Broadband Architectures, ISP Business Plans, and Open Access

Something suspiciously resembling a double standard exists in US regulation of broadband access carriers. Incumbent local exchange carriers?ILECs?are required to open their networks to competing service providers, while cable television companies are not. Where did Congress and the FCC get it right? In the telco case, where open access is required, and there is a nascent competitive market for telephony and DSL services, or in the case of cable data networks, where consumers usually have no choice but to buy their service from the cable company's affiliated ISP? Or is disparity the best policy

A Taxonomy of Communications Demand

Demand forecasts are an essential tool for planning capacity and formulating policy. Traffic estimates are becoming increasingly unreliable, however, as accelerating rates of use and new communications applications invalidate conventional forecasting assumptions. This paper presents an alternative approach to the study of telecommunications demand: build aggregate estimates for demand based on the elasticity of demand for bandwidth. We argue that price elasticity models are necessary to grasp the interaction between Moore-type technological progress and non-linear demand functions. Traditional marketing models are premised on existing or, at best, foreseeable services. But in a period of sustained price declines, applications-based forecasts will be unreliable. Dramatically lower prices can cause fundamental changes in the mix of applications and, hence, the nature of demand. We consider the option of posing demand theoretically in terms of service attributes. Our conclusion is that the positive feedback loop of technology-driven price decreases and high-elasticity demand will quickly make it possible to base forecasts on bandwidth elasticity alone. Industry analysts and policymakers need models of consumer demand applicable under dynamic conditions. We conclude by drawing implications of our demand model for network planning, universal service policies, and the commoditization of communications carriage

Human-rainforest interactions in Island Southeast Asia: Holocene vegetation history in Sarawak (Malaysian Borneo) and Palawan (western Philippines)

428 pages; 128 figures; 24 tables; 4 appendicesThis research employs a modern analogue approach to examine relationships between pollen, vegetation change, and land use in the tropical environments of Island Southeast Asia over the past ~5000 years. Interpretation of fossil pollen data relies upon uniformitarian principles. Few modern pollen- vegetation studies from the region exist, and those that do have focused on climatic or ecological aims. Main contributions of this study are: the collection and analysis of modern botanical data and pollen assemblages from various human-modified and ‘natural’ vegetation types; and the comparison of this modern dataset with fossil pollen sequences in order to test hypotheses relating to signatures of past land use. Some fossil assemblages showed statistical similarity with those from modern ‘cultured’ landscapes, whilst others aligned more closely with those from natural vegetation. Cores from the northern Kelabit Highlands of Sarawak, Malaysian Borneo, contain assemblages from 1700 cal BP onwards that are similar to those produced by modern arboriculture; a core from the southern Highlands contains fossil assemblages as old as 2000 cal BP that align with those from modern wet rice paddies. These ages coincide with the earliest archaeological dates from nearby sites. Earlier vegetation changes appear to relate to edaphic development and climatic fluctuations. In northern Palawan, western Philippines, the first fossil pollen sequence from the island records post-5000 cal BP marine regression, hydrological fluctuations that are likely related to ENSO cyclicities, and persistence of open landscapes with minor evidence of closed forest after 2750 cal BP. This contrasts with existing proxy data that imply increasingly closed forest through the Holocene. In a region where direct archaeobotanical evidence is sparse, and little modern pollen- vegetation work has been done, this research contributes to clarifying modes and timings of changes in subsistence-related disturbance, as well as bolstering recent interpretations from other palaeoclimatic proxies for ENSO intensification from ~4000 cal BP. These results, and those from similar future studies, can provide baseline data for long-term monitoring and conservation initiatives.Evans Fellowship; Smuts Memorial Fund; Homerton College Postgraduate Research fund

Quality of service monitoring: Performance metrics across proprietary content domains

