Designing and Operating Safe and Secure Transit Systems: Assessing Current Practices in the United States and Abroad, MTI Report 04-05

Public transit systems around the world have for decades served as a principal venue for terrorist acts. Today, transit security is widely viewed as an important public policy issue and is a high priority at most large transit systems and at smaller systems operating in large metropolitan areas. Research on transit security in the United States has mushroomed since 9/11; this study is part of that new wave of research. This study contributes to our understanding of transit security by (1) reviewing and synthesizing nearly all previously published research on transit terrorism; (2) conducting detailed case studies of transit systems in London, Madrid, New York, Paris, Tokyo, and Washington, D.C.; (3) interviewing federal officials here in the United States responsible for overseeing transit security and transit industry representatives both here and abroad to learn about efforts to coordinate and finance transit security planning; and (4) surveying 113 of the largest transit operators in the United States. Our major findings include: (1) the threat of transit terrorism is probably not universal—most major attacks in the developed world have been on the largest systems in the largest cities; (2) this asymmetry of risk does not square with fiscal politics that seek to spread security funding among many jurisdictions; (3) transit managers are struggling to balance the costs and (uncertain) benefits of increased security against the costs and (certain) benefits of attracting passengers; (4) coordination and cooperation between security and transit agencies is improving, but far from complete; (5) enlisting passengers in surveillance has benefits, but fearful passengers may stop using public transit; (6) the role of crime prevention through environmental design in security planning is waxing; and (7) given the uncertain effectiveness of antitransit terrorism efforts, the most tangible benefits of increased attention to and spending on transit security may be a reduction in transit-related person and property crimes

Children's perception of direct and indirect reported speech

This study investigated the abilities of adults and children to distinguish direct reported speech from indirect reported speech in sentences read aloud by a native English speaker. The adults were highly successful, the older children less so and the younger children were relatively unsuccessful. Indirect reported speech appeared to be the default category for the children. Potential prosodic cues were identified and measured from waveforms and pitch contours of the stimulus sentences. Statistical analysis was applied with a view to ascertaining which (combination of) cues best predicted the listener responses. The results suggest that pitch movement and duration both provided important cues to distinguishing the sentence types. The analysis also revealed a learning effect by all groups.caslpub2247pu

Ariel - Volume 2 Number 4

Copyright 1969 Arie

The Canadian Childhood Nephrotic Syndrome (CHILDNEPH) project: Overview of design and methods

Background: Nephrotic syndrome is a commonly acquired kidney disease in children that causes significant morbidity due to recurrent episodes of heavy proteinuria. The management of childhood nephrotic syndrome is known to be highly variable among physicians and care centres. Objectives: The primary objective of the study is to determine centre-, physician-, and patient-level characteristics associated with steroid exposure and length of steroid treatment. We will also determine the association of dose and duration of steroid treatment and time to first relapse as a secondary aim. An embedded qualitative study utilizing focus groups with health care providers will enrich the quantitative results by providing an understanding of the attitudes, beliefs and local contextual factors driving variation in care. Design: Mixed-methods study; prospective observational cohort (quantitative component), with additional semi-structured focus groups of healthcare professionals (qualitative component). Setting: National study, comprised of all 13 Canadian pediatric nephrology clinics. Patients: 400 patients under 18 years of age to be recruited over 2.5 years. Measurements: Steroid doses for all episodes (first presentation, first and subsequent relapses) tracked over course of the study. Physician and centre-level characteristics catalogued, with reasons for treatment preferences documented during focus groups. Methods: All patients tracked prospectively over the course of the study, with data comprising a prospective registry. One focus group at each site to enrich understanding of variation in care. Limitations: Contamination of treatment protocols between physicians may occur as a result of concurrent focus groups. Conclusions: Quantitative and qualitative results will be integrated at end of study and will collectively inform strategies for the development and implementation of standardized evidence-based protocols across centres

Comparison of microbiological diagnosis of urinary tract infection in young children by routine health service laboratories and a research laboratory: Diagnostic cohort study

