Efficient characterisation of large deviations using population dynamics

We consider population dynamics as implemented by the cloning algorithm for analysis of large deviations of time-averaged quantities. We use the simple symmetric exclusion process with periodic boundary conditions as a prototypical example and investigate the convergence of the results with respect to the algorithmic parameters, focussing on the dynamical phase transition between homogeneous and inhomogeneous states, where convergence is relatively difficult to achieve. We discuss how the performance of the algorithm can be optimised, and how it can be efficiently exploited on parallel computing platforms.</p

Engagement in a Public Forum: Knowledge, Action, and Cosmopolitanism

Facing challenges to the civic purpose of higher education, some scholars and administrators turn to the rhetoric of engagement. Simultaneously, the political philosophy of cosmopolitanism has gained intellectual favor, advocating openness to the lived experiences of distant others. We articulate linkages between these two discourses in an extended case study, finding that a cosmopolitan ethos of engagement in a rural context can improve (1) understanding among people ordinarily separated by spatialized social-ecological differences, (2) prospects for longer term environmental sustainability, and (3) the visionary potential of collaborative inquiry. Despite globalization of food systems and neoliberal shifts in fishery management, an annual fisheries forum facilitates coalitions that overcome dichotomies between technocratic and local knowledge, extending benefits to fishing communities, academia, and public policy. Iterative and loosely structured capacity building expands informally through affective processes of recognition and care, as decentralized leadership supports collective mobilization toward alternate futures

Evaluation of updated sepsis scoring systems and systemic inflammatory response syndrome criteria and their association with sepsis in equine neonates

BackgroundThe original equine sepsis score provided a method of identifying foals with sepsis. New variables associated with sepsis have been evaluated, but the sepsis score has not been updated.ObjectivesTo evaluate the sensitivity and specificity of 2 updated sepsis scores and the systemic inflammatory response syndrome (SIRS) criteria in regard to detecting sepsis in foals.AnimalsTwo-hundred and seventy-three ill foals and 25 healthy control foals.MethodsHistorical, physical examination, and clinicopathologic findings were used to calculate the original sepsis score and 2 updated sepsis scores. SIRS criteria were also evaluated. Sepsis scores and positive SIRS scores were statistically compared to foals with sepsis.ResultsOne-hundred and twenty-six foals were septic and 147 sick-nonseptic. The original and updated sepsis scores were significantly higher in septic foals as compared to sick-nonseptic and healthy foals. The sensitivity and specificity of the updated sepsis scores to predict sepsis were not significantly better than those of the original sepsis score. One-hundred and twenty-seven of 273 (46.5%) foals met the original SIRS criteria and 88/273 (32%) foals met the equine neonatal SIRS criteria. The original SIRS criteria had similar sensitivity and specificity for predicting sepsis as did the 3 sepsis scores in our study.Conclusions and clinical importanceThe updated sepsis scores did not provide improved ability in predicting sepsis. Fulfilling the original SIRS criteria provided similar sensitivity and specificity in predicting sepsis as the modified sepsis score and might serve as a diagnostic aid in identifying foals at risk for sepsis

Locating the Judge within Sentencing Research

Research into sentencing is undertaken from a range of theoretical, disciplinary and methodological perspectives. Each approach offers valuable insights, including a conception of the judge, sometimes explicit, often implicit. Little scholarly attention has been paid to directly interrogating the ways in which different research traditions construct the judge in the sentencing process. By investigating how different research approaches locate the judge as an actor in sentencing, theoretically and empirically, this article addresses that gap. It considers key examples of socio-legal scholarship which emphasise the judge as operating within experiential, emotional and social, as well as legal dimensions. This growing body of research offers a more social, relational and interactive understanding of the judge in sentencing, extending and complementing the valuable, but necessarily limited, insights of other research approaches about the place of the judge in sentencing

Locating the Judge within Sentencing Research

Research into sentencing is undertaken from a range of theoretical, disciplinary and methodological perspectives. Each approach offers valuable insights, including a conception of the judge, sometimes explicit, often implicit. Little scholarly attention has been paid to directly interrogating the ways in which different research traditions construct the judge in the sentencing process. By investigating how different research approaches locate the judge as an actor in sentencing, theoretically and empirically, this article addresses that gap. It considers key examples of socio-legal scholarship which emphasise the judge as operating within experiential, emotional and social, as well as legal dimensions. This growing body of research offers a more social, relational and interactive understanding of the judge in sentencing, extending and complementing the valuable, but necessarily limited, insights of other research approaches about the place of the judge in sentencing

