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Objective To characterize the association between prolonged supine postoperative positioning of patients undergoing Descemet-stripping automated endothelial keratoplasty (DSAEK) and graft dislocation rate. Methods In this retrospective cohort study, medical records of patients who underwent uncomplicated DSAEK surgery at Yitzhak Shamir Medical Center between 2010 and 2019 were reviewed. Nursing documentation of patients’ adherence to supine positioning during the postoperative hospitalization period was collected. A patient was considered compliant if he or she was documented as cooperative with supine positioning throughout the first 24 hours. Results A total of 170 eyes of 138 patients were found eligible. Main indications for surgery were pseudophakic bullous keratopathy (50.6%), previous graft failure (25.9%), and Fuch's endothelial dystrophy (FED; 20.6%). Twelve surgeries were combined with cataract extraction. Postoperative graft detachment occurred in 26 eyes (15.3%) after an average period of 1 day (range, 0–20 days). Compliance with supine positioning was documented in 84.1% (n = 143 patients). Noncompliance rates during the first 24 hours in the detached and nondetached groups were 26.9% (n = 7) and 14.4% (n = 20), respectively; after adjustment for possible confounders, the odds ratio (OR) was 1.44 (p = 0.249). Graft dislocation was observed in 13.3% (19 of 143) and 25.9% (7 of 27) of cooperative and noncooperative patients, respectively (p = 0.17). Subanalysis of 120 eyes with either BPK or FED for which it was the first transplantation demonstrated a protective effect of supine positioning (OR 3.42, confidence interval 1.095–10.700; p = 0.034). Findings for both groups remained unchanged in multivariate analysis. Conclusions We found a statistically significant protective effect of 24 hours of postoperative supine positioning against graft detachment after DSAEK in eyes with no prior transplantations.

Lupus erythematosus (LE) is an autoimmune disorder commonly affecting the skin; cutaneous lesions may indicate systemic involvement, warranting further evaluation. Photosensitivity, which may result in hyperpigmentation, is a well-known feature of the disease. In contrast, the prevalence of primary hyperpigmentation as a presenting sign of LE is not well established. Here, we compare 3 unique cases of diffuse facial hyperpigmentation as the primary manifestation of LE (cutaneous or systemic) and review previously reported cases. Our data highlight the need for considering LE in the differential diagnosis of facial hyperpigmentation and substantiate the importance of this unique lupus variant in early diagnosis and patient evaluation.

Autosomal recessive congenital ichthyosis (ARCI) manifests with generalized scaling often associated with generalized erythema. Mutations in at least 13 different genes have been reported to cause ARCI. Acral peeling skin syndrome (APSS) is a rare autosomal recessive disorder manifesting with peeling over the distal limbs and dorsal surfaces of hands and feet. APSS is mostly due to mutations in TGM5, encoding transglutaminase 5. Both ARCI and APSS are fully penetrant genetic traits. Here, we describe a consanguineous family in which one patient with mild ARCI was found to carry a homozygous mutation in ALOXE3 (c.1238G > A; p.Gly413Asp). The patient was also found to carry a known pathogenic homozygous mutation in TGM5 (c.1335G > C; p.Lys445Asn) but did not display acral peeling skin. Her uncle carried the same homozygous mutation in TGM5 but carried the ALOXE3 mutation in a heterozygous state and showed clinical features typical of APSS. Taken collectively, these observations suggested that the ALOXE3 mutation suppresses the clinical expression of the TGM5 variant. We hypothesized that ALOXE3 deficiency may affect the expression of a protein capable of compensating for the lack of TGM5 expression. Downregulation of ALOXE3 in primary human keratinocytes resulted in increased levels of corneodesmosin, which plays a critical role in the maintenance of cell-cell adhesion in the upper epidermal layers. Accordingly, ectopic corneodesmosin expression rescued the cell-cell adhesion defect caused by TGM5 deficiency in keratinocytes as ascertained by the dispase dissociation assay. The present data thus provide evidence for phenotypic suppression in a human hereditary skin disorder.

