditions which have been classified into six main groups and at least twenty-six subgroups. Each main clinical group shows specific pathological changes in the lung distal arteries, capillaries, and small veins. If we combine the haemodynamic and clinical heterogeneity, we understand the complexity of an accurate diagnosis in the individual patient which is crucial for the prognostic assessment and treatment strategy. In addition, the concomitant presence of different haemodynamic and clinical mechanisms cannot be excluded in individual cases (e.g. in patients with congestive heart failure and associated lung diseases). The presence of pulmonary hypertension, as defined above, is always an ominous prognostic sign, even if the severity may differ according to the haemodynamic changes and underlying clinical condition. The therapeutic approach also is markedly different, according to the clinical group, and symptomatic and haemodynamic severity. For these reasons, the four more frequent clinical groups are discussed individually, while the classifications are described in the Introduction section.

The conclusion of contracts was known in ancient times and is still relevant today. Shares that are not distributed in kind can cause certain difficulties that force the interested parties to decide on distribution.Joint ownership of inherited property received from a family member necessitates joint decision-making on its maintenance, ownership, use, and disposal, and it is difficult to achieve such a consensus on all issues. Therefore, quite often a certain period may pass from the acquisition of the right to a share in the joint property to its distribution, but due to conflicts regarding the use of the property or in the case of the need to receive funds or for other reasons, the joint property is divided by the co-owners. That is, the reasons may even be questions of how to use agricultural land, for example, to rent it out, sow it yourself, plant a garden, etc. However, the complexity of the division of land plots is because it is difficult to «divide» agricultural lands at least. After all, their intended use depends on the size, etc. Quite often, disputes also arise regarding the use of residential buildings, since the size and location of the rooms make their use impossible or difficult, as well as the distribution in kind according to the inherited shares. In other words, there is a certain «trading» of assets. If the situation is related to the distribution of a small plot of land where the house is located, then questions also arise regarding the establishment of an easement, as well as mutual concessions for the compensation of a part of the house in exchange for most of the land. In general, there are protracted negotiations, from the point of view of which these parties, who are still in a family relationship, agree on the division of property.Factors that can affect the outcome of property division include unique family circumstances, the specific nature of assets, and traditional legal practices. The parties will use different mechanisms for the division of joint assets: sale, donation, or exchange, under the terms of which they «trade» with the consent of others their rights as co-owners of jointly owned objects. The various evolutionary stages of the agreement on the division of property by the testator’s family culminate in the final stage of agreeing. The agreement on the division of inheritance is a complex legal process. Potentially, in a single transaction, the beneficiaries can choose and implement the division by sale, exchange, or donation. These different legal constructions reflect the uniqueness of the decisions in each agreement and to some extent demonstrate the specific legal practice of the individual Old Babylonian city-state and the particular circumstances of each family.However, in addition to the division of property, there are other agreements regarding the division of inheritance. For example, an agreement on quasi-partition upon adoption (quasi-adoption), an agreement on the division of residential property by the owner between its future beneficiaries.The need to conclude such agreements arises when an agreement on the division of property is required, which differs from such concepts as sale, donation, exchange, etc.Domestic scientists consider the agreement on the distribution of joint property very broadly and include other types of agreements in the list of such agreements, establishing that the agreement on changing the succession of the right to inheritance by law is atypical. It was determined that the contract under investigation belongs to contracts on the distribution of inheritance. Agreements on the distribution of inheritance are concluded in the field of inheritance, which indicates that they belong to inheritance agreements. It is proposed to supplement the existing classifications of civil law contracts by distinguishing a new type of civil law contracts – contracts in the law of inheritance on the level with the selection of a new type of inheritance contracts – contracts on the distribution of inheritance.» This is a bold hypothesis, but it is difficult to agree with it for various reasons, not least because the distribution of inheritance has been known since ancient times.The factor that the term «distribution» of inheritance and giving it a broad legal meaning is analyzed is an interesting author’s hypothesis. At the same time, according to our position, the term «distribution of inheritance» is more balanced, since in Art. 1278 of the Civil Code does not quite successfully use the term «division», when in the content of this norm it is about the equality of shares in the inheritance and the allocation of a share in kind, and not about division. However, in Part 1 of Art. 1280 of the Civil Code, the term «distribution» is used with a direct meaning and «redistribution» as an opportunity to review the results of the distribution under new circumstances – in the case of acceptance of the inheritance by other heirs. In essence, the obvious meaning of the term «distribution» follows from this norm as the initial determination of the ownership of the share of each of the heirs. In this sense, the redistribution of the inheritance should be connected with the possible introduction of changes to the previously made distribution, that is, in this case, we do not limit the number of subsequent redistributions of the inheritance. This hypothesis is related to the fact that the number of heirs who missed the deadline for valid reasons is not limited by legislation and cannot be limited, but is determined by various legal circumstances.Therefore, it is hardly expedient and possible, to apply in Art. 1280 of the Civil Code, the concept of «distribution» should be given a wider meaning than it has in the Civil Code, as this would lead to its ambiguous perception and application both in theory and in legislation and practice. Usually, theoretical terms should be distinguished by being original and should accurately reflect the legal meaning of actions, events, or conditions.But an important element of the procedure for the distribution of common inheritance property or its redistribution are the subjects who must fix the relevant agreement or carry out such distribution according to their conviction.It is indicated that the practice of concluding contracts by the living owner with his future heirs is widespread in foreign countries. At the same time, German experts equate inheritance with what they consider to be contractual inheritance.It should be noted that the practice of concluding contracts on the distribution of inheritance in the practice of the Ukrainian notary is relatively new and does not have clear boundaries in regulation, which complicates the activity of notaries in certifying such contracts. There are several difficulties in the application of relevant legal norms in practice, as there is a lack of understanding of the legal nature and essence of the conclusion of contracts, the term of conclusion, and the procedure for notarization.The opinions of individual authors are studied, about legal relations regarding the division of inheritance characterized by a weak state policy, this obliges the participants of such relations to draw up the content of agreements on the division of inheritance independently. For agreements between heirs on the distribution of inheritance to be valid regulators of the relations of its participants (heirs), conditions (clauses) must be clarified and formulated, which will be disclosed with sufficient completeness and consistency of the content of the relevant agreement and the purpose of its conclusion.We do not agree with this point of view of the scientist regarding «weak state policy», since the Central Committee of Ukraine was not created by politicians or the Ministry of Justice of Ukraine, but by leading scientists of Ukraine. It is also difficult to agree with the statement that the lack of clear regulation of the terms of inheritance contracts «obliges the participants of such relationships to independently draw up the content of inheritance distribution contracts.» In Ukraine, some good notaries and lawyers can draw up high-quality contracts for the distribution of inheritance. Moreover, according to Art. 4 of the Law of Ukraine «On Notaries», notaries