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BACKGROUND: The use of social media and photo-editing practice has grown enormously over the past decades. Photo editing can alter a person's desire to look better in photographs posted on social media platforms. OBJECTIVE: To assess the cosmetic dermatology seeking behavior of social media users and those who edit photographs before posting them on social media platforms. METHODS: A validated self-administered structured questionnaire via Google form was sent to 550 social media users in Nepal. It included 5 sub-headings: use of social networking sites, photo-editing practices, awareness and motivation about cosmetic dermatology care, cosmetic dermatology care seeking behavior and self-esteem. RESULTS: Facebook and Instagram were the preferred social networking sites for posting photographs. One-fourth of the participants edited >40% of the total photos posted in social media. Hiding skin lesions was the most common reason (36.3%) for photograph editing. Fifty percent of the respondents felt the need to look better; repair skin damage; be able to look good without make up; look younger; feel happier and improve total quality of life as a "lot and top" motivation for using the cosmetic dermatological procedures. A majority preferred to seek cosmetic dermatology care from non-dermatologists because they felt dermatologist visit was not needed, the services were costly and they could not visit due to their busy schedule. On multivariate analysis, respondents who were aware of skin care favored seeking cosmetic dermatology care from dermatologists. CONCLUSION: Higher investment in social media and photo-editing practices might be associated with increased non-dermatologist seeking behavior.

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PRECIS: The agreement between a head-mounted perimeter [GearVision (GV)] and Humphrey field analyzer (HFA) for total threshold sensitivity was a mean difference of -1.9 dB (95% limits of agreement -5 to 1). GV was the preferred perimeter in 68.2% of participants. PURPOSE: The purpose of this study was to compare reliability indices and threshold sensitivities obtained using a novel, smartphone-based, head-mounted perimeter (GV) with the HFA in normal, glaucoma suspect and glaucoma patients. A secondary objective was to evaluate the subjective experience participants had with both perimeters using a questionnaire. METHODS: In a prospective, cross-sectional study; 107 eyes (34 glaucoma, 18 glaucoma suspect, and 55 normal) of 54 participants underwent HFA and GV in random order. The main outcome measure was the agreement of threshold sensitivities using Bland and Altman analysis. Participants also completed a questionnaire about their experience with the devices. RESULTS: Median false-positive response rate for GV was 7% (4% to 12%), while for HFA it was 0% (0% to 6%, P<0.001). Median false-negative response rate was similar for both tests. In all, 84 eyes with reliable HFA and GV results were included in the final analysis. Median threshold sensitivity of all 52 points on HFA was 29.1 dB (26.5 to 30.7 dB) and for GV was 30.6 dB (29.1 to 32.6 dB; P<0.001). Mean difference (95% limits of agreement) in total threshold sensitivity between HFA and GV was -1.9 dB (-5 to 1 dB). The 95% limits of agreement were fairly narrow (-8 to 2 dB) across the 6 Garway-Heath sectors. Most participants preferred to perform GV (68.2%) if required to repeat perimetry compared with HFA (20.6%, P<0.001). CONCLUSIONS: There was fairly good agreement between the threshold sensitivities of GV and HFA. GV was also preferred by most patients and could potentially supplement HFA as a portable or home perimeter.

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Manipulation of physical models such as tangrams and tiles is a popular approach to teaching early mathematics concepts. This pedagogical approach is extended by new computational media, where mathematical entities such as equations and vectors can be virtually manipulated. The cognitive and neural mechanisms supporting such manipulation-based learning-particularly how actions generate new internal structures that support problem-solving-are not understood. We develop a model of the way manipulations generate internal traces embedding actions, and how these action-traces recombine during problem-solving. This model is based on a study of two groups of sixth-grade students solving area problems. Before problem-solving, one group manipulated a tangram, the other group answered a descriptive test. Eye-movement trajectories during problem-solving were different between the groups. A second study showed that this difference required the tangram's geometrical structure, just manipulation was not enough. We propose a theoretical model accounting for these results, and discuss its implications.

