Playing Producer: An alternative perspective on video games as film

This paper proposes a perspective on analyzing video games as film by comparing the interactions of the player with those of a producer or other member in the film-making process. This contrasts with existing methodologies which focus on formal characteristics or narratology. This proposal also provides a method for combining the interactivity of games with the storytelling capacity of cinema without encountering the narrative paradox

Mapping poverty in rural China: how much does the environment matter?

A recently developed small area estimation technique is used to geographically derive detailed estimates of consumption-based poverty and inequality in rural Shaanxi, China. These estimates may be helpful for targeting since there is wide variability in poverty rates within Shaanxi but low levels of inequality within most counties and townships. We also investigate whether including environmental variables in the equation used to predict consumption and poverty improves upon typical approaches that only use household survey and census data. Ignoring environmental variables appears likely to produce targeting errors

Mapping poverty in rural China: How much does the environment matter?

In this paper, we apply a recently developed small-area estimation technique to derive geographically detailed estimates of consumption-based poverty and inequality in rural Shaanxi, China. We also investigate whether using environmental variables derived mainly from satellite remote sensing improves upon traditional approaches that only use household survey and census data. According to our results, ignoring environmental variables in statistical analyses that predict small-area poverty rates leads to targeting errors. In other words, using environmental variables both helps more accurately identify poor areas (so they should be able to receive more transfers of poor area funds) and identify non-poor areas (which would allow policy makers to reduce poverty funds in these better off areas and redirect them to poor areas). Using area-based targeting may be an efficient way to reach the poor since many counties and townships in rural Shaanxi have low levels of inequality, even though, on average, there is more within-group than between-group inequality. Using information on locations that are, in fact, receiving poverty assistance, our analysis also produces evidence that official poverty policy in Shaanxi targets particular areas which in reality are no poorer than other areas that do not get targeted

Spaces of justice

Thesis: M. Arch., Massachusetts Institute of Technology, Department of Architecture, 2018.This electronic version was submitted by the student author. The certified thesis is available in the Institute Archives and Special Collections.Cataloged from student-submitted PDF version of thesis.Includes bibliographical references (pages 137-140).The US has the highest incarceration rate in the world by far. Premised on punishment and isolation, incarceration most heavily affects vulnerable neighborhoods and individuals and creates a system of disenfranchised citizens. Incarceration makes it difficult for these individuals to earn jobs and income, receive necessary healthcare, and maintain social ties. In a move towards reform, the Massachusetts state legislature is currently proposing bills for the implementation of restorative justice and justice reinvestment practices. Restorative justice offers an opportunity for the offender, victim, and other affected parties to engage in a mediated discussion to understand and agree on how the harm done can be repaired. It promotes a healing rather than punitive response to crime. Justice reinvestment reassesses how funds spent on incarceration can be diverted to help vulnerable individuals and neighborhoods, through beneficial programs such as youth crime prevention and education. This thesis, Spaces of Justice, adopts these strategies of reform to propose a new place of community corrections that offers vocational training and restorative justice practices for minor offenders and returning citizens. Community corrections is where convicted individuals serve their sentence in society, such as probation, rather than locked in a facility. However, a report in Massachusetts found that, because judges lack faith in current community corrections programs, they choose to incarcerate people 85% of the time, even when community corrections would be a more appropriate sentence. Indeed, in Boston, the current facility that provides services to probationers is located across from the city prison, in an inaccessible area near the highway. As an inhospitable place, it discourages use by both judges and probationers, and thus detracts from the potential that community corrections has in decreasing incarceration and lifting neighborhoods out of the incarceration cycle. This thesis proposes an alternative model that, first and foremost, is actually located within the community it serves. In doing so, it reduces isolation and stigma associated with those involved in the criminal justice system by creating new relationships among spaces of justice, public space, and the neighborhood.by James Addison and Olivia Huang.M. Arch

cis-regulatory circuits regulating NEK6 kinase overexpression in transformed B cells Are super-enhancer independent

Alterations in distal regulatory elements that control gene expression underlie many diseases, including cancer. Epigenomic analyses of normal and diseased cells have produced correlative predictions for connections between dysregulated enhancers and target genes involved in pathogenesis. However, with few exceptions, these predicted cis-regulatory circuits remain untested. Here, we dissect cis-regulatory circuits that lead to overexpression of NEK6, a mitosis-associated kinase, in human B cell lymphoma. We find that only a minor subset of predicted enhancers is required for NEK6 expression. Indeed, an annotated super-enhancer is dispensable for NEK6 overexpression and for maintaining the architecture of a B cell-specific regulatory hub. A CTCF cluster serves as a chromatin and architectural boundary to block communication of the NEK6 regulatory hub with neighboring genes. Our findings emphasize that validation of predicted cis-regulatory circuits and super-enhancers is needed to prioritize transcriptional control elements as therapeutic targets

