A Roadmap for Change: Federal Policy Recommendations for Addressing the Criminilization of LGBT People and People Living with HIV

Each year in the United States, thousands of lesbian, gay, bisexual, transgender, Two Spirit, queer, questioning and gender non-conforming (LGBT) people and people living with HIV come in contact with the criminal justice system and fall victim to similar miscarriages of justice.According to a recent national study, a startling 73% of all LGBT people and PLWH surveyed have had face-to-face contact with police during the past five years.1 Five percent of these respondents also report having spent time in jail or prison, a rate that is markedly higher than the nearly 3% of the U.S. adult population whoare under some form of correctional supervision (jail, prison, probation, or parole) at any point in time.In fact, LGBT people and PLWH, especially Native and LGBT people and PLWH of color, aresignificantly overrepresented in all aspects of the penal system, from policing, to adjudication,to incarceration. Yet their experiences are often overlooked, and little headway has been madein dismantling the cycles of criminalization that perpetuate poor life outcomes and push already vulnerable populations to the margins of society.The disproportionate rate of LGBT people and PLWH in the criminal system can best be understoodin the larger context of widespread and continuing discrimination in employment, education, socialservices, health care, and responses to violence

High temperature reliability of power module substrates

The thermal cycling reliability of candidate copper and aluminium power substrates has been assessed for use at temperatures exceeding 300°C peak using a combination of thermal cycling, nanoindentation and finite element modelling to understand the relative stresses and evolution of the mechanical properties. The results include the relative cycling lifetimes up to 350°C, demonstrating almost an order of magnitude higher lifetime for active metal brazed Al / AlN substrates over Cu / Si3N4, but four times more severe roughening and cracking of the Ni-P plating's on the Al / AlN (DBA) substrates. The nonlinear finite element modelling illustrated that the yield strength of the metal and the thickness of the ceramic are the main stress controlling factors, but comparisons with the cycling lifetime results demonstrated that the fracture toughness (resistance) of the ceramic is the over-riding controlling factor for the overall passive thermal cycling lifetimes. In order to achieve the highest substrate lifetime for the highly stressed high temperature thermal cycled applications, the optimum solution appears to be annealed copper, brazed on to a thicker than normal or higher fracture toughness Si3N4 ceramic

Efficacy of pharmacotherapies for short-term smoking abstinance: A systematic review and meta-analysis

Background: Smoking cessation has important immediate health benefits. The comparative shorttermeffectiveness of smoking cessation interventions is not well known. We aimed to determinethe relative effectiveness of nicotine replacement therapy (NRT), bupropion and varenicline at 4weeks post-target quit date. Methods: We searched 10 electronic medical databases (inception to October 2008). Weselected randomized clinical trials [RCTs] evaluating interventions for our primary outcome ofabstinence from smoking at at-least 4 weeks post-target quit date, with biochemical confirmation.We conducted random-effects odds ratio (OR) meta-analysis and meta-regression. We comparedtreatment effects across interventions using head-to-head trials and calculated indirectcomparisons. Results: We combined a total of 101 trials evaluating delivery of NRT versus inert controls atapproximately 4 weeks post-target quit date (total n = 31,321). The pooled overall OR is OR 2.05(95% Confidence Interval [CI], 1.89-2.23, P =< 0.0001). We pooled data from 31 bupropion trialscontributing a total n of 11,118 participants and found a pooled OR of 2.25 (95% CI, 1.94-2.62, P=< 0.0001). We evaluated 9 varenicline trials compared to placebo. Our pooled estimate forcessation at 4 weeks post-target quit date found a pooled OR of 3.16 (95% CI, 2.55-3.91, P =<0.0001). Two trials evaluated head to head comparisons of varenicline and bupropion and found apooled estimate of OR 1.86 (95% CI, 1.49-2.33, P =< 0.0001 at 4 weeks post-target quit date.Indirect comparisons were: NRT and bupropion, OR, 1.09, 95% CI, 0.93-1.31, P = 0.28; vareniclineand NRT, OR 1.56, 95% CI, 1.23-1.96, P = 0.0002; and, varenicline and bupropion, OR 1.40, 95%CI, 1.08-1.85, P = 0.01. Conclusion: Pharmacotherapeutic interventions are effective for increasing smoking abstinencerates in the short-term

A Method for Revealing and Addressing Security Vulnerabilities in Cyber-physical Systems by Modeling Malicious Agent Interactions with Formal Verification

Several cyber-attacks on the cyber-physical systems (CPS) that monitor and control critical infrastructure were publically announced over the last few years. Almost without exception, the proposed security solutions focus on preventing unauthorized access to the industrial control systems (ICS) at various levels – the defense in depth approach. While useful, it does not address the problem of making the systems more capable of responding to the malicious actions of an attacker once they have gained access to the system. The first step in making an ICS more resilient to an attacker is identifying the cyber security vulnerabilities the attacker can use during system design. This paper presents a method that reveals cyber security vulnerabilities in ICS through the formal modeling of the system and malicious agents. The inclusion of the malicious agent in the analysis of an existing systems identifies security vulnerabilities that are missed in traditional functional model checking

Influence of oxidative stress, diaphragm fatigue, and inspiratory muscle training on the plasma cytokine response to maximum sustainable voluntary ventilation