We propose a quality of service (QoS) monitoring program for broadband access to measure the impact of proprietary network spaces. Our paper surveys other QoS policy initiatives, including those in the airline, and wireless and wireline telephone industries, to situate broadband in the context of other markets undergoing regulatory devolution. We illustrate how network architecture can create impediments to open communications, and how QoS monitoring can detect such effects. We present data from a field test of QoS-monitoring software now in development. We suggest QoS metrics to gauge whether information "walled gardens" represent a real threat for dividing the Internet into proprietary spaces. To demonstrate our proposal, we are placing our software on the computers of a sample of broadband subscribers. The software periodically conducts a battery of tests that assess the quality of connections from the subscriber's computer to various content sites. Any systematic differences in connection quality between affiliated and non-affiliated content sites would warrant research into the behavioral implications of those differences. QoS monitoring is timely because the potential for the Internet to break into a loose network of proprietary content domains appears stronger than ever. Recent court rulings and policy statements suggest a growing trend towards relaxed scrutiny of mergers and the easing or elimination of content ownership rules. This policy environment could lead to a market with a small number of large, vertically integrated network operators, each pushing its proprietary content on subscribers.Comment: 29th TPRC Conference, 200

The Availability of Prior ECGs Improves Paramedic Accuracy in Recognizing ST-Segment Elevation Myocardial Infarction

Introduction Early and accurate identification of ST-elevation myocardial infarction (STEMI) by prehospital providers has been shown to significantly improve door to balloon times and improve patient outcomes. Previous studies have shown that paramedic accuracy in reading 12 lead ECGs can range from 86% to 94%. However, recent studies have demonstrated that accuracy diminishes for the more uncommon STEMI presentations (e.g. lateral). Unlike hospital physicians, paramedics rarely have the ability to review previous ECGs for comparison. Whether or not a prior ECG can improve paramedic accuracy is not known. Study hypothesis The availability of prior ECGs improves paramedic accuracy in ECG interpretation. Methods 130 paramedics were given a single clinical scenario. Then they were randomly assigned 12 computerized prehospital ECGs, 6 with and 6 without an accompanying prior ECG. All ECGs were obtained from a local STEMI registry. For each ECG paramedics were asked to determine whether or not there was a STEMI and to rate their confidence in their interpretation. To determine if the old ECGs improved accuracy we used a mixed effects logistic regression model to calculate p-values between the control and intervention. Results The addition of a previous ECG improved the accuracy of identifying STEMIs from 75.5% to 80.5% (p = 0.015). A previous ECG also increased paramedic confidence in their interpretation (p = 0.011). Conclusions The availability of previous ECGs improves paramedic accuracy and enhances their confidence in interpreting STEMIs. Further studies are needed to evaluate this impact in a clinical setting

Re-circumscription of the mimosoid genus Entada including new combinations for all species of the phylogenetically nested Elephantorrhiza (Leguminosae, Caesalpinioideae, mimosoid clade)

Recent phylogenomic analyses of 997 nuclear genes support the long-held view that the genus Entada is congeneric with Elephantorrhiza. Entada is resolved as monophyletic only if the genus Elephantorrhiza is subsumed within it. The two genera were distinguished solely by relatively minor differences in the mode of dehiscence of the fruits (a craspedium separating into one-seeded endocarp segments in Entada versus a craspedium with the whole fruit valve breaking away from the persistent replum in Elephantorrhiza) and the craspedial fruit type itself provides a shared synapomorphy for the re-circumscribed Entada. Here, we provide a synopsis of Entada, including 11 new combinations in total, for the eight species, one subspecies and one variety previously placed in Elephantorrhiza, as well as a new combination for a subspecies of Entada rheedei Spreng. not previously dealt with when Entada pursaetha DC. was placed in synonymy. These new combinations are: Entada burkei (Benth.) S.A. O’Donnell & G.P. Lewis, comb. nov.; Entada elephantina (Burch.) S.A. O’Donnell & G.P. Lewis, comb. nov.; Entada goetzei (Harms) S.A. O’Donnell and G.P. Lewis, comb. nov.; Entada goetzei subsp. lata (Brenan & Brummitt) S.A. O’Donnell & G.P. Lewis, comb. nov.; Entada obliqua (Burtt Davy) S.A. O’Donnell & G.P. Lewis, comb. nov.; Entada praetermissa (J.H. Ross) S.A. O’Donnell & G.P. Lewis, comb. nov.; Entada rangei (Harms) S.A. O’Donnell & G.P. Lewis, comb. nov.; Entada rheedei subsp. sinohimalensis (Grierson & D.G. Long) S.A. O’Donnell & G.P. Lewis, comb. nov.; Entada schinziana (Dinter) S.A. O’Donnell & G.P. Lewis, comb. nov.; Entada woodii (E. Phillips) S.A. O’Donnell & G.P. Lewis, comb. nov.; and Entada woodii var. pubescens (E. Phillips) S.A. O’Donnell & G.P. Lewis, comb. nov. We provide a revised circumscription of the genus Entada which now comprises 40 species distributed pantropically, with the greatest diversity of species in tropical Africa. We present a complete taxonomic synopsis, including a map showing the global distribution of the genus and photographs showing variation amongst species in habit, foliage, flowers and fruits. A short discussion about extrafloral nectaries, mainly observed in the Madagascan species, is presented