Purpose Immigration studies can shed light on myopia development and reveal high-risk populations. To this end, we investigated the association among immigration, age at immigration, and myopia occurrence during adolescence. Design Population-based, retrospective, cross-sectional study. Participants Six hundred seven thousand eight hundred sixty-two adolescents, Israeli born and immigrants, with origins in the former Union of Soviet Socialist Republics (USSR), Ethiopia, or Israel, assessed for medical fitness for mandatory military service at 17 years of age between 1993 and 2016. Methods Myopia and high myopia were defined based on right eye refractive data. Age at immigration was categorized into 0 to 5 years of age, 6 to 11 years of age, and 12 to 19 years of age. Univariate and multivariate logistic regression models were created. Myopia odds ratios (ORs) were calculated according to immigration status, with Israeli-born natives as controls. Next, myopia ORs were calculated according to age at immigration, with Israeli-born of same origin as controls. Main Outcome Measures Myopia prevalence and ORs. Results Myopia was less prevalent among immigrants than Israeli-born controls. When stratified according to age at immigration, a decrease in myopia prevalence and ORs with increasing age at migration were observed, most prominent in immigrants arriving after 11 years of age, who also showed lower high-myopia ORs. The immigrants from the USSR and Ethiopia arriving after 11 years of age showed a myopia OR of 0.65 (95% confidence interval [CI], 0.63–0.67; P Conclusions Immigrants arriving after 11 years of age showed markedly lower ORs for myopia and high myopia relative to Israeli-born controls or those arriving during early childhood, likely because of environmental and lifestyle changes. Differences between immigrants arriving up to 5 years of age and those arriving between 6 and 11 years of age were relatively smaller, suggesting exposures at elementary school age play a greater role in this population.

Context A correlation between myopia and insulin resistance has been suggested. Objective We investigated the association between myopia in adolescence and type 2 diabetes (T2D) incidence in young adulthood. Methods This population-based, retrospective, cohort study comprised 1 329 705 adolescents (579 543 women, 43.6%) aged 16 to 19 years, who were medically examined before mandatory military service during 1993 to 2012, and whose data were linked to the Israel National Diabetes Registry. Myopia was defined based on right-eye refractive data. Cox proportional models were applied, separately for women and men, to estimate hazard ratios (HRs) for T2D incidence per person-years of follow-up. Results There was an interaction between myopia and sex with T2D (P Conclusion For women, myopia in adolescence was associated with a significantly increased risk for incident T2D in young adulthood, in a severity-dependent manner. This finding may support the role of insulin resistance in myopia pathogenesis.

OBJECTIVES: To compare the visual outcome of patients treated for non-arthritic central retinal artery occlusion (CRAO) in a medical centre that uses hyperbaric oxygen therapy (HBOT) as part of the standard of care (SOC) to medical centres that does not. METHODS: The study included data from two tertiary medical centres. The medical records of all patients diagnosed with non-arthritic CRAO without a patent cilioretinal artery between January 2010 and December 2018 in two tertiary medical centres were reviewed. RESULTS: One hundred and twenty-one patients were treated by HBOT and 23 patients received only SOC. In the HBOT group, best-corrected visual acuity (BCVA) improved from 2.89 ± 0.98 logMAR at presentation to 2.15 ± 1.07 logMAR upon the end of HBOT (P < 0.001), while the SOC group had no significant improvement, from 3.04 ± 0.82 logMAR at presentation to 2.80 ± 1.50 logMAR (P = 0.24). With adjustment for age, gender, and the duration of symptoms, final BCVA in the HBOT group was significantly better compared to the control group (P = 0.023). Rates of patients achieving vision of 20/200 or better were similar between groups (17.4% vs. 19.8%, P = 0.523). CONCLUSION: Utilizing HBOT as part of the SOC for CRAO improves the final visual outcome. HBOT is safe and can be implemented, if available, as part of SOC in all tertiary medical centres.

