A Game Theoretical Model of Radiological Terrorism Defense

Radiological dispersal devices (RDD) pose a threat to the United States. Healthcare facilities housing high-risk radioactive materials and devices are potentially easy targets for unauthorized access and are vulnerable to malevolent acts of theft or sabotage. The three most attractive candidates for use in RDD considered in this study are: 60Co (radiosurgery devices), 137Cs (blood irradiators) and 192Ir (brachytherapy high dose radiation device). The threat posed by RDDs has led to evaluating the security risk of radioactive materials and defending against attacks. The concepts of risk analysis used in conjunction with game theory lay the foundations of quantitative security risk management. This paper develops a two player non-cooperative one-shot simultaneous defender-attacker game. The defender (healthcare facility) chooses to defend one of the three high-risk radioactive material targets and the attacker (terrorists or adversaries) chooses to attack one of the three high-risk radioactive material targets. A risk-informed approach is used to model players’ payoffs or expected utilities for each choice of strategies. A game-theoretic model (RDD game) captures the strategic interaction between competing players who act rationally to maximize their expected utility. The evaluation of the RDD game results in a von Neuman max-min strategy solution being preferable to a mixed strategy Nash equilibrium solution. The von Neumann max-min strategy solution of the defender defending cobalt and the attacker attacking cesium is found to be the most prescriptive result, thus favoring the current efforts of phasing out cesium blood irradiators and replacing them with alternative technologies. The RDD game not only gives the defender strategic options to budget scarce security resources but also helps healthcare facilities make optimal choices under severe uncertainty about the terrorist threat

Experiences with Teaching Nuclear Security Professional Development Courses for Health Physicists

Health physicists are professionals that are experts in the recognition, evaluation, and control of health hazards to permit the safe use and application of radiation. They typically have broad knowledge in radiation (ionizing and non-ionizing), biology, ecology and safety. With this wealth expertise we believe the health physicists would be useful partners in an effective security culture. As such over three years, a total of seven professional enrichment courses have been offered by the authors to health physics and radiation protection professionals, both nationally and internationally. Five have been through the Health Physics Society meetings, one through the International Radiation Protection Association meeting, and one at the Massachusetts Institute of Technology. This paper will briefly introduce these courses and will include learning objectives and descriptions of courses’ content. There was limited documented course participant feedback with only 1 of the 7 courses having documented course evaluations. Through both written and verbal feedback to the instructors it was clear the courses were well received

Paediatric drowning: a standard operating procedure to aid the prehospital management of paediatric cardiac arrest resulting from submersion

Objectives: Drowning is one of the leading causes of death in children. Resuscitating a child following submersion is a highpressure situation, and standard operating procedures can reduce error. Currently, the Resuscitation Council UK guidance does not include a standard operating procedure on paediatric drowning. The objective of this project was to design a standard operating procedure to improve outcomes of drowned children. Methods: A literature review on the management of paediatric drowning was conducted. Relevant publications were used to develop a standard operating procedure for management of paediatric drowning. Results: A concise standard operating procedure was developed for resuscitation following paediatric submersion. Specific recommendations include: the Heimlich manoeuvre should not be used in this context; however, prolonged resuscitation and therapeutic hypothermia are recommended. Conclusions: This standard operating procedure is a potentially useful adjunct to the Resuscitation Council UK guidance and should be considered for incorporation into its next iteration

Use of Research as a Tool to Enhance Nuclear Security Education

Introduction: Nuclear security education covers essential topics related to the security of nuclear materials. In order to provide effective training, educators are faced with the challenge of improving the trainees’ ability to retain and utilize knowledge. This project investigated whether academic research is beneficial for educators seeking to enhance nuclear security education. Methods: A survey using Google Forms was sent to nuclear security educators in academic and research institutes. The survey included questions on their experience with different aspects of nuclear security education, how research may influence nuclear security education, and how to increase knowledge retention. Results: In total, 45 people participated in the survey, with 71.1% of respondents from university settings and 13.3% from research institutes. Of these university and research institute respondents, 93.3% were members of the International Nuclear Security Education Network (INSEN), and 75.6% identified as educators. All participants indicated that research is important in order to enhance nuclear security education. Conclusion: Research on training and education in nuclear security can support trainees’ knowledge retention and application. Research is also useful for developing nuclear security training programs and curricula

