StateSim: Lessons Learned from 20 Years of A Country Modeling and Simulation Toolset

A holy grail for military, diplomatic, and intelligence analysis is a valid set of software agent models that act as the desired ethno-political factions so that one can test the effects of alternative courses of action in different countries. This article explains StateSim, a country modeling approach that synthesizes best-of-breed theories from across the social sciences and that has helped numerous organizations over 20 years to study insurgents, gray zone actors, and other societal instabilities. The country modeling literature is summarized (Sect 1.1) and synthetic inquiry is contrasted with scientific inquiry (Sect. 1.2 and 2). Section 2 also explains many fielded StateSim applications and 100s of past acceptability tests and validity assessments. Section 3 then describes how users now construct and run ‘first pass’ country models within hours due to the StateSim Generator, while Section 4 offers two country analyses that illustrate this approach. The conclusions explain lessons learned

L’impact d’un campus clinique régional en milieu urbain : les perceptions des parties prenantes de la collectivité

Background: Regional medical campuses (RMC) have shown promise in addressing physician shortages. RMCs have been positively evaluated in rural/remote communities, however, it is unclear whether this model will be as beneficial in underserved urban areas. This study evaluated the impact of a RMC on a midsized urban city (Windsor, Ontario). We compare our results with a similar study conducted in a remote community in British Columbia (BC). Methods: A broad array of community stakeholders representing different sectors were consulted using a semi-structured interview format replicated from the BC Northern Medical Program (NMP) study. Thematic analysis based on the resulting rich data was conducted within a grounded theory context. Results: Twenty-three participants (52% male) representing healthcare, education, business, community and government/politico sectors were consulted. Their views regarding the Windsor Regional Medical Campus (WRMC) aligned around several themes: improved healthcare, enhanced community reputation, stimulated economic/community development, expanded training opportunities and an engaged community regarding the WRMC. These results were compared to the main findings of the NMP study with both similarities (e.g. increased community pride) and differences (e.g. resource concerns) discussed. Conclusion: Community stakeholders provided strong support for the WRMC through their perceptions of its positive impact on this urban region. These findings are consistent with similar RMC studies in rural/remote areas. Those interested in developing a RMC might benefit from considering these findings.Contexte : Les campus cliniques régionaux (CCR) se sont révélés prometteurs pour remédier à la pénurie de médecins. Les CCR ont été évalués positivement dans les collectivités rurales/éloignées, mais il n’est pas certain que ce modèle soit aussi bénéfique dans les zones urbaines mal desservies. La présente étude évalue l’impact d’un CCR dans une ville de taille moyenne (Windsor, Ontario). Nous comparons nos résultats avec ceux d’une étude similaire menée dans une collectivité éloignée en Colombie-Britannique (BC). Méthode : Un large éventail de parties prenantes de la collectivité représentant différents secteurs a été consulté par le biais d’entrevues semi-structurées calquées sur celles de l’étude du BC Northern Medical Program (NMP). L’analyse thématique des riches données obtenues a été faite selon l’approche de la Grounded Theory (théorie ancrée). Résultats : Vingt-trois participants (52 % d’hommes) des secteurs de la santé, de l’éducation, des affaires, de la vie communautaire, du gouvernement ou encore du monde politique ont été consultés. Leurs opinions concernant le campus clinique régional de Windsor (WRMC) s’articulaient autour de plusieurs thèmes : l’amélioration des soins de santé, le renforcement de la réputation de la collectivité, la stimulation du développement économique et communautaire, l’élargissement des possibilités de formation et l’engagement de la communauté envers le WRMC. Les résultats ont été comparés aux principales conclusions de l’étude du NMP, en analysant aussi bien les similitudes (par exemple, fierté accrue de la collectivité) que les différences (par exemple, les préoccupations en matière de ressources). Conclusion : Percevant l’impact positif qu’a eu le WRMC dans la région urbaine, les acteurs de la collectivité témoignent d’un ferme appui à son égard. Ces résultats sont conformes aux études similaires portant sur des CCR dans les zones rurales/éloignées. Les résultats de l’étude seraient utiles à tous ceux qui souhaitant mettre sur pied un CCR

Barriers to Family Suspicious Activity Reporting (SAR) of Mobilization Behaviors and Pre-Operational Planning: Report to the U.S. Department of Homeland Security

The Nationwide Suspicious Activity Reporting (SAR) Initiative (NSI) is one of many tools used by law enforcement to help prevent terrorism and terrorism-related activity (see Figure 1). In addition to state, local, tribal, and territorial (SLTT) agencies and federal law enforcement, the Department of Homeland Security (DHS) relies on communities to report suspicious behaviors. While much is known about the actual SAR process, 1 less is known about an essential segment of the community: family members. Family members of violent extremists (VE) play an important role in countering violent extremism (CVE), whether by supporting disengagement and deradicalization or by alerting authorities when concerned for the safety of their loved one(s) and/or others. However, due to issues like mistrust and fear of law enforcement, or a general lack of understanding about SAR and the investigative process, family members may be reluctant to report suspicious behaviors. This fundamental issue reduces the effectiveness of any CVE program or policy. It thus warrants an investigation into how law enforcement agencies can better support and promote family members reporting of suspicious activity. This report seeks to determine whether the DHS and the NSI collaborative have protocols to address family engagement in CVE and report suspicious behaviors. The following two research questions will guide the remainder of this report: (1) How do SAR trainings address family engagement in suspicious reporting? (2) How do members of the NSI collaborative perceive family engagement in the SAR process (i.e., report suspicious behavior)

Family Responses to White Supremacist Extremism: Report to the U.S. Department of Homeland Security

Executive Overview: • Families often express some form of disapproval to relatives involved in white supremacist extremism (WSE); • Expressions of disapproval are often limited to “staying out of trouble” or involve limited to no clearly defined intervention; • Families fear “closing doors” will increase the likelihood they will push their relative away; • Families rarely seek out formal assistance from either governmental or non-governmental agencies; • While nearly 34% of the sample received counseling during childhood and/or adolescence, none of those counseling sessions addressed WSE; the counseling focused exclusively on non-WSE issues (e.g., academic failure, generic delinquency, etc.)