Contextual language models have led to significantly better results, especially when pre-trained on the same data as the downstream task. While this additional pre-training usually improves performance, it can lead to information leakage and therefore risks the privacy of individuals mentioned in the training data. One method to guarantee the privacy of such individuals is to train a differentially-private language model, but this usually comes at the expense of model performance. Also, in the absence of a differentially private vocabulary training, it is not possible to modify the vocabulary to fit the new data, which might further degrade results. In this work we bridge these gaps, and provide guidance to future researchers and practitioners on how to improve privacy while maintaining good model performance. We introduce a novel differentially private word-piece algorithm, which allows training a tailored domain-specific vocabulary while maintaining privacy. We then experiment with entity extraction tasks from clinical notes, and demonstrate how to train a differentially private pre-trained language model (i.e., BERT) with a privacy guarantee of 𝜖=1.1 and with only a small degradation in performance. Finally, as it is hard to tell given a privacy parameter 𝜖 what was the effect on the trained representation, we present experiments showing that the trained model does not memorize private information.

Isolated ocular muscle hematoma due to blunt trauma is very rare. In this study, a 15-year-old patient presented with an isolated superior rectus hematoma due to an orbital hit from a cellular phone. He was treated with oral corticosteroids alone. Marked improvement in symptoms and eye movements was observed.

Immigration studies can shed light on diabetes pathogenesis and risk factors. To this end, we investigated the association between age at immigration and diabetes occurrence at adolescence among immigrants to Israel. We analysed cross-sectional data on 2,721,767 Jewish adolescents assessed for mandatory military service at approximately 17 years of age between 1967 and 2014. The study population comprised 430,176 immigrants with origins in Ethiopia, former USSR, Middle East and North Africa (ME/NA) and western countries. ORs for diabetes were calculated for men and women, grouped according to age at immigration, with Israel-born participants as controls. Unadjusted and fully adjusted models were made to account for possible confounders. Additionally, the study population was stratified by origin and each immigrant group was referenced to Israel-born participants of the same origin. There was a graded decrease in OR for diabetes across the study groups in the fully adjusted model. Immigrants arriving at age 0–5 years had comparable OR for diabetes to the Israeli-born reference group; those arriving at age 6–11 years had an OR of 0.82 (95% CI 0.70, 0.97; p = 0.017) and recent immigrants, arriving at age 12–19 years, had the lowest OR of 0.65 (95% CI 0.54, 0.77; p

Epidermolytic ichthyosis (EI) is a rare disorder of cornification caused by mutations in KRT1 and KRT10, encoding two suprabasal epidermal keratins. Because of the variable clinical features and severity of the disease, histopathology is often required to correctly direct the molecular analysis. EI is characterized by hyperkeratosis and vacuolar degeneration of the upper epidermis, also known as epidermolytic hyperkeratosis, hence the name of the disease. In the current report, the authors describe members of 2 families presenting with clinical features consistent with EI. The patients were shown to carry classical mutations in KRT1 or KRT10, but did not display epidermolytic changes on histology. These observations underscore the need to remain aware of the limitations of pathological features when considering a diagnosis of EI.

OBJECTIVES Immigration studies can shed light on hypertension development and reveal high-risk populations. To this end, we investigated the association between age at immigration and hypertension occurrence at adolescence among immigrants to Israel. METHODS We analyzed cross-sectional data on 2 681 294 adolescents assessed for mandatory military service at approximately 17 years of age between 1967 and 2016. The study population constituted of 410 488 immigrants with origins in Ethiopia, Middle East and North Africa, Former USSR and Western Countries. Age at immigration was categorized into 0-5, 6-11 and 12-19 years. Odds ratios (ORs) for hypertension were calculated according to age at immigration with Israel-born participants as controls. Models were made to account for possible confounders. Additionally, the study population was stratified by country of origin and each immigrant group referenced to Israel-born participants of the same origin. RESULTS In the fully-adjusted model, immigrants arriving until age 11 years had comparable ORs for hypertension to the Israeli-born reference group, whereas recent immigrants, arriving at age 12-19 years had a marked lower OR of 0.30 (95% CI 0.27-0.33; P

