Jack Voltaic 3.0 Cyber Research Report

The Jack Voltaic (JV) Cyber Research project is an innovative, bottom-up approach to critical infrastructure resilience that informs our understanding of existing cybersecurity capabilities and identifies gaps. JV 3.0 contributed to a repeatable framework cities and municipalities nationwide can use to prepare. This report on JV 3.0 provides findings and recommendations for the military, federal agencies, and policy makers

Suburbanization and cultural change: the case of club cricket in Surrey, 1870–1939

This article examines the social, economic and political origins of what was a new, distinctly elitist, culture of ‘non-competitive’ sport, and how these values, which emerged from a small group of metropolitan elites, spread throughout the south-east of England. It argues that a long-term analysis of sport provides a valuable contextual tool for urban historians. In this case, how the gradual adoption of a distinctly ‘metropolitan’ culture throughout Surrey, and the associated changes in the social structure and purpose of cricket, may contribute towards a more nuanced assessment of that county's ‘suburbanization’, and how this region interacted with the urban cor

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis.

BACKGROUND: Child maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems. OBJECTIVES: To synthesise evidence of the effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment. STUDY DESIGN: For effectiveness, we included any controlled study. Other study designs were considered for economic decision modelling. For acceptability, we included any study that asked participants for their views. PARTICIPANTS: Children and young people up to 24 years 11 months, who had experienced maltreatment before the age of 17 years 11 months. INTERVENTIONS: Any psychosocial intervention provided in any setting aiming to address the consequences of maltreatment. MAIN OUTCOME MEASURES: Psychological distress [particularly post-traumatic stress disorder (PTSD), depression and anxiety, and self-harm], behaviour, social functioning, quality of life and acceptability. METHODS: Young Persons and Professional Advisory Groups guided the project, which was conducted in accordance with Cochrane Collaboration and NHS Centre for Reviews and Dissemination guidance. Departures from the published protocol were recorded and explained. Meta-analyses and cost-effectiveness analyses of available data were undertaken where possible. RESULTS: We identified 198 effectiveness studies (including 62 randomised trials); six economic evaluations (five using trial data and one decision-analytic model); and 73 studies investigating treatment acceptability. Pooled data on cognitive-behavioural therapy (CBT) for sexual abuse suggested post-treatment reductions in PTSD [standardised mean difference (SMD) -0.44 (95% CI -4.43 to -1.53)], depression [mean difference -2.83 (95% CI -4.53 to -1.13)] and anxiety [SMD -0.23 (95% CI -0.03 to -0.42)]. No differences were observed for post-treatment sexualised behaviour, externalising behaviour, behaviour management skills of parents, or parental support to the child. Findings from attachment-focused interventions suggested improvements in secure attachment [odds ratio 0.14 (95% CI 0.03 to 0.70)] and reductions in disorganised behaviour [SMD 0.23 (95% CI 0.13 to 0.42)], but no differences in avoidant attachment or externalising behaviour. Few studies addressed the role of caregivers, or the impact of the therapist-child relationship. Economic evaluations suffered methodological limitations and provided conflicting results. As a result, decision-analytic modelling was not possible, but cost-effectiveness analysis using effectiveness data from meta-analyses was undertaken for the most promising intervention: CBT for sexual abuse. Analyses of the cost-effectiveness of CBT were limited by the lack of cost data beyond the cost of CBT itself. CONCLUSIONS: It is not possible to draw firm conclusions about which interventions are effective for children with different maltreatment profiles, which are of no benefit or are harmful, and which factors encourage people to seek therapy, accept the offer of therapy and actively engage with therapy. Little is known about the cost-effectiveness of alternative interventions. LIMITATIONS: Studies were largely conducted outside the UK. The heterogeneity of outcomes and measures seriously impacted on the ability to conduct meta-analyses. FUTURE WORK: Studies are needed that assess the effectiveness of interventions within a UK context, which address the wider effects of maltreatment, as well as specific clinical outcomes. STUDY REGISTRATION: This study is registered as PROSPERO CRD42013003889. FUNDING: The National Institute for Health Research Health Technology Assessment programme

The Correlation between Running Economy and Maximal Oxygen Uptake: Cross-Sectional and Longitudinal Relationships in Highly Trained Distance Runners