The Harms of Screening: A Proposed Taxonomy and Application to Lung Cancer Screening

IMPORTANCE Making rational decisions about screening requires information about its harms, but high-quality evidence is often either not available or not used. One reason may be that we lack a coherent framework, a taxonomy, for conceptualizing and studying these harms. OBJECTIVE To create a taxonomy, we categorized harms from several sources: systematic reviews of screening, other published literature, and informal discussions with clinicians and patients. We used this information to develop an initial taxonomy and vetted it with local and national experts, making revisions as needed. RESULTS We propose a taxonomy with 4 domains of harm from screening: physical effects, psychological effects, financial strain, and opportunity costs. Harms can occur at any step of the screening cascade. We provide definitions for each harm domain and illustrate the taxonomy using the example of screening for lung cancer. CONCLUSIONS AND RELEVANCE The taxonomy provides a systematic way to conceptualize harms as experienced by patients. As shown in the lung cancer screening example, the taxonomy also makes clear where (which domains of harms and which parts of the screening cascade) we have useful information and where there are gaps in our knowledge. The taxonomy needs further testing and validation across a broad range of screening programs. We hope that further development of this taxonomy can improve our thinking about the harms of screening, thus informing our research, policy making, and decision making with patients about the wisdom of screening

Efficient characterisation of large deviations using population dynamics

We consider population dynamics as implemented by the cloning algorithm for analysis of large deviations of time-averaged quantities. Using the simple symmetric exclusion process as a prototypical example, we investigate the convergence of the results with respect to the algorithmic parameters, focussing on the dynamical phase transition between homogeneous and inhomogeneous states, where convergence is relatively difficult to achieve. We discuss how the performance of the algorithm can be optimised, and how it can be efficiently exploited on parallel computing platforms.Comment: 23 pages, final versio

The Structure of Episodic Memory: Ganeri's ‘Mental Time Travel and Attention’

We offer a framework for assessing what the structure of episodic memory might be, if one accepts the Buddhist denial of persisting selves. This paper is a response to Jonardon Ganeri's paper "Mental time travel and attention", which explores Buddhaghosa's ideas about memory. (It will eventually be published with a reply by Ganeri)

A Comparative Effectiveness Trial of Alternate Formats for Presenting Benefits and Harms Information for Low-Value Screening Services: A Randomized Clinical Trial

Healthcare overuse, the delivery of low-value services, is increasingly recognized as a critical problem. However, little is known about the comparative effectiveness of alternate formats for presenting benefits and harms information to patients as a strategy to reduce overuse. To examine the effect of different benefits and harms presentations on patients' intentions to accept low-value or potentially low-value screening services (prostate cancer screening in men ages 50-69 years; osteoporosis screening in low-risk women ages 50-64 years; or colorectal cancer screening in men and women ages 76-85 years). Randomized clinical trial of 775 individuals eligible to receive information about any 1 of the 3 screening services and scheduled for a visit with their clinician. Participants were randomized to 1 of 4 intervention arms that differed in terms of presentation format: words, numbers, numbers plus narrative, and numbers plus framed presentation. The trial was conducted from September 2012 to June 2014 at 2 family medicine and 2 internal medicine practices affiliated with the Duke Primary Care Research Consortium. The data were analyzed between May and September of 2015. One-page evidence-based decision support sheets on each of the 3 screening services, with benefits and harms information presented in 1 of 4 formats: words, numbers, numbers plus narratives, or numbers plus a framed presentation. The primary outcome was change in intention to accept screening (on a response scale from 1 to 5). Our secondary outcomes included general and disease-specific knowledge, perceived risk and consequences of disease, screening attitudes, perceived net benefit of screening, values clarity, and self-efficacy for screening. We enrolled and randomly allocated 775 individuals, aged 50 to 85 years, to 1 of 4 intervention arms: 195 to words, 192 to numbers, 196 to narrative, and 192 to framed formats. Intentions to accept screening were high before the intervention and change in intentions did not differ across intervention arms (words, -0.07; numbers, -0.05; numbers plus narrative, -0.12; numbers plus framed presentation, -0.02; P = .57 for all comparisons). Change in other outcomes also showed no difference across intervention arms. Results were similar when stratified by screening service. Single, brief, written decision support interventions, such as the ones in this study, are unlikely to be sufficient to change intentions for screening. Alternate and additional interventions are needed to reduce overused screening services. clinicaltrials.gov Identifier: NCT01694784