International audience; Background: Central centrifugal cicatricial alopecia (CCCA) is the most common form of scarring alopecia among women of African ancestry. The disease is occasionally observed to affect women in families in a manner that suggests an autosomal dominant trait and usually manifests clinically after intense hair grooming. We sought to determine whether there exists a genetic basis of CCCA and, if so, what it is. Methods: We used exome sequencing in a group of women with alopecia (discovery set), compared the results with those in a public repository, and applied other filtering criteria to identify candidate genes. We then performed direct sequencing to identify disease-associated DNA variations and RNA sequencing, protein modeling, immunofluorescence staining, immunoblotting, and an enzymatic assay to evaluate the consequences of potential etiologic mutations. We used a replication set that consisted of women with CCCA to confirm the data obtained with the discovery set. Results: In the discovery set, which included 16 patients, we identified one splice site and three heterozygous missense mutations in PADI3 in 5 patients (31%). (The approximate prevalence of the disease is up to 5.6%.) PADI3 encodes peptidyl arginine deiminase, type III (PADI3), an enzyme that post-translationally modifies other proteins that are essential to hair-shaft formation. All three CCCA-associated missense mutations in PADI3 affect highly conserved residues and are predicted to be pathogenic; protein modeling suggests that they result in protein misfolding. These mutations were found to result in reduced PADI3 expression, abnormal intracellular localization of the protein, and decreased enzymatic activity - findings that support their pathogenicity. Immunofluorescence staining showed decreased expression of PADI3 in biopsy samples of scalp skin obtained from patients with CCCA. We then directly sequenced PADI3 in an additional 42 patients (replication set) and observed genetic variants in 9 of them. A post hoc analysis of the combined data sets showed that the prevalence of PADI3 mutation was higher among patients with CCCA than in a control cohort of women of African ancestry (P = 0.002 by the chi-square test; P = 0.006 by Fisher's exact test; and after adjustment for relatedness of persons, P = 0.03 and P = 0.04, respectively). Conclusions: Mutations in PADI3, which encodes a protein that is essential to proper hair-shaft formation, were associated with CCCA. (Funded by the Ram Family Foundation and others.).

Background Spiny hyperkeratosis refers to a rare clinical phenotype characterized by nonfollicular keratotic projections and sometimes associated with other acquired and inherited conditions. We describe a case of congenital patterned spiny hyperkeratosis. Methods To identify the cause of this disorder, we used a combination of whole exome sequencing, direct sequencing and TaqMan assay. Results We found that the peculiar clinical features displayed by the patient are due to somatic mosaicism for a heterozygous mutation in the GJB2 gene. Conclusion Because histopathologic examination of two independent biopsies did not reveal porokeratotic eccrine ostial and dermal duct nevus (PEODDN), previously reported to result from somatic mutations in GJB2, it appears that mutations in this gene can cause nevoid spiny hyperkeratosis in the context of PEODDN or as an isolated finding.

Objective: To describe the prenatal imaging features enabling diagnosis of developmental venous anomalies (DVA). Methods: Four fetuses with unexplained persistent echogenic parenchymal brain lesions were studied. The evaluation included dedicated neurosonography, fetal MRI, serology for intrauterine infection, screening for coagulation abnormalities, and chromosomal microarray. Postnatal neurodevelopmental follow-up or autopsy results were assessed. Results: DVA presented as very slowly growing echogenic brain lesions without cystic components, calcifications, or structural changes on otherwise normal neurosonographic scans performed at 2- to 3-week intervals. A specific Doppler feature was a collecting vein draining the echogenic parenchyma. Fetal brain MRI depicted normal anatomy on half-Fourier acquisition single-shot turbo spin-echo and diffusion-weighted imaging. The rest of the evaluation was normal. Conclusions: In cases with a persistent, parenchymal echogenic lesion without clastic or structural changes, DVA should be considered. Demonstration of a collecting vein draining the lesion and normal brain anatomy on MRI confirm the diagnosis.