Mid-Holocene coastline reconstruction from geomorphological sea level indicators in the Tràng An World Heritage Site, Northern Vietnam

In this paper we present a high resolution palaeo coastline model for the isolated limestone massif of Tràng An, Ninh Bình province, Vietnam. The archaeological and palaeoecological record here comprise rich archives of human activity set within a landscape that was cyclically transformed between inland and archipelagic states under the influence of past sea level changes. These records have become informative proxies in the study of current sea level rise. Well-preserved notches along the vertical limestone cliffs within the study property reveal several phases of prolonged stable sea levels that likely pertain to the Mid-Holocene marine transgression 8 ka BP to 4 ka BP and allow for detailed coastline reconstructions for parts of the Red River Delta (RRD). The resulting coastline model facilitates a closer look at past human responses to landscape and environmental changes at local and individual site-level, which improves our understanding of past human adaptations to climate-change induced sea level rise. These data also stand to inform current coastal vulnerability assessments and climate change response models

Out-of-hospital cardiac arrest volumes and characteristics during the COVID-19 pandemic

This article is made available for unrestricted research re-use and secondary analysis in any form or by any means with acknowledgement of the original source. These permissions are granted for the duration of the World Health Organization (WHO) declaration of COVID-19 as a global pandemic.Aim The COVID-19 pandemic has significantly impacted Emergency Medical Services (EMS) operations throughout the country. Some studies described variation in total volume of out-of-hospital cardiac arrests (OHCA) during the pandemic. We aimed to describe the changes in volume and characteristics of OHCA patients and resuscitations in one urban EMS system. Methods We performed a retrospective cohort analysis of all recorded atraumatic OHCA in Marion County, Indiana, from January 1, 2019 to June 30, 2019 and from January 1, 2020 to June 30, 2020. We described patient, arrest, EMS response, and survival characteristics. We performed paired and unpaired t-tests to evaluate the changes in those characteristics during COVID-19 as compared to the prior year. Data were matched by month to control for seasonal variation. Results The total number of arrests increased from 884 in 2019 to 1034 in 2020 (p = 0.016). Comparing 2019 to 2020, there was little difference in age [median 62 (IQR 59–73) and 60 (IQR 47–72), p = 0.086], gender (38.5% and 39.8% female, p = 0.7466, witness to arrest (44.3% and 39.6%, p = 0.092), bystander AED use (10.1% and 11.4% p = 0.379), bystander CPR (48.7% and 51.4%, p = 0.242). Patients with a shockable initial rhythm (19.2% and 15.4%, p = 0.044) both decreased in 2020, and response time increased by 18 s [6.0 min (IQR 4.5–7.7) and 6.3 min (IQR 4.7–8.0), p = 0.008]. 47.7% and 54.8% (p = 0.001) of OHCA patients died in the field, 19.7% and 19.3% (p = 0.809) died in the Emergency Department, 21.8% and 18.5% (p = 0.044) died in the hospital, 10.8% and 7.4% (p = 0.012) were discharged from the hospital, and 9.3% and 5.9% (p = 0.005) were discharged with Cerebral Performance Category score ≤ 2. Conclusion Total OHCA increased during the COVID-19 pandemic when compared with the prior year. Although patient characteristics were similar, initial shockable rhythm, and proportion of patients who died in the hospital decreased during the pandemic. Further investigation will explore etiologies of those findings