have the right to draw up relevant draft contracts. In our opinion, it is worth emphasizing here that this is a right, not a duty of a notary public. That is, the notary may not undertake the drafting of the relevant project, but this provision is positive for interested parties since the lack of experience in drafting original contracts will most likely lead to the drafting of a low-quality draft contract. Indeed, in this case, it is worth looking for an experienced notary who will be able to draw up a draft contract, but this will make it possible to prevent errors in its drafting with a high probability.Thus, the agreement on the distribution of inheritance enters into force if the parties reach an agreement in the proper form on all the essential terms of the agreement. The main essential condition for agreeing on the division of inheritance is the subject of the agreement. However, either party may consider this condition insufficient and propose to include additional conditions in the contract. In this case, these conditions become essential. In connection with the instability of the regulation of the content of contracts between heirs on the distribution of inheritance, it can be concluded that the inclusion of normal conditions in the contract is currently impossible. We believe that such a general scheme of perception of contract terms is not entirely rational, since how to perceive ordinary terms or essential terms of a contract quite often in practice depends on the judgments of the parties to the contract unless otherwise regulated by legislation. This issue can be approached more precisely if we take into account the possibility of interpreting transactions and contracts (Article 213 of the Civil Code).So, based on the essence of the process of concluding contracts, it should be taken into account that the notary who drafts the contract can edit it, therefore it is worth recognizing the right of the notary to interpret it, since according to Art. 5 of the Law of Ukraine «On Notaries», he is obliged to clarify the legal consequences that will arise for persons after his certification. It follows from this that the notary must be given the official right to interpret the contract upon its certification, then it will be clear that after its certification, the court can interpret the content of the contract. In this regard, Art. 213 of the Civil Code is proposed to be supplemented with a corresponding provision regarding the powers of the notary, namely: his duty to interpret the content of the deed or contract before and during its certification.The Inheritance Regulation, which envisages wide acceptance of the inheritance contract, is considered. It is noted that it is worth revising Ukrainian inheritance law in advance for compliance with European standards since after Ukraine accedes to the EU it will be necessary to inform all EU countries about what types of contracts in Ukraine will be related to the issuance of the European Certificate of Succession.This is also important for inheritance by law, because, in case of non-fulfillment of the terms of the lifetime maintenance (care) agreement and the inheritance agreement, they will have to be terminated or recognized as invalid or unfulfilled by the acquirer, so the property that was the subject of this agreement will be inherited by law. At the same time, if the terms of these agreements are fulfilled, the part of the property that belonged to the testator will not be inherited but will become the property of the acquirers.The process of accepting the inheritance is quite long, and the inheritance law allows for several agreements between the heirs, which can significantly affect the size of the inheritance shares and the real things in each share in the inheritance. Therefore, it is necessary to analyze the possibility of agreements between the heirs at different stages of accepting or not accepting the inheritance. From communication with one of the clients, the author learned that the notary unofficially advised the heirs to agree on the distribution of the inheritance, as well as for certain heirs to waive the right to inheritance, but to receive a proper share of the inheritance in household items. When the author was informed of all the circumstances of the inheritance case, it became clear that the notary could not solve the complex inheritance problem, since the inheritance took place based on a will and some heirs had the right to a mandatory share, as well as part of the property remained. So, in such a situation, it was necessary to solve an arithmetical and at the same time legal problem, the complexity of which was determined by the complex subject composition of numerous heirs. Therefore, the notary tried to simplify its solution by artificially «transforming» the heirs who have the right to a mandatory share into ordinary heirs who claim property that is not subject to recording in the certificate of the right to inheritance.A natural will was considered, when the testator bequeathed the specific property to each of the heirs, namely: a house to a daughter, a factory to one son, and a yacht to another let’s say. In such a case, the will of the testator is formulated in the Shodo of the objects of inheritance, so it is difficult to perceive the consequences of the refusal of one of the heirs to inherit, when the yacht will be divided into equal shares between the son and the daughter, because: firstly, the value of the factory and the house will be different, so someone from the testator gave the children a larger inheritance than the other. Secondly, in the case of the existence of a part of the inheritance not covered by the will, it can be assumed with a high degree of probability that the will of the testator was formulated about a certain property and nothing more. Therefore, in case of refusal of one of the heirs to inherit under the will, the property bequeathed to him should be considered as not covered by the will and should be inherited according to the law. That is, if the will of the testator regarding the entire property is revealed, it can be assumed that he thus intended to deprive one of the heirs of the right to inheritance.At the same time, the will must be interpreted not only by the heirs under the will but also by the heirs under the law, when its content concerns the right to a mandatory share in the inheritance, which belongs to the heirs under the law of the first rank, who due to incapacity have the right to claim it, as well as the recipients of the response. With a high degree of probability, it can be assumed that the inheritance, which consists of household items, will be divided even without a written agreement. However, the interpretation of a will, which concerns a substantial inheritance between a significant number of heirs, requires not only a written form of recording of agreements – a contract, but also, in our opinion, a notarial form that will allow recording the agreement more reliably, to explain to the parties to the contract the consequences of its conclusion. If all interested parties sign the agreement, and the notary recognizes it as legal, then it will be difficult to recognize it as illegal or invalid in the next one. Therefore, the agreement on the interpretation of the will, which will establish the specific rights of the heirs and their obligations regarding the coverage of the testator’s debts, is a rational form of specification of the terms of the inheritance, which will allow establishing the executor of the will, if he was not determined by the testator.We can assume with a high degree of probability that similar «simplified calculations» are made by other notaries, as well as directly by the heirs, and certain agreements are not necessary here.

Abstract Frege presented his theory of signs in a series of essays, the most important of which is entitled “Über Sinn und Bedeutung.” Its English title is “On Sense and Reference.” I will introduce the basic thoughts of Fregean sign theory by means of this essay, referring to his other writings at points where further explanation seems necessary. Frege was primarily a mathematician and logician, and only secondarily a philosopher of language. His thoughts on language were motivated essentially by his aspiration to formulate the fundamentals of mathematics and logic clearly and rigorously. Evidently it was not common among the mathematicians of his time to differentiate clearly between “form” and “content,” for example (Frege 1966a: 21), specifying whether a number sign meant the numeral (that is, the written character) or what the numeral stands for (the number). As Frege writes, this can lead to “numerals being taken to be numbers, the proper objects of our discussion; and then, I admit, 7 and 2 +5 would indeed be different. But such a conception is untenable, for we cannot speak of any arithmetical properties of numbers whatsoever without going back to what the signs stand for” (Frege 1966a: 21). In other words, it is absolutely necessary to distinguish between “form and content, sign and thing signified” (Frege 1966a: 21). Yet the distinction of form and content frequently does not suffice for the adequate interpretation of a sentence. Frege makes this clear with the example of statements of equality of the form a=b: “Is it [equality] a relation.