Background Atopic dermatitis (AD) is a highly prevalent chronic inflammatory skin disease that is known to be, at least in part, genetically determined. Mutations in caspase recruitment domain-containing protein 14 (CARD14) have been shown to result in various forms of psoriasis and related disorders. Objective We aimed to identify rare DNA variants conferring a significant risk for AD through genetic and functional studies in a cohort of patients affected with severe AD. Methods Whole-exome and direct gene sequencing, immunohistochemistry, real-time PCR, ELISA, and functional assays in human keratinocytes were used. Results In a cohort of patients referred with severe AD, DNA sequencing revealed in 4 patients 2 rare heterozygous missense mutations in the gene encoding CARD14, a major regulator of nuclear factor κB (NF-κB). A dual luciferase reporter assay demonstrated that both mutations exert a dominant loss-of-function effect and result in decreased NF-κB signaling. Accordingly, immunohistochemistry staining showed decreased expression of CARD14 in patients' skin, as well as decreased levels of activated p65, a surrogate marker for NF-κB activity. CARD14-deficient or mutant-expressing keratinocytes displayed abnormal secretion of key mediators of innate immunity. Conclusions Although dominant gain-of-function mutations in CARD14 are associated with psoriasis and related diseases, loss-of-function mutations in the same gene are associated with a severe variant of AD.

We examine the adoption of an Open Government Data (OGD) transparency policy innovation in five developing countries: Brazil, Kenya, Moldova, Morocco, and the Philippines. We combine an innovative big data analysis of published OGD data with a qualitative study of key moments in the history of adopting the OGD innovation in the five countries of focus. We discover that in all five countries most OGD activity occurred on a handful of days, usually immediately before or after a standalone "OGD event" such as a visit by a key World Bank official, or a major policy announcement. In the final section of the paper, we pay close attention to Brazil, the only country where the OGD innovation appears to be sustainable thanks to strong domestic OGD demand and an existing, multi-layered, government-transparency legal framework that supports the OGD innovation.

This paper develops and tests a theoretical model, which proposes to examine cities’ commitment to the concept of open government data (OGD) according to three typical levels. Level 1, Way of Life, indicates high commitment to OGD; Level 2, On the Fence, represents either a low or erratic commitment; Level 3, Lip Service, refers to either scarce or no commitment. This study shows that these types exhibit distinct behavior in four key indicators: (1) Rhythm, (2) Coverage, (3) Categorization, and (4) Feedback. This theoretical framework is examined using longitudinal mixed-method analysis of the OGD behavior of 16 US cities over a period of four years, using a corpus of municipal quantitative metadata and primary qualitative data. This methodology allows us to represent, for the first time, cities’ evolving OGD commitment, or “OGD heartbeat”.

Government deals daily with massive volumes of data, and yet poor public-sector information sharing remains a critical government challenge that wastes public funds and put lives at risk. Peled’s book Traversing Digital Babel proposes an innovative solution to improve information sharing inside government by using selective incentives to nudge government officials to exchange data in an automated Public Sector Information Exchange (PSIE). Enabled by grants from Google and Yissum, Peled embarked on the first step to creating a testable PSIE prototype: building the world’s first fully-automated corpus of metadata about Open Government Data (OGD) released by local and national governmental agencies worldwide. The OGD corpus currently contains metadata about information assets from 24 different countries, and presents rich opportunities for research including examining and comparing government patterns of information release. The corpus could also enable an innovative model of combined free and for-payment government data release.