Diagnostic Ultrasound Safety Review for Point-of-Care Ultrasound Practitioners

Potential ultrasound exposure safety issues are reviewed, with guidance for prudent use of point‐of‐care ultrasound (POCUS). Safety assurance begins with the training of POCUS practitioners in the generation and interpretation of diagnostically valid and clinically relevant images. Sonographers themselves should minimize patient exposure in accordance with the as‐low‐as‐reasonably‐achievable principle, particularly for the safety of the eye, lung, and fetus. This practice entails the reduction of output indices or the exposure duration, consistent with the acquisition of diagnostically definitive images. Informed adoption of POCUS worldwide promises a reduction of ionizing radiation risks, enhanced cost‐effectiveness, and prompt diagnoses for optimal patient care

The INSEN Experience, by INSEN Chairs

As a feature of this issue, we asked INSEN chairs to share their thoughts about what the organization has meant to them as they led this network of colleagues in the mission of improving nuclear security education and training at institutions and organizations around the world. Below are their stories. The chairs describe their paths to INSEN leadership, the organization’s work, challenges, and successes, and how the experience of leading INSEN affected their professional and personal lives. IJNS thanks each of the authors contributing to this collaborative article. Every chair has done a tremendous job in their tenure as INSEN’s leader—and we, the membership and all who have benefitted from their dedication and expertise, are deeply grateful. We look forward to INSEN’s next decade under the leadership of colleagues and friends like these

Implications of Arm Restraint on Lower Extremity Kinetics During Gait

Background Literature indicates the importance of the upper extremities in providing stability and propulsion for the body during ambulation. However, the kinetic implications of upper extremity restraint during gait are not as well documented. Aim The objective of this study was to examine the effect of arm restraint (unilateral and bilateral) on lower extremity joint kinetics during walking. Methods Twenty-three healthy young participants were instrumented for three dimensional motion analysis, and tested in four randomly ordered upper extremity restraint conditions (unrestrained, bilateral restraint, right side restraint, and left side restraint). Temporal spatial parameters and gait/phase-specific lower extremity kinetics and kinematics were measured. For each restraint condition, pointwise differences from the unrestrained condition were compared using a two-way ANOVA model of restraint condition (“Condition”) and gait cycle phase (“Timing”). Results Decreases in walking speed and stride length were observed for all restraint conditions. Differences in kinetic demands were also noted, primarily at the hip and knee. Conclusion Upper extremity restraint in healthy young adults leads to significant changes in temporal-spatial parameters and proximal joint kinetics, most prominently during periods of load accommodation and balance

Brief of Intellectual Property Law Scholars As Amici Curiae in Support of Neither Party, WesternGeco LLC v. Ion Geophysical Corp., No. 16-1011, US Supreme Court

