The long and short of it: Global liberalization, poverty and inequality

Global deregulation of current and capital account is often touted as successful means to reduce poverty and inequality. On the face of it, though, the evidence does not support this claim. Rising intra-country inequality is widespread, income inequality between countries grows, the absolute number of people living in poverty increases, and poverty rate reductions are geographically isolated. Critics of global deregulation have charged that more deregulated trade flows result in a worse income distribution and unregulated capital flows in more macro economic instabilities that are especially harmful to the poor. Using data from the World Bank, the IMF and the UN, we test the impact of increased deregulation on the incomes of the poor. Our results indicate that global deregulation of trade and capital markets does hurt the poor. We find that the income share of the poor is generally lower in deregulated and in macro economically less stable environments, which are more prone to occur after capital account liberalization. The evidence also suggests that trade flows in more regulated environments may be good for growth and, by extension, for the poor in the long-run. --

Hybrid mode-scattering/sound-absorbing segmented liner system and method

A hybrid mode-scattering/sound-absorbing segmented liner system and method in which an initial sound field within a duct is steered or scattered into higher-order modes in a first mode-scattering segment such that it is more readily and effectively absorbed in a second sound-absorbing segment. The mode-scattering segment is preferably a series of active control components positioned along the annulus of the duct, each of which includes a controller and a resonator into which a piezoelectric transducer generates the steering noise. The sound-absorbing segment is positioned acoustically downstream of the mode-scattering segment, and preferably comprises a honeycomb-backed passive acoustic liner. The invention is particularly adapted for use in turbofan engines, both in the inlet and exhaust

A stimulus to define informatics and health information technology

<p>Abstract</p> <p>Background</p> <p>Despite the growing interest by leaders, policy makers, and others, the terminology of health information technology as well as biomedical and health informatics is poorly understood and not even agreed upon by academics and professionals in the field.</p> <p>Discussion</p> <p>The paper, presented as a Debate to encourage further discussion and disagreement, provides definitions of the major terminology used in biomedical and health informatics and health information technology. For informatics, it focuses on the words that modify the term as well as individuals who practice the discipline. Other categories of related terms are covered as well, from the associated disciplines of computer science, information technolog and health information management to the major application categories of applications used. The discussion closes with a classification of individuals who work in the largest segment of the field, namely clinical informatics.</p> <p>Summary</p> <p>The goal of presenting in Debate format is to provide a starting point for discussion to reach a documented consensus on the definition and use of these terms.</p

GRAPHENE: A Precise Biomedical Literature Retrieval Engine with Graph Augmented Deep Learning and External Knowledge Empowerment

Effective biomedical literature retrieval (BLR) plays a central role in precision medicine informatics. In this paper, we propose GRAPHENE, which is a deep learning based framework for precise BLR. GRAPHENE consists of three main different modules 1) graph-augmented document representation learning; 2) query expansion and representation learning and 3) learning to rank biomedical articles. The graph-augmented document representation learning module constructs a document-concept graph containing biomedical concept nodes and document nodes so that global biomedical related concept from external knowledge source can be captured, which is further connected to a BiLSTM so both local and global topics can be explored. Query expansion and representation learning module expands the query with abbreviations and different names, and then builds a CNN-based model to convolve the expanded query and obtain a vector representation for each query. Learning to rank minimizes a ranking loss between biomedical articles with the query to learn the retrieval function. Experimental results on applying our system to TREC Precision Medicine track data are provided to demonstrate its effectiveness.Comment: CIKM 201

Diagnosis of Classic Homocystinuria in Two Boys Presenting with Acute Cerebral Venous Thrombosis and Neurologic Dysfunction after Normal Newborn Screening

