Cross-layer wireless bit rate adaptation

This paper presents SoftRate, a wireless bit rate adaptation protocol that is responsive to rapidly varying channel conditions. Unlike previous work that uses either frame receptions or signal-to-noise ratio (SNR) estimates to select bit rates, SoftRate uses confidence information calculated by the physical layer and exported to higher layers via the SoftPHY interface to estimate the prevailing channel bit error rate (BER). Senders use this BER estimate, calculated over each received packet (even when the packet has no bit errors), to pick good bit rates. SoftRate's novel BER computation works across different wireless environments and hardware without requiring any retraining. SoftRate also uses abrupt changes in the BER estimate to identify interference, enabling it to reduce the bit rate only in response to channel errors caused by attenuation or fading. Our experiments conducted using a software radio prototype show that SoftRate achieves 2X higher throughput than popular frame-level protocols such as SampleRate and RRAA. It also achieves 20% more throughput than an SNR-based protocol trained on the operating environment, and up to 4X higher throughput than an untrained SNR-based protocol. The throughput gains using SoftRate stem from its ability to react to channel variations within a single packet-time and its robustness to collision losses.National Science Foundation (U.S.) (Grant CNS-0721702)National Science Foundation (U.S.) (Grant CNS-0520032)Foxconn International Holdings Ltd

Trading Structure for Randomness in Wireless Opportunistic Routing

Opportunistic routing is a recent technique that achieves high throughput in the face of lossy wireless links. The current opportunistic routing protocol, ExOR, ties the MAC with routing, imposing a strict schedule on routers' access to the medium. Although the scheduler delivers opportunistic gains, it misses some of the inherent features of the 802.11 MAC. For example, it prevents spatial reuse and thus may underutilize the wireless medium. It also eliminates the layering abstraction, making the protocol less amenable to extensions of alternate traffic type such as multicast.This paper presents MORE, a MAC-independent opportunistic routing protocol. MORE randomly mixes packets before forwarding them. This randomness ensures that routers that hear the same transmission do not forward the same packets. Thus, MORE needs no special scheduler to coordinate routers and can run directly on top of 802.11. Experimental results from a 20-node wireless testbed show that MORE's average unicast throughput is 20% higher than ExOR, and the gains rise to 50% over ExOR when there is a chance of spatial reuse. For multicast, MORE's gains increase with the number of destinations, and are 35-200% greater than ExOR

Spinal codes

Spinal codes are a new class of rateless codes that enable wireless networks to cope with time-varying channel conditions in a natural way, without requiring any explicit bit rate selection. The key idea in the code is the sequential application of a pseudo-random hash function to the message bits to produce a sequence of coded symbols for transmission. This encoding ensures that two input messages that differ in even one bit lead to very different coded sequences after the point at which they differ, providing good resilience to noise and bit errors. To decode spinal codes, this paper develops an approximate maximum-likelihood decoder, called the bubble decoder, which runs in time polynomial in the message size and achieves the Shannon capacity over both additive white Gaussian noise (AWGN) and binary symmetric channel (BSC) models. Experimental results obtained from a software implementation of a linear-time decoder show that spinal codes achieve higher throughput than fixed-rate LDPC codes, rateless Raptor codes, and the layered rateless coding approach of Strider, across a range of channel conditions and message sizes. An early hardware prototype that can decode at 10 Mbits/s in FPGA demonstrates that spinal codes are a practical construction.Massachusetts Institute of Technology (Irwin and Joan Jacobs Presidential Fellowship)Massachusetts Institute of Technology (Claude E. Shannon Assistantship)Intel Corporation (Intel Fellowship

Development of DYNAMIX Policy Mixes - Deliverable 4.2, revised version, of the DYNAMIX project