Directly observed antiretroviral therapy: a systematic review and meta-analysis of randomised clinical trials.

BACKGROUND: Directly observed therapy has been recommended to improve adherence for patients with HIV infection who are on highly active antiretroviral therapy, but the benefit and cost-effectiveness of this approach has not been established conclusively. We did a systematic review and meta-analysis of randomised trials of directly observed versus self-administered antiretroviral treatment. METHODS: We did duplicate searches of databases (from inception to July 27, 2009), searchable websites of major HIV conferences (up to July, 2009), and lay publications and websites (March-July, 2009) to identify randomised trials assessing directly observed therapy to promote adherence to antiretroviral therapy in adults. Our primary outcome was virological suppression at study completion. We calculated relative risks (95% CIs), and pooled estimates using a random-effects method. FINDINGS: 12 studies met our inclusion criteria; four of these were done in groups that were judged to be at high risk of poor adherence (drug users and homeless people). Ten studies reported on the primary outcome (n=1862 participants); we calculated a pooled relative risk of 1.04 (95% CI 0.91-1.20, p=0.55), and noted moderate heterogeneity between the studies (I(2)= 53.8%, 95% CI 0-75.7, p=0.0247) for directly observed versus self-administered treatment. INTERPRETATION: Directly observed antiretroviral therapy seems to offer no benefit over self-administered treatment, which calls into question the use of such an approach to support adherence in the general patient population. FUNDING: None

Building an Open Source Classifier for the Neonatal EEG Background: A Systematic Feature-Based Approach From Expert Scoring to Clinical Visualization

Neonatal brain monitoring in the neonatal intensive care units (NICU) requires a continuous review of the spontaneous cortical activity, i.e., the electroencephalograph (EEG) background activity. This needs development of bedside methods for an automated assessment of the EEG background activity. In this paper, we present development of the key components of a neonatal EEG background classifier, starting from the visual background scoring to classifier design, and finally to possible bedside visualization of the classifier results. A dataset with 13,200 5-minute EEG epochs (8–16 channels) from 27 infants with birth asphyxia was used for classifier training after scoring by two independent experts. We tested three classifier designs based on 98 computational features, and their performance was assessed with respect to scoring system, pre- and post-processing of labels and outputs, choice of channels, and visualization in monitor displays. The optimal solution achieved an overall classification accuracy of 97% with a range across subjects of 81–100%. We identified a set of 23 features that make the classifier highly robust to the choice of channels and missing data due to artefact rejection. Our results showed that an automated bedside classifier of EEG background is achievable, and we publish the full classifier algorithm to allow further clinical replication and validation studies.Peer reviewe

Coordination chemistry and biology of chelators for the treatment of iron overload disorders

Treatment of the medical condition generally referred to as iron overload through the delivery of chelators has recently received a major boost. In 2005 Novartis gained FDA approval for the drug deferasirox, which may be taken orally. Until this time most patients with Fe overload have had to endure long periods of subcutaneous infusions of the orally ineffective drug desferrioxamine (desferal) which has led to major problems with patient compliance. An effective Fe chelator must possess a number of properties for it to be able to complex Fe in vivo and be excreted intact. This Perspective will provide an overview of the current state of chelators for Fe overload; both those currently approved and those undergoing preclinical development

Heart Fields: Spatial Polarity and Temporal Dynamics

In chick and mouse, heart fields undergo dynamic morphological spatiotemporal changes during heart tube formation. Here, the dynamic change in spatial polarity of such fields is discussed and a new perspective on the heart fields is proposed. The heart progenitor cells delaminate through the primitive streak and migrate in a semicircular trajectory craniolaterally forming the bilateral heart fields as part of the splanchnic mesoderm. They switch their polarity from anteroposterior to mediolateral. The anterior intestinal portal posterior descent inverts the newly formed heart field mediolateral polarity into lateromedial by 125° bending. The heart fields revert back to their original anteroposterior polarity and fuse at the midline forming a semi heart tube by completing their half circle movement. Several names and roles were assigned to different portions of the heart fields: posterior versus anterior, first versus second, and primary versus secondary heart field. The posterior and anterior heart fields define basically physical fields that form the inflow–outflow axis of the heart tube. The first and second heart fields are, in contrast, temporal fields of differentiating cardiomyocytes expressing myosin light chain 2a and undifferentiated and proliferating precardiac mesoderm expressing Isl1 gene, respectively. The two markers present a complementary pattern and are expressed transiently in all myocardial lineages. Thus, Isl1 is not restricted to a portion of the heart field or one of the two heart lineages as has been often assumed. Anat Rec, 297:175–182, 2014. © 2013 Wiley Periodicals, Inc.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102627/1/ar22831.pd