President Obama's inaugural flagship Open Data program emphasizes the values of transparency, participation, and collaboration in governmental work. The Open Data performance data analysis, published here for the first time, proposes that most federal agencies have adopted a passive–aggressive attitude toward this program by appearing to cooperate with the program while in fact effectively ignoring it. The analysis further suggests that a tiny group of agencies are the only “real players” in the web arena. This research highlights the contradiction between Open Data's transparency goal (“All data must be freed”) and federal agencies' goal of collaborating with each other through data trade. The research also suggests that agencies comprehended that Open Data is likely to exacerbate three critical, back-office data-integration problems: inclusion, confusion, and diffusion. The article concludes with a proposal to develop an alternative Federal Information Marketplace (FIM) to incentivize agencies to improve data sharing. © 2011 Wiley Periodicals, Inc.

Federal computer projects frequently fail because federal organizations are mandated to follow an erroneous Enterprise Architecture (EA) metaphor. The article promotes an alternative metaphor that highlights the principles of incremental evolution, learning, exploration and slow adaptation, experimentation, and minimal architecture. To advance this approach, the archaeological history of excavating the oldest man-made mountain ( Tel Gezer where 28 ancient civilizations are layered one on top of the other) is compared with the history of modernizing the latest man-made mountain (the Internal Revenue Service's main computer systems where numerous generations of computer programs are layered one on top of the other). Through this most unusual “comparative tale,” the article also exposes the human characteristics of successful federal information technology project leaders: humility, curiosity, and patience.

Since 2009 governments worldwide have been developing Open Government Data (OGD) programs. Our paper examines the ways in which public agencies in the two leading OGD countries, the US and the UK, have released information assets to promote public sector accountability. Theoretically and empirically, we discuss the vision and execution of the OGD policy in these countries since 2009 and demonstrate that the movement took a different path than the one chartered by the original policy makers. We then propose a new path for the OGD movement to better support the democratic ideal of improved accountability of public sector agencies. Keywords: (Open Data; Accountability; Open Government; Transparency; Disclosure) Copyright : Copyright is held by the authors. 1 Introduction The conceptual origins of the open government data (OGD) movement 1 and freedom of information (FOI) legislation are rooted in a desire to improve public accountability. However, the OGD movement blurred the original intent, combining the goal of accountability with concepts such as participation, collaboration, innovation and improvement of public service. The latter may have no significant impact or even contradict accountability (Peled, 2011; Yu & Robinson, 2012). We therefore ask: Do the designs of US and UK OGD policies demonstrate an understanding of how to harness the potential of OGD to improve public sector accountability? If not, what can be done to fulfill OGD’s promise to improve accountability? We propose that open government programs must be evaluated according to three dimensions: informational, explanatory and enforcement. By empirically examining US and UK OGD datasets, we found a divergence between the OGD vision and its execution since 2009 in these two countries. We explain how the OGD movement grew to its current state of ‘release any data now’ disconnected from the accountability goal. We also propose to provide incentives to agencies to release even less datasets but ones that are more closely aligned with the goal of accountability. Critics may propose that ‘improved accountability’ is but one goal competing against other, no less valuable goals (Robinson et. al. 2009). We propose that the goal of ‘improved accountability’ is so demanding that it sets the ‘OGD bar’ very high. To meet this bar, agencies will be forced to publish information that is better linked to other information, better documented, and embedded in richer context. Such information will therefore also contribute to the attainment of additional OGD.

As part of endorsing the open government data movement in many parts of the world, governments have worked to increase openness in actions where information technologies play a major role. Releasing public data was perceived by many governments and officials as a fundamental element to achieve transparency and accountability. Many studies have criticized this approach and illustrated that open government data does not necessarily lead to open government. Our study examines for the first time in a systematic, quantitative way the status of open government data in the US, by focusing on the disclosure of data by US federal agencies. Our findings suggest that most US federal agencies largely do not follow the open government policies of 2009 and 2013. The paper discusses the type of public data that is released, and analyzes the (non) strategy of its release.