Homocystinuria, caused by cystathionine β-synthase deficiency, is a rare inherited disorder involving metabolism of methionine. Impaired synthesis of cystathionine leads to accumulation of homocysteine that affects several organ systems leading to abnormalities in the skeletal, cardiovascular, ophthalmic and central nervous systems. We report a 14-month-old and a 7-year-old boy who presented with neurologic dysfunction and were found to have cerebral venous sinus thromboses on brain magnetic resonance imaging (MRI)/magnetic resonance venogram (MRV) and metabolic and hypercoagulable work-up were consistent with classic homocystinuria. The 14-month-old boy had normal newborn screening. The 7-year-old boy initially had an abnormal newborn screen for homocystinuria but second tier test that consisted of total homocysteine was normal, so his newborn screen was reported as normal. With the advent of expanded newborn screening many treatable metabolic disorders are detected before affected infants and children become symptomatic. Methionine is the primary target in newborn screening for homocystinuria and total homocysteine is a secondary target. Screening is usually performed after 24–48 h of life in most states in the US and some states perform a second screen as a policy on all tested newborns or based on when the initial newborn screen was performed. This is done in hopes of detecting infants who may have been missed on their first screen. In the United Kingdom, NBS using dried blood spot is performed at 5 to 8 days after birth. It is universally known that methionine is a poor target and newborn screening laboratories have used different cutoffs for a positive screen. Reducing the methionine cutoff increases the sensitivity but not necessarily the specificity of the test and increasing the cutoff will miss babies who may have HCU whose levels may not be high enough to be detected at their age of ascertainment. It is not clear whether adjusting methionine level to decrease the false negative rates combined with total homocysteine as a second-tier test can be used effectively and feasibly to detect newborns with HCU. Between December 2005 and December 2020, 827,083 newborns were screened in Kentucky by MS/MS. Kentucky NBS program uses the postanalytical tools offered by the Collaborative Laboratory Integrated Reports (CLIR) project which considers gestational age and birthweight. One case of classical homocystinuria was detected and two were missed on first and second tier tests respectively. The newborn that had confirmed classical homocystinuria was one of twenty-three newborns that were referred for second tier test because of elevated methionine (cutoff is \u3e60 µmol/L) and/or Met/Phe ratio (cutoff is \u3e1.0); all 23 dried blood spots had elevated total homocysteine. One of the subjects of this case report had a normal methionine on initial screen and the other had a normal second-tier total homocysteine level. The performance of methionine and total homocysteine as screening analytes for homocystinuria suggest that it may be time for newborn screening programs to consider adopting next generation sequencing (NGS) platforms as alternate modality of metabolic newborn screening. Because of cost considerations, newborn screening programs may not want to adopt NGS, but the downstream healthcare cost incurred due to missed cases and the associated morbidity of affected persons far exceed costs to newborn screen programs. Since NGS is becoming more widely available and inexpensive, it may be feasible to change testing algorithms to use Newborn Metabolic NGS as the primary mode of testing on dry blood specimens with confirmation with biochemical testing. Some commercial laboratories have Newborn Screening Metabolic gene panel that includes all metabolic disorders on the most comprehensive newborn screening panel in addition to many other conditions that are not on the panel. A more targeted NGS panel can be designed that may not cost much and eventually help avoid the pitfalls associated with delayed diagnosis and cost of screening

Accounting for data heterogeneity in integrative analysis and prediction methods: An application to Chronic Obstructive Pulmonary Disease

Epidemiologic and genetic studies in chronic obstructive pulmonary disease (COPD) and many complex diseases suggest subgroup disparities (e.g., by sex). We consider this problem from the standpoint of integrative analysis where we combine information from different views (e.g., genomics, proteomics, clinical data). Existing integrative analysis methods ignore the heterogeneity in subgroups, and stacking the views and accounting for subgroup heterogeneity does not model the association among the views. To address analytical challenges in the problem of our interest, we propose a statistical approach for joint association and prediction that leverages the strengths in each view to identify molecular signatures that are shared by and specific to males and females and that contribute to the variation in COPD, measured by airway wall thickness. HIP (Heterogeneity in Integration and Prediction) accounts for subgroup heterogeneity, allows for sparsity in variable selection, is applicable to multi-class and to univariate or multivariate continuous outcomes, and incorporates covariate adjustment. We develop efficient algorithms in PyTorch. Our COPD findings have identified several proteins, genes, and pathways that are common and specific to males and females, some of which have been implicated in COPD, while others could lead to new insights into sex differences in COPD mechanisms