Abstract It seems that we do not, for the following reasons: As Augustine says in his work Against Faustus, “Sin is a word or deed or desire contrary to the eternal law.” But every sin contrary to the eternal law is mortal. Therefore, every sin is mortal. Therefore, we do not properly distinguish sin into mortal and venial sin. Sin by its nature deserves punishment. But pardon, which takes away punishment, is contrary to punishment. Therefore, the venial is contrary to the nature of sin. But no specific difference dividing a genus is contrary to the genus. Therefore, the mortal and the venial cannot properly distinguish sin. Whoever turns inordinately, turns toward a transitory good and away from the immutable good, since in every movement, one who approaches one terminus recedes from the other. Therefore, whoever sins turns away from the immutable good. But this is to sin mortally. Therefore, whoever sins sins mortally. Therefore, there are not two kinds of sin: one mortal, the other venial.

This chapter studies the prominent place of the photograph in contemporary Black feminist writing. While the presence of the photograph could be interpreted as conveying Black feminists’ sense of the limits of the written word itself—the photograph appears as a sign or symbol of what words cannot describe or will not capture—this chapter argues that beautiful Black feminist writing has performed its work through the creation of a black feminist grammar that is always both discursive and visual. The visual logics of Black feminist beautiful writing have yielded a new form that includes the discursive and the representational.

Abstract It seems that gluttony is not, for the following reasons: No one sins regarding what one cannot avoid, as Augustine says in his work On Free Choice.1 But no one can avoid gluttony, for Gregory says in his work Morals that “in eating, pleasure is mixed with need; we do not know what need requires, or what plea-sure suffices. Therefore, gluttony is not a sin. Augustine says in his Confessions: Who is there, O Lord, who does not partake of food a little beyond the measure of need?”3 But doing such belongs to gluttony. There-fore, we cannot avoid gluttony. Therefore, gluttony is not a sin. Augustine says in his work On Free Choice that there is no moral fault where nature and need dominate.4 But nature and need move us to gluttony. Therefore, it seems that gluttony is not a sin.

Chapter two chronicles the ways that Black residents of Clarksdale define, talk about, and "use" the blues. Foster identifies three elements of blues talk—definitions that center personal memories and past experiences, definitions that draw distinctions between who can and cannot sing/live the blues, and definitions that celebrate a shared sense of group belonging. Foster considers the role that these definitions—and the feelings they engender—play in process of racial identity and social boundary making.

Abstract Chapter 6 addresses the following question: Can we recommend curative forgivingness to people living under oppression? At first blush, virtuous anger seems overall a more fitting response to wrongdoers whose actions express and perpetuate systemic evil. The chapter surveys and clarifies several ways in which anger can be taken to be virtuous. It then articulates a model of practical selfhood—the dialogical/dramatic model—that aims to accommodate both forgivingness and the virtue of anger for individuals living in non-ideal circumstances. It illustrates how the dialogical/dramatic model responds to a serious worry about anger-entrenchment. It suggests a theological meta-narrative that makes sense simultaneously of the virtues of anger and forgivingness. The picture that emerges is this: the virtuousness of anger cannot be assessed piecemeal, in separation from larger psychological forces active in one’s agency. These in turn depend on the larger meta-narratives, and one of the stories available to those oppressed expresses God’s own responses to systemic injustices. The chapter and the book end by suggesting not only that curative forgivingness is compatible with virtuous anger, but that they can be brought closer together through the concept of normative hope in persons.

Abstract Josephus’ account of the revolt against Rome and the events leading up to it includes reports of the activities of several figures who are usually described as sign prophets by scholars. There is some dispute about precisely which figures should be included in this category. My own list of Jewish sign prophets includes the following six individuals or groups: In this chapter, I shall review Josephus’ accounts concerning these figures and sketch the most important features of the prophetic type they represent. I shall concentrate, in the first instance, on simply describing their actions and behavior, as reported by Josephus, but I shall also attempt to give an account of the intentions and expectations of the sign prophets, insofar as this is possible. That last qualification is a significant one. In order to understand fully what the sign prophets intended by their actions and what they expected to happen, we would need to know a great deal more than we do about what they said and did, about the precise historical circumstances that gave rise to the movements they led, and about the religious beliefs and expectations current among Jews of their day. In what follows, I shall indicate the points at which my own views about the intentions and expectations of the sign prophets differ significantly from the current scholarly consensus and I shall state as clearly as possible what I think we can and cannot say with confidence.

Abstract This chapter explores Augustine’s account of why we sin and who is to blame for our sinning. The first section sets out Augustine’s core view that we sin due to our free choices and that we are to be blamed for our sinning. The second section looks at Augustine’s proposal for reconciling human freedom and divine foreknowledge. In the third section, the chapter explores Augustine’s reasons for maintaining that God cannot be blamed for our sinning even though he foreknows that we will sin. The fourth section presents Augustine’s reasons for maintaining that it is not necessary that some humans sin. Finally, the fifth section discusses three views concerning the relationship between freedom and divine foreknowledge.

Bind us together, Lord Bind us together With cords that cannot be broken Bind us together, Lord Bind us together Bind us together in Love There is only one God, There is only one King, There is only one Body, That is why we sing....

