Pluralism in Regional Health Planning: An Analysis of Public Engagement in Ontario’s Local Health Integration Networks

This study identifies and explains variation in the choices of public engagement methods across Ontario’s Local Health Integration Networks, in order to inform the policy space these organizations operate in with respect to enabling citizen participation in regional health planning decisions. The websites of all 14 Local Health Integration Networks (LHINs) were searched for three key documents that detail their past and future public engagement method choices. Drawing from the literature, a multi-metric qualitative scoring framework was designed to explore patterns of variation in public engagement method choices across each region. The findings demonstrate that there is minimal variation in the choices of public engagement methods across Local Health Integration Networks, but suggest that variation in regional characteristics provide different justification for the same methods being chosen across multiple jurisdictions. The study concludes by outlining opportunities for public engagement practitioners in Ontario and other jurisdictions to improve the rigour of the proposed framework and potential use as a predictive tool of public engagement method choice dependent on variation in regional characteristics

Virtual-Acoustic Instrument Design: Exploring the Parameter Space of a String-Plate Model

Exploration is an intrinsic element of designing and engaging with acoustic as well as digital musical instruments. This paper reports on the ongoing development of a virtual-acoustic instrument based on a physical model of a string coupled nonlinearly to a plate. The performer drives the model by tactile interaction with a string-board controller fitted with piezo-electric sensors. The string-plate model is formulated in a way that prioritises its parametric explorability. Where the roles of creating performance gestures and designing instruments are traditionally separated, such a design provides a continuum across these domains. The string-plate model, its real-time implementation, and the control interface are described, and the system is preliminarily evaluated through informal observations of how musicians engage with the system

Co-tuning virtual-acoustic performance ecosystems: observations on the development of skill and style in the study of musician-instrument relationships

In this paper we report preliminary observations from an ongoing study into how musicians explore and adapt to the parameter space of a virtual-acoustic string bridge plate instrument. These observations inform (and are informed by) a wider approach to understanding the development of skill and style in interactions between musicians and musical instruments. We discuss a performance-driven ecosystemic approach to studying musical relationships, drawing on arguments from the literature which emphasise the need to go beyond simplistic notions of control and usability when assessing exploratory and performatory musical interactions. Lastly, we focus on processes of perceptual learning and co-tuning between musician and instrument, and how these activities may contribute to the emergence of personal style as a hallmark of skilful music-making

Predicting Unethical Physician Behavior At Scale: A Distributed Computing Framework

As the amount of publicly shared data increases, developing a robust pipeline to stream, store and process data is critical, as the casual user often lacks the technology, hardware and/or skills needed to work with such voluminous data. In this research, the authors employ Amazon EC2 and EMR, MongoDB, and Spark MLlib to explore 28.5 gigabytes of CMS Open Payments data in an attempt to identify physicians who may have a high propensity to act unethically, owing to significant transfers of wealth from medical companies. A Random Forest Classifier is employed to predict the top decile of physicians who have the highest risk of unethical behavior in the following year, resulting in an F-Score of 91%. The data is also analyzed by an anomaly detection algorithm that correctly identified a highprofile case of a physician leaving his prestigious position, as he failed to disclose anomalously-large transfers of wealth from medical companies

Thinning of the Motor-Cingulate-Insular Cortices in Siblings Concordant for Tourette Syndrome

Fraternal twin studies on normal subjects have demonstrated low heritability (intra-class correlation coefficient) estimates for frontal brain regions (r=0.43). Here we aimed to investigate the relatedness/similarity estimates of the frontal brain regions in fraternal subjects concordant for Tourette syndrome (TS). We sought to identify regional brain similarities between siblings concordant for TS as an exploratory step towards the identification of potential brain structures involved in the TS phenotype. The identified brain structures may then serve in subsequent molecular genetic and linkage studies. In addition, we regressed cortical thickness and TS clinical severity scores to assess the relation between TS clinical symptoms and cortical structures. Sixteen sibling pairs concordant for TS were scanned using a 1.5T magnetic resonance imaging scanner (age range 10-25, mean 17.19±4.1). Brain morphology was assessed using the fully automated Civet pipeline at the Montreal Neurological Institute. TS was assessed using the Children's Yale-Brown Obsessive Compulsive Scale (CY-BOCS), Yale Global Tic Severity Scale (YGTSS) and the Goetz Tic Scale. We report high relatedness/similarity estimates for fraternal siblings concordant for TS (r=0.86-0.60) in the middle frontal-motor/cingulate/insular cortices. Regression analysis revealed significant negative correlations in the right insula with the YGTSS (r=−0.41, F=6.09, P<0.02) and the left cingulated cortex with the (CY-BOCS) (r=−0.35, F=4.30, P<0.05). Since previous findings have concluded that normal fraternal siblings are less alike in frontal cortices, the present findings may be attributed to TS. We speculate that the high ICC between siblings and the negative correlation between TS symptoms severity and cortical thickness measurements are related to the disturbances in the maturation of the motor-cingulate-insular cortical neural system that mediate self-regulatory processes. Such delayed maturation may consequently contribute to the development of TS by releasing motor and vocal tics from regulatory control. These findings may have important genetic implication

Mesospheric vertical thermal structure and winds on Venus from HHSMT CO spectral-line observations