Efficient interagency information sharing is critical to the execution of functions in the transparent state, and yet agencies persistently fail to share information. In the United States, members of the Hurricane Katrina (29 August 2005) investigation committee wrote that the American government remains the largest purchaser of information technology (IT) in the world and yet is ‘woefully incapable of storing, moving and accessing information’ (US Congress, Select Bipartisan Committee to Investigate the Preparation for and Response to Hurricane Katrina, 2006, p. 1). In Australia, a Board of Inquiry determined that government agencies’ refusal to share data contributed to the death of Northern Territory infants through starvation (Bamblett et al., 2010). In Britain, several agencies’ failure to share information contributed to the death of several children at the hands of their guardians (The Bichard Inquiry, 2004). Why do government agencies fail to share information with each other and how can we incentivize public sector institutions to share information more effectively?

Large public organizations that adopted computers in the early 1960s ever since have been accumulating “electronic mounds” consisting of layers upon layers of computer systems, data cemeteries, and software-inscribed, special case rules. These electronic mounds acquire a life of their own and are responsible for huge amounts of new electronic red tape that, in turn, inhibit flexibility, innovation, and reform. However, these electronic mounds are also the living carriers of organizational memory and needs, past and present. Organizations must learn how to coexist with their electronic mounds rather than constantly try to modernize them.

The rapidly growing governmental IT outsourcing trend raises different questions: Who, inside bureaucracy, governs computer systems after outsourcing? Which actors gain or lose political clout when the government begins to aggressively outsource its IT operations? How does IT outsourcing change the relationships among bureaucrats, consultants, and vendors? The article highlights the increasingly important and behind-the-scenes role the consultant plays as an intermediary between the MIS bureaucrat and technological vendors. IT consultants exert an enormous amount of political power because they are the “glue” binding together all the actors involved in producing and maintaining public information technology. Regrettably, this new consultant-centered environment is responsible for the degradation of the organizational and technological skills of MIS bureaucrats and also impairs the feedback information flow between bureaucrats and vendors regarding the status of public computer projects. Therefore, the article suggests that the unchecked power of IT consultants hinders the ability of bureaucrats to be accountable for the systems they manage.

Develops a “politics‐first” theoretical framework to explain why, how, and when innovative IT projects are implemented successfully in public organizations. Explains how individuals who share a technological interest find each other in issue‐networks. Describes why and how the interests of technologists, bureaucrats, and politicians converge to a point where a coalition with a concrete project agenda emerges. Argues that, frequently, more than one coalition emerges from a single issue‐network and describes how these coalitions compete against each other to institutionalize new dominant designs. Discusses the reasons why some coalitions win while others lose. Provides examples based on innovative national and municipal IT projects in Australia, China, Israel, Japan, The Netherlands, New Zealand, Norway, the UK, and the USA.

Can the new information and communication technologies (ICTs) such as the Internet change the power relationships within a bureaucracy? The dominant centralization approach argues that the existing power elite manipulates computers to perpetuate and augment its power. Although not a coherent school of thought, other scholars suggest that technology can decentralize bureaucratic structures and diffuse bureaucratic power. The little-known history of the ICT revolution in the Israeli public sector suggests that the same empirical evidence can be woven into two starkly different historical narratives supporting each of these approaches depending on the kinds of questions scholars ask at the onset of their research.

Besieged by the distance learning revolution, many senior university and college administrators are asking: how can traditional classroom teaching be modified in order to keep pace with the rapidly evolving high‐tech marketplace for higher education? The Faculty of Social Science at the Hebrew University of Jerusalem in Israel launched a three‐year pilot project to use multimedia and distance learning tools to improve classroom teaching. There are initial signs of success for this unique project that knits together powerful new multimedia infrastructure, WWW course sites, and electronic “smart classrooms.” This article proposes nine political guidelines for university administrators who seek to advance similar pilots but who also fear that faculty members will oppose such revolutionary projects.