OBJECTIVES: To compare the validity of diagnosis of urinary tract infection (UTI) through urine culture between samples processed in routine health service laboratories and those processed in a research laboratory. POPULATION AND METHODS: We conducted a prospective diagnostic cohort study in 4808 acutely ill children aged <5 years attending UK primary health care. UTI, defined as pure/predominant growth ≥105 CFU/mL of a uropathogen (the reference standard), was diagnosed at routine health service laboratories and a central research laboratory by culture of urine samples. We calculated areas under the receiver-operator curve (AUC) for UTI predicted by pre-specified symptoms, signs and dipstick test results (the "index test"), separately according to whether samples were obtained by clean catch or nappy (diaper) pads. RESULTS: 251 (5.2%) and 88 (1.8%) children were classified as UTI positive by health service and research laboratories respectively. Agreement between laboratories was moderate (kappa = 0.36; 95% confidence interval [CI] 0.29, 0.43), and better for clean catch (0.54; 0.45, 0.63) than nappy pad samples (0.20; 0.12, 0.28). In clean catch samples, the AUC was lower for health service laboratories (AUC = 0.75; 95% CI 0.69, 0.80) than the research laboratory (0.86; 0.79, 0.92). Values of AUC were lower in nappy pad samples (0.65 [0.61, 0.70] and 0.79 [0.70, 0.88] for health service and research laboratory positivity, respectively) than clean catch samples. CONCLUSIONS: The agreement of microbiological diagnosis of UTI comparing routine health service laboratories with a research laboratory was moderate for clean catch samples and poor for nappy pad samples and reliability is lower for nappy pad than for clean catch samples. Positive results from the research laboratory appear more likely to reflect real UTIs than those from routine health service laboratories, many of which (particularly from nappy pad samples) could be due to contamination. Health service laboratories should consider adopting procedures used in the research laboratory for paediatric urine samples. Primary care clinicians should try to obtain clean catch samples, even in very young children

The Diagnosis of Urinary Tract infection in Young children (DUTY): a diagnostic prospective observational study to derive and validate a clinical algorithm for the diagnosis of urinary tract infection in children presenting to primary care with an acute illness

Background: It is not clear which young children presenting acutely unwell to primary care should be investigated for urinary tract infection (UTI) and whether or not dipstick testing should be used to inform antibiotic treatment.Objectives: To develop algorithms to accurately identify pre-school children in whom urine should be obtained; assess whether or not dipstick urinalysis provides additional diagnostic information; and model algorithm cost-effectiveness.Design: Multicentre, prospective diagnostic cohort study.Setting and participants: Children &lt; 5 years old presenting to primary care with an acute illness and/or new urinary symptoms.Methods: One hundred and seven clinical characteristics (index tests) were recorded from the child’s past medical history, symptoms, physical examination signs and urine dipstick test. Prior to dipstick results clinician opinion of UTI likelihood (‘clinical diagnosis’) and urine sampling and treatment intentions (‘clinical judgement’) were recorded. All index tests were measured blind to the reference standard, defined as a pure or predominant uropathogen cultured at ? 105 colony-forming units (CFU)/ml in a single research laboratory. Urine was collected by clean catch (preferred) or nappy pad. Index tests were sequentially evaluated in two groups, stratified by urine collection method: parent-reported symptoms with clinician-reported signs, and urine dipstick results. Diagnostic accuracy was quantified using area under receiver operating characteristic curve (AUROC) with 95% confidence interval (CI) and bootstrap-validated AUROC, and compared with the ‘clinician diagnosis’ AUROC. Decision-analytic models were used toidentify optimal urine sampling strategy compared with ‘clinical judgement’.Results: A total of 7163 children were recruited, of whom 50% were female and 49% were &lt; 2 years old. Culture results were available for 5017 (70%); 2740 children provided clean-catch samples, 94% of whom were ? 2 years old, with 2.2% meeting the UTI definition. Among these, ‘clinical diagnosis’ correctly identified 46.6% of positive cultures, with 94.7% specificity and an AUROC of 0.77 (95% CI 0.71 to 0.83). Four symptoms, three signs and three dipstick results were independently associated with UTI with an AUROC (95% CI; bootstrap-validated AUROC) of 0.89 (0.85 to 0.95; validated 0.88) for symptoms and signs, increasing to 0.93 (0.90 to 0.97; validated 0.90) with dipstick results. Nappy pad samples were provided from the other 2277 children, of whom 82% were &lt; 2 years old and 1.3% met the UTI definition.‘Clinical diagnosis’ correctly identified 13.3% positive cultures, with 98.5% specificity and an AUROC of 0.63 (95% CI 0.53 to 0.72). Four symptoms and two dipstick results were independently associated with UTI, with an AUROC of 0.81 (0.72 to 0.90; validated 0.78) for symptoms, increasing to 0.87 (0.80 to 0.94; validated 0.82) with the dipstick findings. A high specificity threshold for the clean-catch model was more accurate and less costly than, and as effective as, clinical judgement. The additional diagnostic utility of dipstick testing was offset by its costs. The cost-effectiveness of the nappy pad model was not clear-cut.Conclusions: Clinicians should prioritise the use of clean-catch sampling as symptoms and signs can cost-effectively improve the identification of UTI in young children where clean catch is possible. Dipstick testing can improve targeting of antibiotic treatment, but at a higher cost than waiting for a laboratory result. Future research is needed to distinguish pathogens from contaminants, assess the impact of the clean-catch algorithm on patient outcomes, and the cost-effectiveness of presumptive versus dipstick versus laboratory-guided antibiotic treatment.Funding: The National Institute for Health Research Health Technology Assessment programme.<br/