This report documents the development of the initial dynamic policy mixes that were developed for assessment in the DYNAMIX project. The policy mixes were designed within three different policy areas: overarching policy, land-use and food, and metals and other materials. The policy areas were selected to address absolute decoupling in general and, specifically, the DYNAMIX targets related to the use of virgin metals, the use of arable land and freshwater, the input of the nutrients nitrogen and phosphorus, and emissions of greenhouse gases. Each policy mix was developed within a separate author team, using a common methodological framework that utilize previous findings in the project. Specific drivers and barriers for resource use and resource efficiency are discussed in each policy area. Specific policy objectives and targets are also discussed before the actual policy mix is presented. Each policy mix includes a set of key instruments, which can be embedded in a wider set of supporting and complementary policy instruments. All key instruments are described in the report through responses to a set of predefined questions. The overarching mix includes a broad variety of key instruments. The land-use policy mix emphasizes five instruments to improve food production through, for example, revisions of already existing policy documents. It also includes three instruments to influence the food consumption and food waste. The policy mix on metals and other materials primarily aims at reducing the use of virgin metals through increased recycling, increased material efficiency and environmentally justified material substitution. To avoid simply shifting of burdens, it includes several instruments of an overarching character

Positive psychology of Malaysian students: impacts of engagement, motivation, self-compassion and wellbeing on mental health

Malaysia plays a key role in education of the Asia Pacific, expanding its scholarly output rapidly. However, mental health of Malaysian students is challenging, and their help-seeking is low because of stigma. This study explored the relationships between mental health and positive psychological constructs (academic engagement, motivation, self-compassion, and wellbeing), and evaluated the relative contribution of each positive psychological construct to mental health in Malaysian students. An opportunity sample of 153 students completed the measures regarding these constructs. Correlation, regression, and mediation analyses were conducted. Engagement, amotivation, self-compassion, and wellbeing were associated with, and predicted large variance in mental health. Self-compassion was the strongest independent predictor of mental health among all the positive psychological constructs. Findings can imply the strong links between mental health and positive psychology, especially selfcompassion. Moreover, intervention studies to examine the effects of self-compassion training on mental health of Malaysian students appear to be warranted.N/

Improving Access to Primary and Pain Care for Patients Taking Opioids for Chronic Pain in Michigan: Recommendations from an Expert Panel

This multidisciplinary expert panel was convened to generate recommendations to address the limited access to care that patients experience when taking opioids for chronic pain. Recent policies and guidelines instituted to reduce inappropriate opioid prescribing have had unintended consequences for the 5-8 million patients taking long-term opioid therapy for chronic pain in the U.S. As providers discontinue prescribing and turn away patients dependent on opioids, this population faces limited access to both primary and pain-related care. The root causes of this access issue can be attributed to several overarching barriers, including new opioid-related policies, payment models, a lack of care coordination, stigma, and racial biases. Over multiple rounds of deliberation, the panel brainstormed possible solutions, considering feasibility, impact, and importance, and ultimately ranked their final recommendations in order of implementation priority. The final list included 11 recommendations, from which three overarching themes emerged: 1. Improving care models to better support patients with chronic pain Three recommendations involved improving care models, including the top two: increasing reimbursement for the time needed to treat complex chronic pain and establishing coordinated care models that bundle payments for multimodal pain treatment. 2. Enhancing provider education and training Four recommendations involving provider education efforts received slightly lower rankings and included training on biopsychosocial factors of pain care and clarifying the continuum between physical dependency and opioid use disorder. 3. Implementing practices to reduce racial biases and inequities The remaining four recommendations address racial biases and inequities, ranging from standardizing pain management protocols to reduce bias to increasing recruitment and retention of providers from underrepresented racial minorities. Throughout the process, panelists emphasized the interconnectedness of their proposed solutions, and indicated that multiple approaches are likely needed to meaningfully improve access to care for this patient population. Importantly, though this panel was convened in Michigan, and its expertise grounded in Michigan’s healthcare ecosystem, there are millions of patients taking opioids for chronic pain across the country, and reports of limited access to care are not unique to Michigan. Consequently, there may also be opportunity to apply these recommendations more broadly, in other states and at multiple levels of the United States healthcare system.This research was funded by the Michigan Health Endowment Fund (grant # R-1808-143371).http://deepblue.lib.umich.edu/bitstream/2027.42/168420/1/Lagisetty - Improving Access to Care for Patients Taking Opioids - 2021.pdfDescription of Lagisetty - Improving Access to Care for Patients Taking Opioids - 2021.pdf : White PaperSEL

Indications for and Utilization of ACE Inhibitors in Older Individuals with Diabetes