Background: Multiple System Atrophy is a neurodegenerative disease with parkinsonism, cerebelar ataxia and autonomic failure. Neurodegeneration with Brain Iron Accumulation diseases are neurodegenerative diseases, as the Pantothenate Kinase-Associated Neurodegeneration, with a very distinct pattern on neuroimaging, known as the “Eye of the Tiger Sign”, which is rare in MSA but many studies confirm the role of striatal regions iron accumulation in parkinsonisms. Objective: We describe MSA patients with iron accumulation in striatal regions in neuroimaging. Methods: We report clinical cases from São Paulo State University-Brazil. Results: 62-year-old with 5 years of bradykinesia and stiffness progressing to wheelchair, REM sleep behavioral disorder, no improvement with levodopa, disarthrophonia and choking with gastrostomy after 3 years, associated to syncope episodes. Neurological examination showed blood pressure of 105x80mmHg lying down and 80x60mmHg standing up, severe disarthrophonia, anterocapitis, severe parkinsonism, postural instability and ataxia. Neuroimaging showed the “Eye of the Tiger”, “putaminal rim” and the “hot cross bun” signs. 78-year-old with 1.5 years syncope episodes, slow walking, falls, difficulty moving hands and feet and constipation. No improvement with levodopa. Neurological examination showed blood pressure of 130x80 mmHg lying down and 90x60 mmHg standing up, severe bradykinesia and stiffness, drooling, ataxia and “square-wave jerks”. Neuroimaging showed “Eye of Tiger” and bilateral “putaminal rim” signs and cerebellar atrophy. In both cases were excluded all differential diagnosis. Conclusions: Both cases fulfilled criteria for MSA, with the radiological sign of the “Eye of the Tiger”. We emphasize the importance of knowing this variation of MSA to avoid diagnostic confusion.

We consider delamination crack growth controlled by gas diffusion into crack. Initially, with small pressure, the crack can be considered as an ideal sink. However, as crack grows, the pressure becomes greater, and therefore the crack cannot be considered an ideal sink anymore. In this research for both ideal- and real-sink conditions, closed-form solutions for the dependence of the radius of the growing delamination on time are obtained.

Autonomous vehicles have the potential to improve safety by eliminating human error in driving, as well as providing mobility to those who cannot safely drive. Such vehicles do require new technology to monitor their environment and ensure that they are operating safely. One such technology that will be necessary is the ability of the vehicle to recognize traffic situations and traffic signs. This can be accomplished by an appropriate implementation of edge detection methods. In this paper, we compare three different edge detection methods: Canny method, Sobel method and Zhang method. This comparison was conducted on both still pictures and on a video. When analyzing the video, which was taken on a clear day with an undamaged and clearly visible stop sign, all three methods performed equally well; the time at which the stop sign was identified, based on the edge map, was the same. The purpose of this comparison is to evaluate the performance of each of the three methods, in the context of the problem of identifying traffic signs. The methods are compared on still images of a stop sign under various conditions, in addition to the single video comparison. Based on the still image comparison, we conclude that Zhang’s method (linear prediction) generates the best edge map, particularly when the images include snow, ice, rain or other factors and even at night vision.

It is no doubt that communication plays a vital role in human life. There is, however, a significant population of hearing-impaired people who use non-verbal techniques for communication, which a majority of the people cannot understand. The predominant of these techniques is based on sign language, the main communication protocol among hearing impaired people. In this research, we propose a method to bridge the communication gap between hearing impaired people and others, which translates signed gestures into text. Most existing solutions, based on technologies such as Kinect, Leap Motion, Computer vision, EMG and IMU try to recognize and translate individual signs of hearing impaired people. The few approaches to sentence-level sign language recognition suffer from not being user-friendly or even practical owing to the devices they use. The proposed system is designed to provide full freedom to the user to sign an uninterrupted full sentence at a time. For this purpose, we employ two Myo armbands for gesture-capturing. Using signal processing and supervised learning based on a vocabulary of 49 words and 346 sentences for training with a single signer, we were able to achieve 75-80% word-level accuracy and 45-50% sentence level accuracy using gestural (EMG) and spatial (IMU) features for our signer-dependent experiment.

A comprehensive study is needed to address the human behavior at railroad grade crossings. Human behavior at different signs changes and it may lead to crashes. No guidance is provided in the recommendations provided by Manual on Uniform Traffic Control Devices where and when different type of signs and different combination of signs are appropriate. Crashes occur mostly when the drivers try to go through the gate or around the gate when a train is approaching. Drivers come to a complete stop at stop signs and then proceed only if a train is not coming, this may lead to a crash when they cannot accelerate in time to cross the tracks. Yield sign may have better results in this case. Cross-buck signs are same as the yield sign where drivers should slow down, look for the train and then proceed. However, people may tend to proceed without yielding as it is not as common of a sign. Hence we can say driver behavior at specific sign is important for the recommendation or the guideline to install a sign. Adopting a common sign at all grade crossings could provide enhanced consistency and reduce crashes. A literature review was done on human behavior at grade crossings and the crash rate at different types of signs. Driver behavior at the time of the crash for 15 states was studied from the Federal Railroad Administration data by reviewing detailed reasons for every crash. Driver behavior at different types of signs at the time of each crash was studied from the reviewed data and the literature review. Driver behavior at different signs was summarized.

The etching or machining of grooves so as to delineate isolated areas on a nonlinear interference filters (NLIFs) inhibits transverse conduction and consequently reduced both cross-talk effects and switch powers for optically bistable arrays. Assuming one-dimensional heat-flow through an insulating layer, into a high thermal conductivity substrate, switch energies in ZnSe NLIFs of around 10 pJ μm-2 are predicted [1,2]. The insulating layer between the NLIF and the heat-sink, which is to be pixellated, must be a non-crystalline material, for low thermal conductivity. Consequently direct etching, to form deep, narrow grooves, cannot be achieved with chemical etching techniques. Instead, we have used a laser micro-machining technique to process glass substrates, both before and after deposition of the multilayer device.

Elderly and disabled individuals must be able to access the indoor and outdoor environment in an easy and safe manner. Accessibility must be assessed not only in terms of physical friendliness for users, but also of cognitive friendliness such as the ease of wayfinding. To ensure the ease of wayfinding, signage information available at every key decision point is essential because it enables people to find their way in unfamiliar environment. The aim of the present study is to develop virtual accessibility evaluation system that evaluates the environment accessibility from the cognitive friendliness aspect, such as the ease of wayfinding, by combining realistic human behavior simulation using a digital human model (DHM) with as-is environment models. To realize this system, we develop a vision-based wayfinding simulation algorithm for the DHM in textured three-dimensional (3D) as-is environment models. The as-is environment models are constructed with the structure-from-motion (SfM) technique. During the wayfinding simulation, the visibility and legibility of each sign are evaluated on the basis of the visual perception of the DHM and its visibility catchment area (VCA). The DHM walking trajectory is dynamically generated depending on the perceived sign. When a disorientation place is detected where the DHM cannot find any sign indicating its destination, plans for rearranging the signs are proposed by the simulation user and then examined using a developed virtual eyesight simulator (VES). The VES enables the user to check the DHM eyesight virtually during the wayfinding simulation through a head-mounted display. To mimic visual impairments, visual impairment filters are introduced into the VES. In this paper, we demonstrate the process of detecting the disorientation place, and planning and evaluating the rearranged signage.