Technical note: development of a 3D printed subresolution sandwich phantom for validation of brain SPECT analysis

Purpose: To make an adaptable, head shaped radionuclide phantom to simulate molecular imaging of the brain using clinical acquisition and reconstruction protocols. This will allow the characterization and correction of scanner characteristics, and improve the accuracy of clinical image analysis, including the application of databases of normal subjects. Methods: A fused deposition modeling 3D printer was used to create a head shaped phantom made up of transaxial slabs, derived from a simulated MRI dataset. The attenuation of the printed polylactide (PLA), measured by means of the Hounsfield unit on CT scanning, was set to match that of the brain by adjusting the proportion of plastic filament and air (fill ratio). Transmission measurements were made to verify the attenuation of the printed slabs. The radionuclide distribution within the phantom was created by adding 99mTc pertechnetate to the ink cartridge of a paper printer and printing images of gray and white matter anatomy, segmented from the same MRI data. The complete subresolution sandwich phantom was assembled from alternate 3D printed slabs and radioactive paper sheets, and then imaged on a dual headed gamma camera to simulate an HMPAO SPECT scan. Results: Reconstructions of phantom scans successfully used automated ellipse fitting to apply attenuation correction. This removed the variability inherent in manual application of attenuation correction and registration inherent in existing cylindrical phantom designs. The resulting images were assessed visually and by count profiles and found to be similar to those from an existing elliptical PMMA phantom. Conclusions: The authors have demonstrated the ability to create physically realistic HMPAO SPECT simulations using a novel head-shaped 3D printed subresolution sandwich method phantom. The phantom can be used to validate all neurological SPECT imaging applications. A simple modification of the phantom design to use thinner slabs would make it suitable for use in PET

Syntactic architecture and its consequences I: Syntax inside the grammar

This volume collects novel contributions to comparative generative linguistics that “rethink” existing approaches to an extensive range of phenomena, domains, and architectural questions in linguistic theory. At the heart of the contributions is the tension between descriptive and explanatory adequacy which has long animated generative linguistics and which continues to grow thanks to the increasing amount and diversity of data available to us. The chapters address research questions on the relation of syntax to other aspects of grammar and linguistics more generally, including studies on language acquisition, variation and change, and syntactic interfaces. Many of these contributions show the influence of research by Ian Roberts and collaborators and give the reader a sense of the lively nature of current discussion of topics in synchronic and diachronic comparative syntax ranging from the core verbal domain to higher, propositional domains. This book is complemented by volume II available at&nbsp;https://langsci-press.org/catalog/book/276 and volume III available at https://langsci-press.org/catalog/book/277

Syntactic architecture and its consequences I: Syntax inside the grammar

This volume collects novel contributions to comparative generative linguistics that “rethink” existing approaches to an extensive range of phenomena, domains, and architectural questions in linguistic theory. At the heart of the contributions is the tension between descriptive and explanatory adequacy which has long animated generative linguistics and which continues to grow thanks to the increasing amount and diversity of data available to us. The chapters address research questions on the relation of syntax to other aspects of grammar and linguistics more generally, including studies on language acquisition, variation and change, and syntactic interfaces. Many of these contributions show the influence of research by Ian Roberts and collaborators and give the reader a sense of the lively nature of current discussion of topics in synchronic and diachronic comparative syntax ranging from the core verbal domain to higher, propositional domains. This book is complemented by volume II available at&nbsp;https://langsci-press.org/catalog/book/276 and volume III available at https://langsci-press.org/catalog/book/277