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UNLABELLED: Regulatory agencies have shifted their emphasis from measuring emissions during certification cycles to measuring emissions during actual use. Emission measurements in this research were made from two different large ships at sea to compare the Simplified Measurement Method (SMM) compliant with the International Maritime Organization (IMO) NOx Technical Code to the Portable Emission Measurement Systems (PEMS) compliant with the US. Environmental Protection Agency (EPA) 40 Code of Federal Regulations (CFR) Part 1065 for on-road emission testing. Emissions of nitrogen oxides (NOx), carbon dioxide (CO2), and carbon monoxide (CO) were measured at load points specified by the International Organization for Standardization (ISO) to compare the two measurement methods. The average percentage errors calculated for PEMS measurements were 6.5%, 0.6%, and 357% for NOx, CO2, and CO, respectively. The NOx percentage error of 6.5% corresponds to a 0.22 to 1.11 g/kW-hr error in moving from Tier III (3.4 g/kW-hr) to Tier I (17.0 g/kW-hr) emission limits. Emission factors (EFs) of NOx and CO2 measured via SMM were comparable to other studies and regulatory agencies estimates. However EF(PM2.5) for this study was up to 26% higher than that currently used by regulatory agencies. The PM2.5 was comprised predominantly of hydrated sulfate (70-95%), followed by organic carbon (11-14%), ash (6-11%), and elemental carbon (0.4-0.8%). IMPLICATIONS: This research provides direct comparison between the International Maritime Organization and U.S. Environmental Protection Agency reference methods for quantifying in-use emissions from ships. This research provides correlations for NOx, CO2, and CO measured by a PEMS unit (certified by U.S. EPA for on-road testing) against IMO's Simplified Measurement Method for on-board certification. It substantiates the measurements of NOx by PEMS and quantifies measurement error. This study also provides in-use modal and overall weighted emission factors of gaseous (NOx, CO, CO2, total hydrocarbons [THC], and SO2) and particulate pollutants from the main engine of a container ship, which are helpful in the development of emission inventory.

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Reducing emissions from ocean-going vessels (OGVs) as they sail near populated areas is a widely recognized goal, and Vessel Speed Reduction (VSR) is one of several strategies that is being adopted by regulators and port authorities. The goal of this research was to measure the emission benefits associated with greenhouse gas and criteria pollutants by operating OGVs at reduced speed. Emissions were measured from one Panamax and one post-Panamax class container vessels as their vessel speed was reduced from cruise to 15 knots or below. VSR to 12 knots yielded carbon dioxide (CO(2)) and nitrogen oxides (NO(x)) emissions reductions (in kg/nautical mile (kg/nmi)) of approximately 61% and 56%, respectively, as compared to vessel cruise speed. The mass emission rate (kg/nmi) of PM(2.5) was reduced by 69% with VSR to 12 knots alone and by ~97% when coupled with the use of the marine gas oil (MGO) with 0.00065% sulfur content. Emissions data from vessels while operating at sea are scarce and measurements from this research demonstrated that tidal current is a significant parameter affecting emission factors (EFs) at lower engine loads. Emissions factors at ≤20% loads calculated by methodology adopted by regulatory agencies were found to underestimate PM(2.5) and NO(x) by 72% and 51%, respectively, when compared to EFs measured in this study. Total pollutant emitted (TPE) in the emission control area (ECA) was calculated, and emission benefits were estimated as the VSR zone increased from 24 to 200 nmi. TPE(CO2) and TPE(PM2.5) estimated for large container vessels showed benefits for CO(2) (2-26%) and PM(2.5) (4-57%) on reducing speeds from 15 to 12 knots, whereas TPE(CO2) and TPE(PM2.5) for small and medium container vessels were similar at 15 and 12 knots.

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Emissions from harbor-craft significantly affect air quality in populated regions near ports and inland waterways. This research measured regulated and unregulated emissions from an in-use EPA Tier 2 marine propulsion engine on a ferry operating in a bay following standard methods. A special effort was made to monitor continuously both the total Particulate Mass (PM) mass emissions and the real-time Particle Size Distribution (PSD). The engine was operated following the loads in ISO 8178-4 E3 cycle for comparison with the certification standards and across biodiesel blends. Real-time measurements were also made during a typical cruise in the bay. Results showed the in-use nitrogen oxide (NOx) and PM(2.5) emission factors were within the not to exceed standard for Tier 2 marine engines. Comparing across fuels we observed the following: a) no statistically significant change in NO(x) emissions with biodiesel blends (B20, B50); b) ∼ 16% and ∼ 25% reduction of PM(2.5) mass emissions with B20 and B50 respectively; c) a larger organic carbon (OC) to elemental carbon (EC) ratio and organic mass (OM) to OC ratio with B50 compared to B20 and B0; d) a significant number of ultrafine nuclei and a smaller mass mean diameter with increasing blend-levels of biodiesel. The real-time monitoring of gaseous and particulate emissions during a typical cruise in the San Francisco Bay (in-use cycle) revealed important effects of ocean/bay currents on emissions: NO(x) and CO(2) increased 3-fold; PM(2.5) mass increased 6-fold; and ultrafine particles disappeared due to the effect of bay currents. This finding has implications on the use of certification values instead of actual in-use emission values when developing inventories. Emission factors for some volatile organic compounds (VOCs), carbonyls, and poly aromatic hydrocarbons (PAHs) are reported as supplemental data.