In the paper, we will discuss two separate, but connected issues: wave-turbulence interactions, and estimates of swell attenuation due to such turbulence. Theoreticaly, potential waves cannot generate the vortex motion, but the scale considerations indicate that if the steepness of waves is not too small, the Reynolds number can exceed the critical values. This means that in presence of initial non-potential disturbances the orbital velocities can generate the vortex motion and turbulence. This problem was investigated by laboratory means, numerical simulations and field observations. As a sink of wave energy, such dissipation is small in presence of wave breaking, but is essential for swell. Swell prediction by spectral wave models is often poor, but is important for offshore and maritime industry. Based on the research of wave-induced turbulence, new swell-dissipation function is proposed. It agrees well with satellite observations of long-distance swell propagation and is being employed and tested in spectral wave models.

Without a machine, human beings cannot process the massive data volume produced by us nowadays for business analysis purposes. Being part of the critical decision-making process in the commercial sector, the usage and role of Big Data, especially those collected from social listening are getting important: how a company listen to the true voices from a group of genuine customers and avoid those misleading, fake comments generated by the robot, to enhance the efficiency on measuring competitor's performance towards their marketing return compared to the investment (MROI), is critical and more challenging.In this paper, we will discuss various analytical methodologies from the angles of business and technological viewpoint: what decision-makers want from social media, what kind of information are they looking into, how visualization provides instant insights and what kind of system design provides enough interaction to the decision-maker. We will investigate the real-world challenges and difficulties: how the data inconsistency affects the computational analysis, what kind of obstacles was facing in the existing product de-sign in the market. Finally, we will conclude the used machine learning techniques that can address the mentioned business problems, including the successful rate, accuracy and various efficiency level in the studied samples.

Optically addressed spatial light modulators (OASLMs) that incorporate nematic liquid crystal (NLC) light modulating layers find many applications in optical information processing due to their gray-scale capability. These devices are usually driven with sine or square-wave voltages at frequencies of 1-10 kHz that are beyond those to which the NLC can respond. The NLC responds to the rms value of the applied voltage across it. Some NLC OASLMs incorporate photosensors of hydrogenated amorphous silicon (a-Si:H) that offer high resolution and high sensitivity[1-6]. We have made some NLC OASLMs with intrinsic a-Si:H for phase-modulation applications. The observed behavior from these devices cannot be explaining using a resistor-capacitor circuit model in which the a-Si:H is treated as a photoconductor. Instead, a metal-insulator-semiconductor (MIS) model is found to fit the experimental data very well. The indium-tin oxide (ITO) electrode and the NLC layer in the OASLM form the respective metal and insulator layers. This MIS model can be used to optimize the thicknesses of the NLC and a-Si:H layers in an OASLM to obtain large phase or amplitude modulation.

New language technologies are coming, thanks to the huge and competing private investment fuelling rapid progress; we can either understand and foresee their effects, or be taken by surprise and spend our time trying to catch up. This report scketches out some transformative new technologies that are likely to fundamentally change our use of language. Some of these may feel unrealistically futuristic or far-fetched, but a central purpose of this report - and the wider LITHME network - is to illustrate that these are mostly just the logical development and maturation of technologies currently in prototype. But will everyone benefit from all these shiny new gadgets? Throughout this report we emphasise a range of groups who will be disadvantaged and issues of inequality. Important issues of security and privacy will accompany new language technologies. A further caution is to re-emphasise the current limitations of AI. Looking ahead, we see many intriguing opportunities and new capabilities, but a range of other uncertainties and inequalities. New devices will enable new ways to talk, to translate, to remember, and to learn. But advances in technology will reproduce existing inequalities among those who cannot afford these devices, among the world’s smaller languages, and especially for sign language. Debates over privacy and security will flare and crackle with every new immersive gadget. We will move together into this curious new world with a mix of excitement and apprehension - reacting, debating, sharing and disagreeing as we always do. Plug in, as the human-machine era dawns.

The wafer-thin poll margins separating President Joe Biden and Donald Trump have surprised and baffled many analysts. This paper attempts no analysis of the election itself. It focuses instead on a clinical assessment of its macroeconomic context. Building on previous work, this paper looks first at inflation’s overall effect on real wages and salaries. It then considers claims advanced by Autor, Dube and McGrew (2023) and others about wages of the lowest paid workers. Real wages for most American workers have declined substantially under inflation. We observe no sign of a radical transformation of the U.S. labor market in favor of the lowest-paid workers. The (modest) increase in real hourly wages of the bottom 10% of U.S. workers during 2021-2023 owed little to any policy change or declining monopsony power: It was a unique case of wages rising to subsistence levels as COVID exponentially multiplied risks of working at what had previously been relatively safe jobs at the bottom of the wage distribution. The paper then analyzes inflation’s persistence in the face of substantial increases in interest rates. We document the wealth gains made by the richest 10% of U.S. households during 2020-2023. These wealth gains, which have no peacetime precedents, enabled the richest American households to step up consumption, even when their real incomes were falling. Empirically plausible estimations of the wealth effect on the consumption of the super-rich show that the wealth effect can account for all of the increase in aggregate consumption spending above its longer-term trend during 2021Q1-2023Q4. Importantly, the lopsided inequality in wealth makes controlling lopsided consumption spending by raising interest rates much harder for the Federal Reserve, without interest rate increases that would bring the rest of the economy to its knees much earlier. We also show that the persistence of inflation in several key service sectors is heavily influenced by captive regulators – a condition that higher interest rates cannot remedy.