This amici curiae brief was filed on behalf of Intellectual Property Law Scholars in WesternGeco LLC v. Ion Geophysical Corp. in the U.S. Supreme Court. The question presented is: Whether the U.S. Court of Appeals for the Federal Circuit erred in holding that lost profits arising from prohibited combinations occurring outside of the United States are categorically unavailable in cases in which patent infringement is proven under 35 U.S.C. § 271(f). In RJR Nabisco, Inc. v. European Community, 136 S. Ct. 2090 (2016), the Supreme Court articulated a two-step method for assessing the extraterritorial reach of a US statute: 1. A court should determine whether the presumption against extraterritoriality has been rebutted—that is, whether the statute gives a clear, affirmative indication that it applies extraterritorially. If the presumption is rebutted, the statute may have extraterritorial reach. 2. But even if the presumption has not been rebutted, a court should look at the focus of the statute. If the conduct relevant to the statute\u27s focus occurred in the United States, then the case involves a permissible domestic application even if other conduct occurred abroad; but if the conduct relevant to the focus occurred in a foreign country, then the case involves an impermissible extraterritorial application regardless of any other conduct that occurred in U.S. territory. The brief of amici curiae makes the follow points: 1. The Supreme Court has not squarely answered the question as to whether the presumption against extraterritoriality applies separately to remedial provisions of a statute generally (here whether it applies to § 284). We argue it does. 2. We argue that the territorial reach § 284 necessarily depends the relevant provision of § 271 used to find liability. Here, under § 271(f), the presumption is rebutted (though it would not be generally for a case under § 271(a), with NTP v. Research in Motion may be a counter-example when one looks at the focus at step 2)). 3. We also argue that the Court should offer more guidance as to what happens even if the RJR test is satisfied. RJR Nabisco seems to operate in binary fashion -- either the statute has extraterritorial reach or it doesn\u27t. But Microsoft Corp. v. AT&T Corp., and earlier Supreme Court decision also interpreting 35 U.S.C. § 271(f), suggests that the presumption may still have a role in interpreting a statute. We offer two suggestions on how the presumption should operate in this context. First, courts should seriously and formally consider issues of comity and potential conflicts with foreign law in assessing whether to apply U.S. law extraterritorially. Second, that territoriality should remain relevant in assessments of proximate cause

Altered resting state neuromotor connectivity in men with chronic prostatitis/chronic pelvic pain syndrome: A MAPP: Research Network Neuroimaging Study.

Brain network activity associated with altered motor control in individuals with chronic pain is not well understood. Chronic Prostatitis/Chronic Pelvic Pain Syndrome (CP/CPPS) is a debilitating condition in which previous studies have revealed altered resting pelvic floor muscle activity in men with CP/CPPS compared to healthy controls. We hypothesized that the brain networks controlling pelvic floor muscles would also show altered resting state function in men with CP/CPPS. Here we describe the results of the first test of this hypothesis focusing on the motor cortical regions, termed pelvic-motor, that can directly activate pelvic floor muscles. A group of men with CP/CPPS (N = 28), as well as group of age-matched healthy male controls (N = 27), had resting state functional magnetic resonance imaging scans as part of the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network study. Brain maps of the functional connectivity of pelvic-motor were compared between groups. A significant group difference was observed in the functional connectivity between pelvic-motor and the right posterior insula. The effect size of this group difference was among the largest effect sizes in functional connectivity between all pairs of 165 anatomically-defined subregions of the brain. Interestingly, many of the atlas region pairs with large effect sizes also involved other subregions of the insular cortices. We conclude that functional connectivity between motor cortex and the posterior insula may be among the most important markers of altered brain function in men with CP/CPPS, and may represent changes in the integration of viscerosensory and motor processing

The impacts avoided with a 1.5 °C climate target: a global and regional assessment

The 2015 Paris Agreement commits countries to pursue efforts to limit the increase in global mean temperature to 1.5 °C above pre-industrial levels. We assess the consequences of achieving this target in 2100 for the impacts that are avoided, using several indicators of impact (exposure to drought, river flooding, heat waves and demands for heating and cooling energy). The proportion of impacts that are avoided is not simply equal to the proportional reduction in temperature. At the global scale, the median proportion of projected impacts avoided by the 1.5 °C target relative to a rise of 4 °C ranges between 62 and 95% across sectors: the greatest reduction is for heat wave impacts. The 1.5 °C target results in impacts that would be between 27 and 62% lower than with the 2 °C target. For each indicator, there are differences in the proportions of impacts avoided between regions depending on exposure and the regional changes in climate (particularly precipitation). Uncertainty in the proportion of impacts that are avoided for a specific sector depends on the range in the shape of the relationship between global temperature change and impact, and this varies between sectors