The influence of oxidative stress, diaphragm fatigue, and inspiratory muscle training (IMT) on the cytokine response to maximum sustainable voluntary ventilation (MSVV) is unknown. Twelve healthy males were divided equally into an IMT or placebo (PLA) group, and before and after a 6-wk intervention they undertook, on separate days, 1h of (1) passive rest and (2) MSVV, whereby participants undertook volitional hyperpnea at rest that mimicked the breathing and respiratory muscle recruitment patterns commensurate with heavy cycling exercise. Plasma cytokines remained unchanged during passive rest. There was a main effect of time (P < 0.01) for plasma interleukin-1 (IL-1) and interleukin-6 (IL-6) concentrations and a strong trend (P = 0.067) for plasma interleukin-1 receptor antagonist concentration during MSVV. Plasma IL-6 concentration was reduced after IMT by 27 + 18% (main effect of intervention, P = 0.029), whereas there was no change after PLA (P = 0.753). There was no increase in a systemic marker of oxidative stress [DNA damage in peripheral blood mononuclear cells (PBMC)], and diaphragm fatigue was not related to the increases in plasma IL-1 and IL-6 concentrations. A dose-response relationship was observed between respiratory muscle work and minute ventilation and increases in plasma IL-6 concentration. In conclusion, increases in plasma IL-1 and IL-6 concentrations during MSVV were not due to diaphragm fatigue or DNA damage in PBMC. Increases in plasma IL-6 concentration during MSVV are attenuated following IMT, and the plasma IL-6 response is dependent upon the level of respiratory muscle work and minute ventilation

The effects of inspiratory muscle training in older adults

Purpose: Declining inspiratory muscle function and structure and systemic low-level inflammation and oxidative stress may contribute to morbidity and mortality during normal ageing. Therefore, we examined the effects of inspiratory muscle training (IMT) in older adults on inspiratory muscle function and structure and systemic inflammation and oxidative stress, and re-examined the reported positive effects of IMT on respiratory muscle strength, inspiratory muscle endurance, spirometry, exercise performance, physical activity levels (PAL) and quality of life (QoL). Methods: Thirty-four healthy older adults (68 ± 3 years) with normal spirometry, respiratory muscle strength and physical fitness were divided equally into a pressure-threshold IMT or sham-hypoxic placebo group. Before and after an 8 week intervention, measurements were taken for dynamic inspiratory muscle function and inspiratory muscle endurance using a weighted plunger pressure-threshold loading device, diaphragm thickness using B-mode ultrasonography, plasma cytokine concentrations using immunoassays, DNA damage levels in peripheral blood mononuclear cells (PBMC) using Comet Assays, spirometry, maximal mouth pressures, exercise performance using a six minute walk test, PAL using a questionnaire and accelerometry, and QoL using a questionnaire

Inter-Rater Reliability of Historical Data Collected by Non-Medical Research Assistants and Physicians in Patients with Acute Abdominal Pain

OBJECTIVES: In many academic emergency departments (ED), physicians are asked to record clinical data for research that may be time consuming and distracting from patient care. We hypothesized that non-medical research assistants (RAs) could obtain historical information from patients with acute abdominal pain as accurately as physicians.METHODS: Prospective comparative study conducted in an academic ED of 29 RAs to 32 resident physicians (RPs) to assess inter-rater reliability in obtaining historical information in abdominal pain patients. Historical features were independently recorded on standardized data forms by a RA and RP blinded to each others' answers. Discrepancies were resolved by a third person (RA) who asked the patient to state the correct answer on a third questionnaire, constituting the "criterion standard." Inter-rater reliability was assessed using kappa statistics (kappa) and percent crude agreement (CrA).RESULTS: Sixty-five patients were enrolled (mean age 43). Of 43 historical variables assessed, the median agreement was moderate (kappa 0.59 [Interquartile range 0.37-0.69]; CrA 85.9%) and varied across data categories: initial pain location (kappa 0.61 [0.59-0.73]; CrA 87.7%), current pain location (kappa 0.60 [0.47-0.67]; CrA 82.8%), past medical history (kappa 0.60 [0.48-0.74]; CrA 93.8%), associated symptoms (kappa 0.38 [0.37-0.74]; CrA 87.7%), and aggravating/alleviating factors (kappa 0.09 [-0.01-0.21]; CrA 61.5%). When there was disagreement between the RP and the RA, the RA more often agreed with the criterion standard (64% [55-71%]) than the RP (36% [29-45%]).CONCLUSION: Non-medical research assistants who focus on clinical research are often more accurate than physicians, who may be distracted by patient care responsibilities, at obtaining historical information from ED patients with abdominal pain

Structure and play: rethinking regulation in the higher education sector

This paper explores possible tactics for academics working within a context of increasing regulation and constraint. One suggested tactic is to move outside of a creativity-conformity binary. Rather than understanding creativity and conformity as separable, where one is seen as excluding the other, the authors consider the potential of examining the relationships between them. The theme of 'structure and play' illustrates the argument. In the first part of the paper, using various examples from art and design - fields generally associated with creativity - the authors explore the interrelatedness of creativity and conformity. For example, how might design styles, which are generally understood as creative outcomes, constrain creativity and lead to conformity within the design field? Is fashion producing creativity or conformity? Conversely, the ways in which conformity provides the conditions for creativity are also examined. For example, the conformity imposed by the state on artists in the former communist bloc contributed to a thriving underground arts movement which challenged conformity and state regulation. Continuing the theme of 'structure and play', the authors recount a story from an Australian university which foregrounds the ongoing renegotiation of power relations in the academy. This account illustrates how programmatic government in a university, with its aim of regulating conduct, can contribute to unanticipated outcomes. The authors propose that a Foucauldian view of distributed power is useful for academics operating in a context of increasing regulation, as it brings into view sites where power might begin to be renegotiated