We used Alexandria Digital, a world leading disinformation detection technology, to analyse almost a million posts on X (formerly known as Twitter) and Reddit comments during the first Republican primary debate and counterprogrammed Tucker Carlson and Donald Trump interview on the 23rd of August. What we did: • Collected 949,259 posts from the platform X, formerly known as Twitter. These posts were collected if they contained one of 11 relevant hashtags or keywords and were posted between 8:45pm and 11:15pm EST on 23rd August 2023. • Collected 20,549 comments from two separate Reddit threads. Both were discussion threads dedicated to the first Republican primary Debate and the Tucker Carlson and Donald Trump interview from r/Conservative and r/politics. • This methodology allowed us to capture narratives and conduct analysis of coordinated behaviour that occurred immediately before, during, and after the Republican primary debate and the airing of the Tucker Carlson interview of Donald Trump. What we found: • A coordinated network of over 1200 accounts promoting the conspiracy theory that Donald Trump won the 2020 United States presidential election that received over 3 million impressions on the platform X; • A sprawling bot network consisting of 1,305 unique accounts with a variety of clusters; • Some of the largest clusters were coordinated troll networks in support of Donald Trump; a coordinated network of misleading news outlets, and a clickbait Pro-Trump bot network. • No coordinated activity was found on Reddit during the Republican Primary Debate or in discussion of the Tucker Carlson and Donald Trump interview. What does this mean? • X is flooded with platform manipulation of various kinds, is not doing enough to moderate content, and has no clear strategy for dealing with political disinformation. • A haven for disinformation. While pre-Musk Twitter previously managed to moderate harmful conspiracy theories such as QAnon, X is now a safe space for conspiracy theorists and political disinformation. • That no evidence of coordinated influence activity was found on Reddit suggests the extensive rules and moderation either prevented or removed coordinated activity from the platform. • Worrying trends. Given the prevalence of mis- and disinformation during the debate and interview, the leadup to the US 2024 Presidential Election is likely to witness a surge of information disorder on the platform. • Trump is back. The reinstatement of Donald Trump’s X account has emboldened conspiracy theorists and the far right, who are interpreting this as a sign that the reason why Trump was suspended (incitement to violence) validates election fraud disinformation and activism. • Anything goes. The lack of a freely available Twitter Application Programming Interface (API) means that researchers, journalists, and regulators cannot monitor disinformation on X and hold the platform to account.

Abstract Rationale Early treatment of asthma exacerbations with inhaled corticosteroids is the best strategy for management, although use of an increased or stable dose is questioned. Objectives To compare the clinical effectiveness and safety of increased versus stable doses of inhaled corticosteroids as part of a patient-initiated action plan for the home management of exacerbations in children and adults with persistent asthma. Search methods We searched the Cochrane Airways Group Specialised Register (part of CENTRAL), MEDLINE, Embase, CINAHL, major trials registries and handsearched abstracts up to 20 December 2021. Eligibility criteria Parallel and cross-over blinded randomised controlled trials (RCTs) Outcomes Treatment failure (the need for rescue oral steroids) in the randomised population and in the subset who initiated the study inhaler, unscheduled physician visits, unscheduled acute care, emergency department or hospital visits, serious and non-serious adverse events, and duration of exacerbation. Risk of bias We used Risk of Bias 2 (RoB 2)and the tool's extension for cross-over trials. Synthesis methods We conducted meta-analyses using fixed-effect models to calculate odds ratios (OR) and 95% confidence intervals (CI) for all but one outcome, which used random-effects models due to heterogeneity (treatment failure in the subset who initiated the study inhaler). We summarised certainty of evidence according to GRADE methods. Included studies We included nine RCTs (seven parallel and two cross‐over) with a total of 1923 participants. The studies were conducted in Europe, North America, and Australasia and were published between 1998 and 2018. Five studies evaluated adult populations (1247 participants; ≥ 15 years), and four studies evaluated child or adolescent populations (676 participants; < 15 years). Approximately 50% of randomised participants initiated the study inhaler (range 23% to 100%). The studies reported treatment failure in various ways, so we made assumptions to allow us to combine data. Synthesis of results People randomised to increase their inhaled corticosteroids dose at the first signs of an exacerbation probably had similar odds of needing rescue oral corticosteroids to those randomised to a placebo inhaler (OR 0.97, 95% CI 0.76 to 1.25; 8 studies, 1774 participants; moderate-certainty evidence). Results for the same outcome in the subset of participants who initiated the study inhaler (approximately 50%) gives a different point estimate with very low certainty due to heterogeneity, imprecision and risk of bias (OR 0.84, 95% CI 0.54 to 1.30; 7 studies, 766 participants; random-effects model used). For adverse effects, imprecision and risk of bias from missing data, outcome measurement and reporting meant we were very uncertain about the effect estimate (serious adverse events OR 1.69, 95% CI 0.77 to 3.71; 2 studies, 394 participants; non-serious adverse events OR 2.15, 95% CI 0.68 to 6.73; 2 studies, 142 participants). We had very low confidence in the effect estimates for unscheduled physician visits, unscheduled acute care, emergency department or hospital visits and duration of exacerbation due to risk of bias. Authors' conclusions Evidence suggests that adults and children with mild to moderate asthma are unlikely to have an important reduction in the need for oral steroids from increasing a patient's inhaled corticosteroid dose at the first sign of an exacerbation. Other clinically important benefits and potential harms cannot be ruled out due to wide confidence intervals, risk of bias in the studies, and assumptions made for synthesis when combining data. Included studies reflect evolving clinical practice and study methods, and the data do not support thorough investigation of effect modifiers such as baseline dose, fold increase, asthma severity and timing. The review does not include recent evidence from pragmatic, unblinded studies showing benefits of larger dose increases in those with poorly controlled asthma. Differences between the blinded and unblinded studies should be investigated. Funding This Cochrane Review had no dedicated funding. Registration Protocol (2009): doi.org/10.1002/14651858.CD007524 Original review (2010): doi.org/10.1002/14651858.CD007524.pub3 Review update (2014): doi.org/10.1002/14651858.CD007524.pub4