Prehistoric pathways to Anthropocene adaptation: Evidence from the Red River Delta, Vietnam

Over the past twenty years, government advisory bodies have placed increasing emphasis on the need for adaptive measures in response to the effects of human-induced climate change. Integrated Assessment Models (IAMs), which incorporate macroeconomic and climate variables, feature prominently in advisory content, though they rarely draw on data from outside strictly constrained hypothetical systems. This has led to assertions that they are not well-suited to approximate complex systemic human-environment processes. Modular, interdisciplinary approaches have offered a way to address this shortcoming; however, beyond climate records, prehistoric data continue to be under-utilised in developing such models. In this paper we highlight the contribution that archaeology and palaeoecology can make to the development of the next generation IAMs that are expected to enhance provision for more local and pro-active adaptations to future climate change. We present data from one of Southeast Asia’s most heavily developed river deltas: the Red River (Song Hong) Delta, in Vietnam and localised analysis from the Tràng An Landscape Complex World Heritage Site, on the delta’s southern margin. Comparison is made between Shared Socio-economic Pathways (SSP) 5–8.5 and SSP2–4.5 emission projection models and the Mid-Holocene inundation of the Red River Basin. We highlight the value to taking a scientific long view of coastal evolution through an illustrative set of eight research foci where palaeo-data can bring new and localised empirical data to bear on future risk management planning. We proceed to demonstrate the applicability of palaeoenvironmental, zooarchaeological and historical evidence to management and the development of sustainable conservation strategies using Tràng An as a case study. In so doing, we further highlight the importance of knowledge exchange between scientific, corporate, non-governmental, local, and state stakeholders to achieve tangible results on the ground

Psychological distress is related to poor health behaviours in COPD and non-COPD patients: Evidence from the CanCOLD study

Background Patients with psychiatric disorders (depression, anxiety) are more likely to have poor health behaviours, including higher smoking and lower physical activity (PA) levels. Smoking is a major risk factor for Chronic Obstructive Pulmonary Disease (COPD), and PA is critical for COPD management. However, no studies have assessed associations between psychological distress and these behaviours among patients with vs without COPD. This is a sub-analysis of the CanCOLD study that assessed the relationships between psychological disorders (depression, anxiety) and poor health behaviours (smoking, PA). Methods 717 COPD and 797 matched non-COPD individuals from the CanCOLD study, completed the Hospital Anxiety Depression Scale (HADS) to assess anxiety and depression. Smoking behaviour was self-reported pack-years smoking. The CHAMPS PA questionnaire determined calorific expenditure as a PA measure. Regressions determined relationships between anxiety/depression and health behaviours, adjusting for age, sex, BMI, GOLD stage and COPD status. Results Across the whole sample, we observed relationships between depression (β = 1.107 ± 0.197; 95%CI = 0.691–1.462; p < .001) and anxiety (β = 0.780 ± 0.170; 95%CI = 0.446–1.114; p < .001) and pack years. Higher depression (β = −0.220 ± 0.028; 95%CI = −0.275 to −0.165; p < .001) and anxiety (β = −0.091 ± 0.025; 95%CI = −0.139 to −0.043; p < .001) scores were related to lower PA. These associations were comparable across COPD and non-COPD patients. Conclusions Results showed that higher levels of anxiety and depression were related to higher cumulative smoking and lower levels of PA in patients with and without COPD, suggesting symptoms of psychological distress is similarly associated with poorer health behaviours in COPD and non-COPD individuals. Future studies need to determine if treating symptoms of psychological distress can improve health behaviours and outcomes in this population