Angiotensin-converting enzyme inhibitors (ACE) and angiotensin receptor blockers (ARB) improve cardiovascular outcomes in high-risk individuals with diabetes. Despite the marked benefit, it is unknown what percentage of patients with diabetes would benefit from and what percentage actually receive this preventive therapy. OBJECTIVES : To examine the proportion of older diabetic patients with indications for ACE or ARB (ACE/ARB). To generate national estimates of ACE/ARB use. DESIGN AND PARTICIPANTS : Survey of 742 individuals≥55 years (representing 8.02 million U.S. adults) self-reporting diabetes in the 1999 to 2002 National Health and Nutrition Examination Survey. MEASUREMENTS : Prevalence of guideline indications (albuminuria, cardiovascular disease, hypertension) and other cardiac risk factors (hyperlipidemia, smoking) with potential benefit from ACE/ARB. Prevalence of ACE/ARB use overall and by clinical indication. RESULTS : Ninety-two percent had guideline indications for ACE/ARB. Including additional cardiac risk factors, the entire (100%) U.S. noninstitutionalized older population with diabetes had indications for ACE/ARB. Overall, 43% of the population received ACE/ARB. Hypertension was associated with higher rates of ACE/ARB use, while albuminuria and cardiovascular disease were not. As the number of indications increased, rates of use increased, however, the maximum prevalence of use was only 53% in individuals with 4 or more indications for ACE/ARB. CONCLUSIONS : ACE/ARB is indicated in virtually all older individuals with diabetes; yet, national rates of use are disturbingly low and key risk factors (albuminuria and cardiovascular disease) are being missed. To improve quality of diabetes care nationally, use of ACE/ARB therapy by ALL older diabetics may be a desirable addition to diabetes performance measurement sets.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/74734/1/j.1525-1497.2006.00351.x.pd

Pivotal Role of Adenosine Neurotransmission in Restless Legs Syndrome

The symptomatology of Restless Legs Syndrome (RLS) includes periodic leg movements during sleep (PLMS), dysesthesias, and hyperarousal. Alterations in the dopaminergic system, a presynaptic hyperdopaminergic state, seem to be involved in PLMS, while alterations in glutamatergic neurotransmission, a presynaptic hyperglutamatergic state, seem to be involved in hyperarousal and also PLMS. Brain iron deficiency (BID) is well-recognized as a main initial pathophysiological mechanism of RLS. BID in rodents have provided a pathogenetic model of RLS that recapitulates the biochemical alterations of the dopaminergic system of RLS, although without PLMS-like motor abnormalities. On the other hand, BID in rodents reproduces the circadian sleep architecture of RLS, indicating the model could provide clues for the hyperglutamatergic state in RLS. We recently showed that BID in rodents is associated with changes in adenosinergic transmission, with downregulation of adenosine A1 receptors (A1R) as the most sensitive biochemical finding. It was hypothesized that A1R downregulation leads to hypersensitive striatal glutamatergic terminals and facilitation of striatal dopamine release. Hypersensitivity of striatal glutamatergic terminals was demonstrated by an optogenetic-microdialysis approach in the rodent with BID, indicating that it could represent a main pathogenetic factor that leads to PLMS in RLS. In fact, the dopaminergic agonists pramipexole and ropinirole and the α2δ ligand gabapentin, used in the initial symptomatic treatment of RLS, completely counteracted optogenetically-induced glutamate release from both normal and BID-induced hypersensitive corticostriatal glutamatergic terminals. It is a main tenet of this essay that, in RLS, a single alteration in the adenosinergic system, downregulation of A1R, disrupts the adenosine-dopamine-glutamate balance uniquely controlled by adenosine and dopamine receptor heteromers in the striatum and also the A1R-mediated inhibitory control of glutamatergic neurotransmission in the cortex and other non-striatal brain areas, which altogether determine both PLMS and hyperarousal. Since A1R agonists would be associated with severe cardiovascular effects, it was hypothesized that inhibitors of nucleoside equilibrative transporters, such as dipyridamole, by increasing the tonic A1R activation mediated by endogenous adenosine, could represent a new alternative therapeutic strategy for RLS. In fact, preliminary clinical data indicate that dipyridamole can significantly improve the symptomatology of RLS