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We report the first joint shipboard and airborne study focused on the chemical composition and water-uptake behavior of particulate ship emissions. The study focuses on emissions from the main propulsion engine of a Post-Panamax class container ship cruising off the central coast of California and burning heavy fuel oil. Shipboard sampling included micro-orifice uniform deposit impactors (MOUDI) with subsequent off-line analysis, whereas airborne measurements involved a number of real-time analyzers to characterize the plume aerosol, aged from a few seconds to over an hour. The mass ratio of particulate organic carbon to sulfate at the base of the ship stack was 0.23 +/- 0.03, and increased to 0.30 +/- 0.01 in the airborne exhaust plume, with the additional organic mass in the airborne plume being concentrated largely in particles below 100 nm in diameter. The organic to sulfate mass ratio in the exhaust aerosol remained constant during the first hour of plume dilution into the marine boundary layer. The mass spectrum of the organic fraction of the exhaust aerosol strongly resembles that of emissions from other diesel sources and appears to be predominantly hydrocarbon-like organic (HOA) material. Background aerosol which, based on air mass back trajectories, probably consisted of aged ship emissions and marine aerosol, contained a lower organic mass fraction than the fresh plume and had a much more oxidized organic component. A volume-weighted mixing rule is able to accurately predict hygroscopic growth factors in the background aerosol but measured and calculated growth factors do not agree for aerosols in the ship exhaust plume. Calculated CCN concentrations, at supersaturations ranging from 0.1 to 0.33%, agree well with measurements in the ship-exhaust plume. Using size-resolved chemical composition instead of bulk submicrometer composition has little effect on the predicted CCN concentrations because the cutoff diameter for CCN activation is larger than the diameter where the mass fraction of organic aerosol begins to increase significantly. The particle number emission factor estimated from this study is 1.3 x 10(16) (kg fuel)(-1), with less than 1/10 of the particles having diameters above 100 nm; 24% of particles (>10 nm in diameter) activate into cloud droplets at 0.3% supersaturation.

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The impact of primary fine particulate matter (PM2.5) from ship emissions within the Southern California Air Basin is quantified by comparing in-stack vanadium (V) and nickel (Ni) measurements from in-use ocean-going vessels (OGVs) with ambient measurements made at 10 monitoring stations throughout Southern California. V and Ni are demonstrated as robust markers for the combustion of heavy fuel oil in OGVs, and ambient measurements of fine particulate V and Ni within Southern California are shown to decrease inversely with increased distance from the ports of Los Angeles and Long Beach (ports). High levels of V and Ni were observed from in-stack emission measurements conducted on the propulsion engines of two different in-use OGVs. The in-stack V and Ni emission rates (g/h) normalized by the V and Ni contents in the fuel tested correlates with the stack total PM emission rates (g/h). The normalized emission rates are used to estimate the primary PM2.5 contributions from OGVs at 10 monitoring locations within Southern California. Primary PM2.5 contributions from OGVs were found to range from 8.8% of the total PM2.5 at the monitoring location closest to the port (West Long Beach) to 1.4% of the total PM2.5 at the monitoring location 80 km inland (Rubidoux). The calculated OGV contributions to ambient PM2.5 measurements at the 10 monitoring sites agree well with estimates developed using an emission inventory based regional model. Results of this analysis will be useful in determining the impacts of primary particulate emissions from OGVs upon worldwide communities downwind of port operations.

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This work presents an all-inclusive set of regulated and nonregulated emission factors for the main propulsion engine (ME), auxiliary engine (AE) and an auxiliary boiler on a Suezmax class tanker while operating at sea. The data include criteria pollutants (carbon monoxide, nitrogen oxides, sulfur oxides, and particulate matter), a greenhouse gas (carbon dioxide), the principal speciated hydrocarbons needed for human health risk assessments, and a detailed analysis of the PM into its primary constituents (ions, elements, organic, and elemental carbon). Measurements followed ISO 8178-1 methods with modifications described in the paper. The vessel burned two fuels: a heavy fuel oil in the ME and boiler and a distillate fuel in the AE. The weighted NO(x) emissions for the ME and AE are 19.87 +/- 0.95 and 13.57 +/- 0.31 g/kWh, respectively. The weighted PM mass emissions factor is 1.60 +/- 0.08 g/kWh for the ME and 0.141 +/- 0.005 g/kWh for the AE, with the sulfate content of the PM being the root cause for the difference. For the ME, sulfate with associated water is about 75% of total PM mass, and the organic carbon ranges from 15 to 25% of the PM mass. A deeper analysis showed that the conversion of fuel sulfur to sulfate in the ME ranged from 1.4to 5%. This article also provides emission factors for selected polycyclic aromatic hydrocarbons, heavy alkanes, carbonyls, light hydrocarbon species, metals, and ions for the ME, AE, and the boiler.

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