Case Report of Rare Mycobacterium Isolated from Mediastinal Abscess

Introduction Mycobacterium arupense, a member of the Mycobacterium terrae complex identified in 2016, rarely causes infections despite isolation from multiple environmental sources, including water, soil and fish tanks.1 Case reports have described tenosynovitis, osteomyelitis and disseminated infection in an immunocompromised host.1-3 Here we describe a case of M. arupense identified in a polymicrobial mediastinal abscess in a pediatric patient subsequently diagnosed with autosomal dominant hyper-IgE syndrome (AD-HIES). Case Description A 4-year-old female with a history of pneumonia, herpetic skin infection, orbital cellulitis, and eczema presented in respiratory distress with concern for pneumonia. Imaging revealed a posterior mediastinal abscess which was drained on Day 3. Blood cultures identified Streptococcus anginosus, and the abscess fluid grew Streptococcus anginosus, Streptococcus mitis/oralis and Candida albicans. An esophagram and esophagogastroduodenoscopy revealed an esophageal sinus opening and fistula draining into the mediastinal abscess. After surgical closure, the fistula recurred, and an esophageal wound vacuum assisted closure (VAC) was placed. On Day 25, the initial acid-fast bacillus (AFB) abscess culture became positive, and ethambutol, rifampin, azithromycin and amikacin were started. The AFB was identified as M. arupense, and treatment was modified to clarithromycin, rifabutin, and ethambutol. Her course was complicated by drug-induced neutropenia and transaminitis. She received in total 61 days of antifungal, 58 days of antibacterial, and 40 days of M. arupense coverage. Due to the atypical infection, immune evaluation was performed and demonstrated low Th17 lymphocytes. Genetic testing detected a heterozygous pathogenic missense variant in STAT3 (c.2141C\u3eT) consistent with AD-HIES. Discussion This is the first case report of M. arupense isolated from a mediastinal abscess. Most M. arupense infections are secondary to direct inoculation injuries with resulting tenosynovitis and osteomyelitis.1,3 It is recognized as a possible respiratory tract colonizer, and therefore must meet clinical and microbiological criteria for diagnosis of NTM pulmonary disease.4,5 Limited susceptibility data has shown 97.5-100% of isolates susceptible to clarithromycin, ethambutol, and rifabutin. 3 Empiric therapy with these three drugs is recommended pending susceptibility data. Treatment duration data is limited but adequate source control is needed as shown here. Evaluation of inborn errors of immunity should be considered in atypical and severe infections, which led to the diagnosis of AD-HIES. AD-HIES due to dominant-negative mutations in STAT3 is characterized by elevated IgE, eczema, connective tissue and skeletal abnormalities, vascular malformations, and recurrent skin and pulmonary infections.6,7 Loss of STAT3 activation and Th17 response underlies our subject’s susceptibility to mycobacterial disease.8https://digitalcommons.unmc.edu/chri_forum/1058/thumbnail.jp

Can vouchers make a difference to the use of private primary care services by older people? Experience from the healthcare reform programme in Hong Kong

<p>Abstract</p> <p>Background</p> <p>As part of its ongoing healthcare reform, the Hong Kong Government introduced a voucher scheme, intended for encouraging older patients to use primary healthcare services in the private sector, thereby, reducing burden on the overwhelmed public sector. The voucher program is also considered one of the strategies to further develop the public private partnership in healthcare, a policy direction of high political priority as indicated in the Chief Executive Policy Address in 2008-09. This study assessed whether the voucher scheme, as implemented so far, has reached its intended goals, and how it might be further improved in the context of public-private partnership.</p> <p>Methods</p> <p>This was a cross-sectional study using structured questionnaires by face-to-face interviews with older people aged 70 or above in Hong Kong, the target group of the demand-side voucher program.</p> <p>Results</p> <p>71.2% of 1,026 older people were aware of the new voucher scheme but only 35.0% had ever used it. The majority of the older people used the vouchers for acute curative services in the private sector (82.4%) and spent less on preventive services. Despite the provision of vouchers valued US$30 per year as an incentive to encourage the use of private primary care services, after 12-months of implementation, 66.2% of all respondents agreed with the statement that "the voucher scheme does not change their health seeking behaviours on seeing public or private healthcare professionals". The most common reasons for no change in their behaviours included "I am used to seeing doctors in the public system" and "The amount of the subsidy is too low". Those who usually used a mix of public and private doctors and those with better self-reported health condition compared to last year were more likely to perceive a change in their own health seeking behaviours.</p> <p>Conclusions</p> <p>Our study showed that despite a reasonably high awareness of the voucher scheme, its usage was low. The voucher alone was not enough to realize the government's policy of greater use of the private primary care services. Greater publicity and more variety of media promotion would increase awareness but the effectiveness of vouchers in changing older people's behaviour needs to be revisited. Designating vouchers for use of preventive services with evidence-based practice could be considered. In addition to the demand-side subsidies, improving transparency and comparability of private services against the public sector might be necessary.</p