A positive relationship between running economy and maximal oxygen uptake (V̇O2max) has been postulated in trained athletes, but previous evidence is equivocal and could have been confounded by statistical artefacts. Whether this relationship is preserved in response to running training (changes in running economy and V̇O2max) has yet to be explored. This study examined the relationships of (i) running economy and V̇O2max between runners, and (ii) the changes in running economy and V̇O2max that occur within runners in response to habitual training. 168 trained distance runners (males, n = 98, V̇O2max 73.0 ± 6.3 mLkg-1min-1; females, n = 70, V̇O2max 65.2 ± 5.9 mL kg-1min-1) performed a discontinuous submaximal running test to determine running economy (kcalkm-1). A continuous incre-mental treadmill running test to volitional exhaustion was used to determine V̇O2max 54 par-ticipants (males, n = 27; females, n = 27) also completed at least one follow up assessment. Partial correlation analysis revealed small positive relationships between running economy and V̇O2max (males r = 0.26, females r = 0.25; P<0.006), in addition to moderate positive re-lationships between the changes in running economy and V̇O2max in response to habitual training (r = 0.35; P<0.001). In conclusion, the current investigation demonstrates that only a small to moderate relationship exists between running economy and V̇O2max in highly trained distance runners. With>85 % of the variance in these parameters unexplained by this relationship, these findings reaffirm that running economy and V̇O2max are primarily determined independently

Minimal residual disease in Myeloma: Application for clinical care and new drug registration

The development of novel agents has transformed the treatment paradigm for multiple myeloma, with minimal residual disease (MRD) negativity now achievable across the entire disease spectrum. Bone marrow–based technologies to assess MRD, including approaches using next-generation flow and next-generation sequencing, have provided real-time clinical tools for the sensitive detection and monitoring of MRD in patients with multiple myeloma. Complementary liquid biopsy–based assays are now quickly progressing with some, such as mass spectrometry methods, being very close to clinical use, while others utilizing nucleic acid–based technologies are still developing and will prove important to further our understanding of the biology of MRD. On the regulatory front, multiple retrospective individual patient and clinical trial level meta-analyses have already shown and will continue to assess the potential of MRD as a surrogate for patient outcome. Given all this progress, it is not surprising that a number of clinicians are now considering using MRD to inform real-world clinical care of patients across the spectrum from smoldering myeloma to relapsed refractory multiple myeloma, with each disease setting presenting key challenges and questions that will need to be addressed through clinical trials. The pace of advances in targeted and immune therapies in multiple myeloma is unprecedented, and novel MRD-driven biomarker strategies are essential to accelerate innovative clinical trials leading to regulatory approval of novel treatments and continued improvement in patient outcomes

Linking Symptom Inventories using Semantic Textual Similarity

An extensive library of symptom inventories has been developed over time to measure clinical symptoms, but this variety has led to several long standing issues. Most notably, results drawn from different settings and studies are not comparable, which limits reproducibility. Here, we present an artificial intelligence (AI) approach using semantic textual similarity (STS) to link symptoms and scores across previously incongruous symptom inventories. We tested the ability of four pre-trained STS models to screen thousands of symptom description pairs for related content - a challenging task typically requiring expert panels. Models were tasked to predict symptom severity across four different inventories for 6,607 participants drawn from 16 international data sources. The STS approach achieved 74.8% accuracy across five tasks, outperforming other models tested. This work suggests that incorporating contextual, semantic information can assist expert decision-making processes, yielding gains for both general and disease-specific clinical assessment

A Rare Complication of Sacrocolpopexy.

Pelvic organ prolapse is a prevalent condition with up to 12% of women requiring surgery in their lifetim

Robotic Resection of Intravesical Polypropylene Mesh Following Tension Free Tape Procedure

Demonstrate the technique of laparoscopic robotic resection of mesh arms within the bladde

Effects of COVID-19 Policy and Communication on Pandemic Control in US Colleges - An Empirical Study Through the Lens of Online Social Media

Most researches in COVID-19 literature focuses on policy making - from the federal government, the CDC, state, and local governments - and case prediction. In this study, we attempt to use online social media data to better understand the student perspective of their university’s reopening and COVID-19 prevention measures and their impact on pandemic control. We collected policy information and case numbers from multiple authority resources. And, we created a web crawler to scrape Twitter data related to 250 universities including tweets, retweets, replies, and likes. Based on those tweets, we gauge student sentiment toward their university’s policy and communication. Moreover, we apply a quantitative analysis approach to explore the role of university policy, student perceptions, and their interaction on pandemic control. We believe that the expected result of our work can help universities better understand the student experiences and therefore improve their policy, response, and communication strategies to survive this turbulent period