Hard Non-Monotonic Attention for Character-Level Transduction

Character-level string-to-string transduction is an important component of various NLP tasks. The goal is to map an input string to an output string, where the strings may be of different lengths and have characters taken from different alphabets. Recent approaches have used sequence-to-sequence models with an attention mechanism to learn which parts of the input string the model should focus on during the generation of the output string. Both soft attention and hard monotonic attention have been used, but hard non-monotonic attention has only been used in other sequence modeling tasks such as image captioning and has required a stochastic approximation to compute the gradient. In this work, we introduce an exact, polynomial-time algorithm for marginalizing over the exponential number of non-monotonic alignments between two strings, showing that hard attention models can be viewed as neural reparameterizations of the classical IBM Model 1. We compare soft and hard non-monotonic attention experimentally and find that the exact algorithm significantly improves performance over the stochastic approximation and outperforms soft attention.Comment: Published in EMNLP 201

A Case Report of Acute Heart Failure Due to Infective Aortic Endocarditis Diagnosed by Point-of-care Ultrasound

Introduction: Infective endocarditis (IE) is a life-threatening condition with significant morbidity and mortality, and can require surgical repair.Case Report: A 36-year-old man presented to the emergency department for worsening dyspnea and chest pain. Point-of-care echocardiography demonstrated a mobile oscillating mass on the aortic valve with poor approximation of the valve leaflets, suggesting aortic valve insufficiency secondary to IE as the cause of acute heart failure. The patient underwent emergent aortic valve replacement within 24 hours.Discussion: While point-of-care echocardiography has been well documented in identifying tricuspid vegetations, aorticvalve involvement and subsequent heart failure is less well described. Earlier recognition of aortic valve vegetations and insufficiency can expedite surgical intervention, with decreased complication rates linked to earlier antimicrobial therapy.Conclusion: This case report highlights the ability of point-of-care ultrasound to identify aortic vegetations, allowing for the earlier diagnosis and therapy

Understanding and Responding to Destructive Leadership in School-Related Contexts: An Autopoietic Perspective

Leadership is integral to the health and wellbeing of individuals and organisations. Relevant literature typically assumes a conception of leadership as ethical influence for good purpose, yet it is not always so. When exercised destructively, leadership has the potential to cause personal distress, group dysfunction and cultural fracture. Although some theoretical literature discusses such leadership, there are few empirical studies. This study applies autopoietic theory to explore the existence and impact of destructive leadership in school-related contexts and suggest possible prevention and intervention strategies. The research methodology used is phenomenography, which seeks to understand a phenomenon by defining variation in collective experience. Fifteen interviews were undertaken with leaders in school-related settings who identified with having past experience of leadership practices they defined as destructive. The purposive sample population was cross-sectoral and cross–school phase. The study is framed by three research questions which aim to identify the qualitatively different ways by which the phenomenon can be understood. The findings suggest that destructive leadership causes significant, lasting and pervasive harm to individuals and organisations; that it is exercised as power and control without adequate checks and balances; derives from personality dispositions, professional inadequacy or aberrant values; and impacts in personal, interpersonal or intrapersonal cycles, mediated or mitigated through individual or social conditions. Five contributions emerge: a phenomenographically-derived framework to analyse a dysfunctional social system; an autopoietically-derived interpretation of individual, organisation and ethical impact; reinforcing vicious and virtuous circles of control and trust; a theory of ‘dysergy’, whereby the sum of the parts of a dysfunctional system constitute a diminished whole; and a whole system approach to intervention. The theoretical implication of the study is of the potential for personal and organisational learning, while the practical implication is for the application of a whole system model of leadership

Contracts, Behavior, and the Land-Assembly Problem:An Experimental Study

We use multilateral bargaining experiments to examine how the order of bargaining (simultaneous or sequential) and the nature of contracts (contingent or non-contingent) affect the duration of bargaining, the efficiency of exchange, and the distribution of the surplus in a laboratory land-assembly game with one buyer and two sellers. While theory predicts an earnings advantage for the first seller when contracts are sequential and contingent, and for the second seller when contracts are sequential and non-contingent, we find that when a seller has an earnings advantage in the laboratory, it is the first seller to bargain in the non-contingent contract treatments. This result contradicts conventional wisdom and a common result from the land-assembly literature that it is advantageous to be the last seller to bargain, a so-called “holdout”. We also find evidence that sequential bargaining leads to more aggressive seller bargaining and greater bargaining delay than simultaneous bargaining, ceteris paribus, and that non-contingent contracts increase bargaining delay and the likelihood of failed agreements. The majority of sellers indicated a preference for being the first seller to bargain in all sequential bargaining treatments.