Abstract Rationale Early treatment of asthma exacerbations with inhaled corticosteroids is the best strategy for management, although use of an increased or stable dose is questioned. Objectives To compare the clinical effectiveness and safety of increased versus stable doses of inhaled corticosteroids as part of a patient-initiated action plan for the home management of exacerbations in children and adults with persistent asthma. Search methods We searched the Cochrane Airways Group Specialised Register (part of CENTRAL), MEDLINE, Embase, CINAHL, major trials registries and handsearched abstracts up to 20 December 2021. Eligibility criteria Parallel and cross-over blinded randomised controlled trials (RCTs) Outcomes Treatment failure (the need for rescue oral steroids) in the randomised population and in the subset who initiated the study inhaler, unscheduled physician visits, unscheduled acute care, emergency department or hospital visits, serious and non-serious adverse events, and duration of exacerbation. Risk of bias We used Risk of Bias 2 (RoB 2)and the tool's extension for cross-over trials. Synthesis methods We conducted meta-analyses using fixed-effect models to calculate odds ratios (OR) and 95% confidence intervals (CI) for all but one outcome, which used random-effects models due to heterogeneity (treatment failure in the subset who initiated the study inhaler). We summarised certainty of evidence according to GRADE methods. Included studies We included nine RCTs (seven parallel and two cross‐over) with a total of 1923 participants. The studies were conducted in Europe, North America, and Australasia and were published between 1998 and 2018. Five studies evaluated adult populations (1247 participants; ≥ 15 years), and four studies evaluated child or adolescent populations (676 participants; < 15 years). Approximately 50% of randomised participants initiated the study inhaler (range 23% to 100%). The studies reported treatment failure in various ways, so we made assumptions to allow us to combine data. Synthesis of results People randomised to increase their inhaled corticosteroids dose at the first signs of an exacerbation probably had similar odds of needing rescue oral corticosteroids to those randomised to a placebo inhaler (OR 0.97, 95% CI 0.76 to 1.25; 8 studies, 1774 participants; moderate-certainty evidence). Results for the same outcome in the subset of participants who initiated the study inhaler (approximately 50%) gives a different point estimate with very low certainty due to heterogeneity, imprecision and risk of bias (OR 0.84, 95% CI 0.54 to 1.30; 7 studies, 766 participants; random-effects model used). For adverse effects, imprecision and risk of bias from missing data, outcome measurement and reporting meant we were very uncertain about the effect estimate (serious adverse events OR 1.69, 95% CI 0.77 to 3.71; 2 studies, 394 participants; non-serious adverse events OR 2.15, 95% CI 0.68 to 6.73; 2 studies, 142 participants). We had very low confidence in the effect estimates for unscheduled physician visits, unscheduled acute care, emergency department or hospital visits and duration of exacerbation due to risk of bias. Authors' conclusions Evidence suggests that adults and children with mild to moderate asthma are unlikely to have an important reduction in the need for oral steroids from increasing a patient's inhaled corticosteroid dose at the first sign of an exacerbation. Other clinically important benefits and potential harms cannot be ruled out due to wide confidence intervals, risk of bias in the studies, and assumptions made for synthesis when combining data. Included studies reflect evolving clinical practice and study methods, and the data do not support thorough investigation of effect modifiers such as baseline dose, fold increase, asthma severity and timing. The review does not include recent evidence from pragmatic, unblinded studies showing benefits of larger dose increases in those with poorly controlled asthma. Differences between the blinded and unblinded studies should be investigated. Funding This Cochrane Review had no dedicated funding. Registration Protocol (2009): doi.org/10.1002/14651858.CD007524 Original review (2010): doi.org/10.1002/14651858.CD007524.pub3 Review update (2014): doi.org/10.1002/14651858.CD007524.pub4

Abstract Rationale Early treatment of asthma exacerbations with inhaled corticosteroids is the best strategy for management, although use of an increased or stable dose is questioned. Objectives To compare the clinical effectiveness and safety of increased versus stable doses of inhaled corticosteroids as part of a patient-initiated action plan for the home management of exacerbations in children and adults with persistent asthma. Search methods We searched the Cochrane Airways Group Specialised Register (part of CENTRAL), MEDLINE, Embase, CINAHL, major trials registries and handsearched abstracts up to 20 December 2021. Eligibility criteria Parallel and cross-over blinded randomised controlled trials (RCTs) Outcomes Treatment failure (the need for rescue oral steroids) in the randomised population and in the subset who initiated the study inhaler, unscheduled physician visits, unscheduled acute care, emergency department or hospital visits, serious and non-serious adverse events, and duration of exacerbation. Risk of bias We used Risk of Bias 2 (RoB 2)and the tool's extension for cross-over trials. Synthesis methods We conducted meta-analyses using fixed-effect models to calculate odds ratios (OR) and 95% confidence intervals (CI) for all but one outcome, which used random-effects models due to heterogeneity (treatment failure in the subset who initiated the study inhaler). We summarised certainty of evidence according to GRADE methods. Included studies We included nine RCTs (seven parallel and two cross‐over) with a total of 1923 participants. The studies were conducted in Europe, North America, and Australasia and were published between 1998 and 2018. Five studies evaluated adult populations (1247 participants; ≥ 15 years), and four studies evaluated child or adolescent populations (676 participants; < 15 years). Approximately 50% of randomised participants initiated the study inhaler (range 23% to 100%). The studies reported treatment failure in various ways, so we made assumptions to allow us to combine data. Synthesis of results People randomised to increase their inhaled corticosteroids dose at the first signs of an exacerbation probably had similar odds of needing rescue oral corticosteroids to those randomised to a placebo inhaler (OR 0.97, 95% CI 0.76 to 1.25; 8 studies, 1774 participants; moderate-certainty evidence). Results for the same outcome in the subset of participants who initiated the study inhaler (approximately 50%) gives a different point estimate with very low certainty due to heterogeneity, imprecision and risk of bias (OR 0.84, 95% CI 0.54 to 1.30; 7 studies, 766 participants; random-effects model used). For adverse effects, imprecision and risk of bias from missing data, outcome measurement and reporting meant we were very uncertain about the effect estimate (serious adverse events OR 1.69, 95% CI 0.77 to 3.71; 2 studies, 394 participants; non-serious adverse events OR 2.15, 95% CI 0.68 to 6.73; 2 studies, 142 participants). We had very low confidence in the effect estimates for unscheduled physician visits, unscheduled acute care, emergency department or hospital visits and duration of exacerbation due to risk of bias. Authors' conclusions Evidence suggests that adults and children with mild to moderate asthma are unlikely to have an important reduction in the need for oral steroids from increasing a patient's inhaled corticosteroid dose at the first sign of an exacerbation. Other clinically important benefits and potential harms cannot be ruled out due to wide confidence intervals, risk of bias in the studies, and assumptions made for synthesis when combining data. Included studies reflect evolving clinical practice and study methods, and the data do not support thorough investigation of effect modifiers such as baseline dose, fold increase, asthma severity and timing. The review does not include recent evidence from pragmatic, unblinded studies showing benefits of larger dose increases in those with poorly controlled asthma. Differences between the blinded and unblinded studies should be investigated. Funding This Cochrane Review had no dedicated funding. Registration Protocol (2009): doi.org/10.1002/14651858.CD007524 Original review (2010): doi.org/10.1002/14651858.CD007524.pub3 Review update (2014): doi.org/10.1002/14651858.CD007524.pub4