Can we import the high‐performance team theory developed in the private sector into the public sector in order to improve the success rates of information technology (IT) projects? This article proposes that public organizations can create effective workgroups (weaker than the private sector’s high‐performance teams but stronger than the weak committees that typically manage public IT projects) in order to improve the chances of concluding IT projects successfully. Two remarkably similar Internet projects in Israel’s Ministry of Trade and Commerce and the Jerusalem Municipality are described, compared, and analyzed. The first adopted the workgroup project model and was concluded successfully. The second adopted the committee project model and ran into problems and delays. Lessons are gleaned from these case studies on how to staff, structure, and supervise public IT workgroups.

Argues that leaders with extensive backgrounds in organizational politics are more likely than technology‐focused leaders to complete their information technology projects successfully. Describes how successful technological leaders in the public sector manage their projects, mainly upwards and outwards, and tailor their technical visions to the day‐to‐day reality of their organizations. Compares the evolution and fate of two information technology projects, one managed by a technology‐oriented scientist (success) and the other by a politics‐driven bureaucrat (failure). Proposes that senior decision makers can hone the political skills of their technological leaders by training them on the “soft” skills of management and helping them balance the skill sets of their teams. Suggests how to change current incentive systems in order to encourage technological leaders to politick their projects to success.

Using Israel as a case study, the article argues that politics rather than technology accounts for the inefficient and wasteful state of technology in the public sector in countries where one finds ample endogenous first-class high tech manpower. In such countries, the article further argues, Information Technology (IT) systems are built and used in power struggles within ministries, among ministries, between the public sector and the public, or among the various branches of government. In Israel, for example, various ministries manipulate their access to first-class endogenous technology to fortify their bureaucratic power by building technological systems that are, sometimes, deliberately incompatible with the solutions of other ministries. Within the context of a third-rate bureaucracy, the article proposes, access to local high tech skills and technology merely makes governmental gridlock more expensive but does not necessarily result in improved services to citizens.

Web-based learning environments are popular on campus nowadays. These software packages improve communication between instructor and students, enable students to take charge over their learning processes, and provide feedback data to the instructor. Universities and colleges are called to foot the bill for these computerized tools by training teachers and students on how to use them, adding new computer classrooms, and upgrading the network backbone. Few, if any, of these academic institutions systematically collect and analyze data in order to assess if their investments in this new approach are paying off. How can academic institutions collect and analyze data in order to determine the effectiveness of the new computer mediated distance learning approach? This is the key question addressed in this article.

What role does politics play in the emerging Big Data domain? The paper argues that Big Data political power struggles surface at three distinct levels of analysis: the social sciences, the information state, and bureaucratic politics. At the social sciences level of analysis, Big Data threatens to divide social scientists into antagonistic methodological camps as it does not conform to traditional research techniques. At the information state level of analysis, a handful of powerful agencies and corporations created around data generation are consolidating their competitive advantage and are unlikely to support important data access and privacy protections. The one brighter spot for Big Data is found inside governmental bureaucracy. Here, trends such as “governance by numbers” at the sub-national level and mutually profitable data exchanges at the national level suggest that Big Data may propel agencies to share information better. The article concludes with a proposal to view Dr. John Snow and his work to stop the cholera epidemic in central London in 1854 as an early harbinger of the Big Data movement. Snow’s work displays redeeming features that may mitigate less desirable effects of Big Data projects across the three levels of analysis. These features are a sense of purpose, ingenuity, clever data collection design, collaboration, humility and humanity.

Since 2009, eighty-one countries subscribed to President Obama’s Open Government program including its dominant Open Data (OD) component. Do Open Data 2.0 plans address the problems detected during the first generation of this program (2010-2012)? If not, how can these plans be improved? The article is a review of the main lines of criticism of the original OD program based on lessons learned worldwide. OD1.0 suffered from bad design, flawed execution, and adverse consequences. Open Data 2.0 plans fail to address the critical flaws of the first Open Data program. The analysis of OD1.0 reveals two primary lessons for converting OD2.0 into a more focused and effective openness program: OD2.0 architects must consider agencies’ data release strategies, and avoid creating a transparency “policy bubble”. Numerous countries followed the path of the original American Open Data program; therefore, the future of this program will have an impact on bureaucracies worldwide.