We report vertical thermal structure and wind velocities in the Venusian mesosphere retrieved from carbon monoxide (12CO J=2-1 and 13CO J=2-1) spectral line observations obtained with the Heinrich Hertz Submillimeter Telescope (HHSMT). We observed the mesosphere of Venus from two days after the second Messenger flyby of Venus (on June 5 2007 at 23:10 UTC) during five days. Day-to-day and day-to-night temperature variations and short-term fluctuations of the mesospheric zonal flow were evident in our data. The extensive layer of warm air detected recently by SPICAV at 90 - to 100 km altitude is also detected in the temperature profiles reported here. These data were part of a coordinated ground-based Venus observational campaign in support of the ESA Venus Express mission. Furthermore, this study attempts to cross-calibrate space- and ground-based observations, to constrain radiative transfer and retrieval algorithms for planetary atmospheres, and to contribute to a more thorough understanding of the global patterns of circulation of the Venusian atmosphere.Comment: 35 pages, 18 figures. Shortcut URL to this page: http://www.sciencedirect.com/science/journal/0032063

Demonstration of safety of intravenous immunoglobulin in geriatric patients in a long-term, placebo-controlled study of Alzheimer's disease.

INTRODUCTION:We present safety results from a study of Gammagard Liquid intravenous immunoglobulin (IGIV) in patients with probable Alzheimer's disease. METHODS:This was a placebo-controlled double-blind study. Subjects were randomized to 400 mg/kg (n = 127), 200 mg/kg (n = 135) IGIV, or to 0.25% human albumin (n = 121) administered every 2 weeks ± 7 days for 18 months. RESULTS:Elevated risk ratios of IGIV versus placebo included chills (3.85) in 9.5% of IGIV-treated subjects (all doses), compared to 2.5% of placebo-treated subjects, and rash (3.08) in 15.3% of IGIV-treated subjects versus 5.0% of subjects treated with placebo. Subjects in the highest IGIV dose group had the lowest proportion of SAEs considered related to product (2 of 127 [1.6%]). Subjects treated with IGIV experienced a lower rate of respiratory and all other infections compared to placebo. DISCUSSION:IGIV-treated subjects did not experience higher rates of renal failure, lung injury, or thrombotic events than the placebo group. There were no unexpected safety findings. IGIV was well tolerated throughout 18 months of treatment in subjects aged 50-89 years

Poisoning of Heat Pipes

Thermal management is critical to space exploration efforts. In particular, efficient transfer and control of heat flow is essential when operating high energy sources such as nuclear reactors. Thermal energy must be transferred to various energy conversion devices, and to radiators for safe and efficient rejection of excess thermal energy. Applications for space power demand exceptionally long periods of time with equipment that is accessible for limited maintenance only. Equally critical is the hostile and alien environment which includes high radiation from the reactor and from space (galactic) radiation. In space or lunar applications high vacuum is an issue, while in Martian operations the systems will encounter a CO2 atmosphere. The effect of contact at high temperature with local soil (regolith) in surface operations on the moon or other terrestrial bodies (Mars, asteroids) must be considered

Human Engineering of Space Vehicle Displays and Controls

Proper attention to the integration of the human needs in the vehicle displays and controls design process creates a safe and productive environment for crew. Although this integration is critical for all phases of flight, for crew interfaces that are used during dynamic phases (e.g., ascent and entry), the integration is particularly important because of demanding environmental conditions. This panel addresses the process of how human engineering involvement ensures that human-system integration occurs early in the design and development process and continues throughout the lifecycle of a vehicle. This process includes the development of requirements and quantitative metrics to measure design success, research on fundamental design questions, human-in-the-loop evaluations, and iterative design. Processes and results from research on displays and controls; the creation and validation of usability, workload, and consistency metrics; and the design and evaluation of crew interfaces for NASA's Crew Exploration Vehicle are used as case studies

Down-regulation of cell surface CXCR4 by HIV-1

<p>Abstract</p> <p>Background</p> <p>CXC chemokine receptor 4 (CXCR4), a member of the G-protein-coupled chemokine receptor family, can serve as a co-receptor along with CD4 for entry into the cell of T-cell tropic X4 human immunodeficiency virus type 1 (HIV-1) strains. Productive infection of T-lymphoblastoid cells by X4 HIV-1 markedly reduces cell-surface expression of CD4, but whether or not the co-receptor CXCR4 is down-regulated has not been conclusively determined.</p> <p>Results</p> <p>Infection of human T-lymphoblastoid cell line RH9 with HIV-1 resulted in down-regulation of cell surface CXCR4 expression. Down-regulation of surface CXCR4 correlated temporally with the increase in HIV-1 protein expression. CXCR4 was concentrated in intracellular compartments in H9 cells after HIV-1 infection. Immunofluorescence microscopy studies showed that CXCR4 and HIV-1 glycoproteins were co-localized in HIV infected cells. Inducible expression of HIV-1 envelope glycoproteins also resulted in down-regulation of CXCR4 from the cell surface.</p> <p>Conclusion</p> <p>These results indicated that cell surface CXCR4 was reduced in HIV-1 infected cells, whereas expression of another membrane antigen, CD3, was unaffected. CXCR4 down-regulation may be due to intracellular sequestering of HIV glycoprotein/CXCR4 complexes.</p