Abstract Rationale Early treatment of asthma exacerbations with inhaled corticosteroids is the best strategy for management, although use of an increased or stable dose is questioned. Objectives To compare the clinical effectiveness and safety of increased versus stable doses of inhaled corticosteroids as part of a patient-initiated action plan for the home management of exacerbations in children and adults with persistent asthma. Search methods We searched the Cochrane Airways Group Specialised Register (part of CENTRAL), MEDLINE, Embase, CINAHL, major trials registries and handsearched abstracts up to 20 December 2021. Eligibility criteria Parallel and cross-over blinded randomised controlled trials (RCTs) Outcomes Treatment failure (the need for rescue oral steroids) in the randomised population and in the subset who initiated the study inhaler, unscheduled physician visits, unscheduled acute care, emergency department or hospital visits, serious and non-serious adverse events, and duration of exacerbation. Risk of bias We used Risk of Bias 2 (RoB 2)and the tool's extension for cross-over trials. Synthesis methods We conducted meta-analyses using fixed-effect models to calculate odds ratios (OR) and 95% confidence intervals (CI) for all but one outcome, which used random-effects models due to heterogeneity (treatment failure in the subset who initiated the study inhaler). We summarised certainty of evidence according to GRADE methods. Included studies We included nine RCTs (seven parallel and two cross‐over) with a total of 1923 participants. The studies were conducted in Europe, North America, and Australasia and were published between 1998 and 2018. Five studies evaluated adult populations (1247 participants; ≥ 15 years), and four studies evaluated child or adolescent populations (676 participants; < 15 years). Approximately 50% of randomised participants initiated the study inhaler (range 23% to 100%). The studies reported treatment failure in various ways, so we made assumptions to allow us to combine data. Synthesis of results People randomised to increase their inhaled corticosteroids dose at the first signs of an exacerbation probably had similar odds of needing rescue oral corticosteroids to those randomised to a placebo inhaler (OR 0.97, 95% CI 0.76 to 1.25; 8 studies, 1774 participants; moderate-certainty evidence). Results for the same outcome in the subset of participants who initiated the study inhaler (approximately 50%) gives a different point estimate with very low certainty due to heterogeneity, imprecision and risk of bias (OR 0.84, 95% CI 0.54 to 1.30; 7 studies, 766 participants; random-effects model used). For adverse effects, imprecision and risk of bias from missing data, outcome measurement and reporting meant we were very uncertain about the effect estimate (serious adverse events OR 1.69, 95% CI 0.77 to 3.71; 2 studies, 394 participants; non-serious adverse events OR 2.15, 95% CI 0.68 to 6.73; 2 studies, 142 participants). We had very low confidence in the effect estimates for unscheduled physician visits, unscheduled acute care, emergency department or hospital visits and duration of exacerbation due to risk of bias. Authors' conclusions Evidence suggests that adults and children with mild to moderate asthma are unlikely to have an important reduction in the need for oral steroids from increasing a patient's inhaled corticosteroid dose at the first sign of an exacerbation. Other clinically important benefits and potential harms cannot be ruled out due to wide confidence intervals, risk of bias in the studies, and assumptions made for synthesis when combining data. Included studies reflect evolving clinical practice and study methods, and the data do not support thorough investigation of effect modifiers such as baseline dose, fold increase, asthma severity and timing. The review does not include recent evidence from pragmatic, unblinded studies showing benefits of larger dose increases in those with poorly controlled asthma. Differences between the blinded and unblinded studies should be investigated. Funding This Cochrane Review had no dedicated funding. Registration Protocol (2009): doi.org/10.1002/14651858.CD007524 Original review (2010): doi.org/10.1002/14651858.CD007524.pub3 Review update (2014): doi.org/10.1002/14651858.CD007524.pub4

Surveys were conducted for the presence of Allegheny woodrats, eastern small-footed bats, and their habitat within Sample Units surrounding potential climbing routes on the White Rocks cliff of Cumberland Gap National Historical Park. White Rocks is a 200-300ft south facing cliff along the Virginia- Kentucky border that contains the typical habitat requirements of both species: rock ledges, outcrops, or a network of fissures and crevices surrounded by forested habitat. The eastern small-footed bat uses this type of habitat primarily during the summer months for roosting while the Allegheny woodrat is present year-round building nests within deep crevices. The eastern small-footed bat is listed as threatened in Kentucky and both are considered Species of Greatest Conservation Need in Virginia. The rock-climbing community has approached the National Park Service with interest in opening the cliff to recreational climbing. The results of this survey will be used to assess impacts to the species and aid in the studies required for the potential development of a formal climbing management plan. Surveys were conducted from August 24 to September 3, 2021, and included searches of the cliff face via rappelling, ground searches of suitable habitat surrounding the rim and base of the climbing routes, and noninvasive woodrat camera trap and bat acoustic surveys. Suitable eastern small-footed bat and Allegheny woodrat habitat was documented along all eleven potential climbing routes, and results of the acoustic and camera trap surveys confirmed the presence of both species. Surveyors did not observe roosting bats during visual encounter surveys, so we cannot confirm they are roosting along the specific climbing routes. It is likely they are using or could use the habitat at some point given their presence at the site. Surveyors did not observe obvious sign of woodrat presence, perhaps due to the complexity of the cliff habitat, but woodrats were captured at 32 of 37 (86%) camera sites. Video of woodrat activity at sites F3-C3, MF-C3, and CC-C1 confirm that these cameras were placed at crevices actively used by woodrats for caching food. Woodrat activity was captured on the first night at nearly half of the camera sites (40%) and within all Sample Units except SU-4. This suggests that the rim and/or base of most climbing routes are at or near core activity centers. Detection data was fitted to occupancy models to estimate probabilities of site occupancy and detection. Consistent with observations of woodrat activity detection probabilities and na?ve estimates of occupancy indicate woodrats are active at both the rim and base throughout the white rocks area. Design constraints, however, make it difficult to make strong inferences about factors affecting occupancy at the site or to predict occupancy at unsampled areas of the White Rocks cliff. Detection probabilities were high in all Sample Units especially after the first night of detection and were positively associated with habitat. However, these variables had little to do with site occupancy rates and are not very informative for predicting the influence of climbing activities on Allegheny woodrats. Research on the effects of rock climbing to roosting bats and Allegheny woodrats is lacking, but it has the potential to negatively impact these species both directly and indirectly. Directly through disturbance or harm to roosting bats or woodrats during climbing activities and indirectly through degradation of the cliff face and loss of suitable habitat. Whether climbing activities negatively affect the population of either species may depend on the amount of suitable habitat in areas where climbing does not occur and the extent of climbing activities. Suitable habitat does not appear to be a limiting factor at the site and the White Rocks cliff area extends beyond the potential climbing areas. These and other factors such as the presence of other species of concern should be considered when evaluating alternatives to continue climbing closures or consider opening the cliff to recreational climbing with protection measures. Measures that may reduce the impact of climbing activities on these species include additional surveys to determine exact roosting or nesting areas, restrictions on the amount and timing of climbing activities, restrictions on actions that degrade or remove vegetation from the rock surface, and education about the presence of these species at the site.