How Strong Is the Primary Care Safety Net? Assessing the Ability of Federally Qualified Health Centers to Serve as Patient-Centered Medical Homes

By expanding access to affordable insurance coverage for millions of Americans, the Affordable Care Act will likely increase demand for the services provided by federally qualified health centers (FQHCs), which provide an important source of care in low-income communities. A pair of Commonwealth Fund surveys asked health center leaders about their ability to function as medical homes. Survey findings show that between 2009 and 2013, the percentage of centers exhibiting medium or high levels of medical home capability almost doubled, from 32 percent to 62 percent. The greatest improvement was reported in patient tracking and care management. Despite this increased capability, health centers reported diminished ability to coordinate care with providers outside of the practice, particularly specialists. Ongoing federal funding and technical support for medical home transformation will be needed to ensure that FQHCs can fulfill their mission of providing high-quality, comprehensive care to low-income and minority populations

Associations of blood pressure with body composition among Afro-Caribbean children in Barbados

Despite complex presentation of adult hypertension and a concomitant obesity epidemic, little is known about overweight in relation to blood pressure among Caribbean children. We examined blood pressure in relation to body size in a cross-sectional study of 573 Barbadian children aged 9–10 years (2010-2011).The United States normative blood pressure percentiles were used to identify children with high (≥ 95th percentile) or high normal blood pressure (90th – 95th percentile). The World Health Organization body mass index cut-off points were used to assess weight status. Major findings: Thirty percent of children were overweight/obese. Percentage fat mass differed between girls (20.4%) and boys (17.72%) (p< 0.05). Mean systolic blood pressure among girls was 106.11 (95% CI 105.05, 107.17) mmHg and 105.23 (104.09, 106.38) for boys. The percentages with high or high-normal mean systolic blood pressurewere14.38% (10.47, 18.29) for girls and 8.08% (4.74, 11.41) for boys. Height and body mass index were independent correlates of systolic and diastolic blood pressure. Mean systolic blood pressure was related to lean mass but not fat mass, while diastolic blood pressure was associated with fat mass index and overweight. Principal conclusion: One third of 9-10 year old children in Barbados were overweight/obese and 12% had elevated mean systolic blood pressure. BP was related to body size. These findings signal potential adverse trends in weight gain and BP trends for children growing up in the context of a country that has recently undergone rapid economic transition

Utilization of Creativity-Based Interventions to Combat Nursing Burnout

In addressing the potential for a creative writing practice to serve as an effective intervention against nurse burnout, we ask the following research question: In RNs who have practiced between 2-10 years, does participation in a creative writing program decrease burnout symptoms compared to nurses who do not participate within a time frame of one year. Burnout syndrome is a collective term that encompasses many subcategories that result in negative attitudes towards patients and coworkers, as well as increased turnover rates. Burnout syndrome was already a significant concern before the COVID-19 pandemic because of the high demand and stress of the nursing profession. Overall prevalence of burnout syndrome within healthcare professionals before the COVID-19 pandemic was 35.1% (Giacomo et al., 2021). However, research conducted on burnout syndrome rates following the COVID-19 pandemic show a rapid increase in psychological stressors that have been linked to burnout syndrome such as anxiety, depression, and loss of confidence. Addressing professional burnout necessitates interdisciplinary attention with an intervention such as creative writing that has been used successfully among other fields. A search of the literature was conducted within CINAHL, PubMed, and Google Scholar using the terms “burnout,” “creative writing,” “nursing,” and “interventions.” Results were limited to those published in peer-reviewed journals between the years 2017 and 2022. The original search resulted in hundreds of articles but was limited to sixteen that met the inclusion criteria. Research suggests the utilization of interdisciplinary interventions such as creative writing may be an efficacious solution to reducing burnout syndrome among the nursing profession

The Adoption and Use of Health Information Technology by Community Health Centers, 2009-2013

With help from targeted federal investments, U.S. physician offices and hospitals have accelerated their adoption and use of patient electronic health records (EHRs) and other health information technology (HIT) in recent years. Comparison of results from. The Commonwealth Fund's two national surveys of federally qualified health centers (FQHCs) in 2009 and 2013 show that HIT adoption has also grown substantially for these important providers of care in poor and underserved communities. Nearly all surveyed FQHCs (93%) now have an EHR system, a 133 percent increase from 2009, the year federal "meaningful use" incentives for HIT were first authorized. Three-quarters of health centers (76%) reported meeting the criteria to qualify for incentive payments. Remaining challenges for health centers include achieving greater interoperability of EHR systems and ensuring patient access to their records. Mobile technology, such as text messaging, may help FQHCs further expand patient outreach and access to care

A Rare Case Report of a Corpus Callosal Splenial Lesion in the Context of Atypical Neuroleptic Malignant Syndrome.

In this report, we describe a case of atypical neuroleptic malignant syndrome (NMS) presenting with an isolated lesion in the splenium of the corpus callosum (ILSCC). There is a paucity of information regarding this topic within the literature and only 7 previous case reports have been published at the time of writing. To our knowledge, this case report is also the first to describe an atypical NMS variant in the context of an ILSCC. In this report, we describe the important considerations in formulating differential diagnosis for ILSCC and are the first report to propose a possible pathophysiological mechanism relating ILSCC with NMS

B Cell IgD Deletion Prevents Alveolar Bone Loss Following Murine Oral Infection

Periodontal disease is one of the most common infectious diseases of humans. Immune responses to infection trigger loss of alveolar bone from the jaw and eventual tooth loss. We investigated the contribution of B cell IgD to alveolar bone loss by comparing the response of B cell normal BALB/cJ mice and IgD deficient BALB/c-Igh-5−/−J mice to oral infection with Porphyromonas gingivalis, a gram-negative periodontopathic bacterium from humans. P. gingivalis-infected normal mice lost bone. Specific antibody to P. gingivalis was lower and oral colonization was higher in IgD deficient mice; yet bone loss was completely absent. Infection increased the proportion of CD69+ activated B cells and CD4+ T cells in immune normal mice compared to IgD deficient mice. These data suggest that IgD is an important mediator of alveolar bone resorption, possibly through antigen-specific coactivation of B cells and CD4+ T cells