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Surgical intervention is required to successfully treat severe, large‐gap (≥4 cm) peripheral nerve injuries. However, all existing treatments have shortcomings and an alternative to the use of autologous nerves is needed. Human and porcine nerves are physiologically similar, with comparable dimensions and architecture, presence and distribution of Schwann cells, and conserved features of the extracellular matrix (ECM). We report the repair of fully transected radial nerves in 10 Rhesus Macaques using viable, whole sciatic nerve from genetically engineered (GalT‐KO), designated pathogen free (DPF) porcine donors. This resulted in the regeneration of the transected nerve, and importantly, recovery of wrist extension function, distal muscle reinnervation, and recovery of nerve conduction velocities and compound muscle action potentials similar to autologous controls. We also demonstrate the absence of immune rejection, systemic porcine cell migration, and detectable residual porcine material. Our preliminary findings support the safety and efficacy of viable porcine nerve transplants, suggest the interchangeable therapeutic use of cross‐species cells, and highlight the broader clinical potential of xenotransplantation. [ABSTRACT FROM AUTHOR]

Working within the framework of extraction ecologies that Miller has laid out for us, we might equally say the opium extract overterritorializes, bringing along with its endless self-perpetuation the dangerous conditions of its own making. The I OED i tells us that this meaning - "of persons: origin, lineage, descent" - begins as early as 1477, though not until its nineteenth-century examples does extraction link specifically with geographical or national origin ("Extraction", n.). No reader of Elizabeth Carolyn Miller's masterful book, I Extraction Ecologies and the Literature of the Long Exhaustion i (2021), can emerge from its pages untouched by a sense of the expansive presence of her arguments. But the "mood of finitude" that suffuses Miller's account is here also inescapable, depleting the human forms living under this opium regime in depredations ranging from aesthetic degenerations to global economic disparities (Miller 8). [Extracted from the article]

Background: Allogeneic skin recovered from human deceased donors (HDD) has been a mainstay interim treatment for severe burns, but unfortunately risk of infectious disease and availability limitations exist. Genetically engineered ɑ‐1,3 galactosyltransferase knockout (GalT‐KO) porcine source animals for viable skin xenotransplants may provide a promising clinical alternative. Methods: Four cynomolgus macaque recipients received full‐thickness surgical wounds to model the defects arising from excision of full‐thickness burn injury and were treated with biologically active skin xenotransplants derived from GalT‐KO, Designated Pathogen Free (DPF) miniature swine. Evaluations were conducted for safety, tolerability, and recipient immunological response. Results: All skin xenotransplants demonstrated prolonged survival, vascularity, and persistent dermal adhesion until the study endpoint at post‐operative day 30. No adverse outcomes were observed during the study. Varying levels of epidermolysis coincided with histologic detection of CD4+ and CD8+ T cells, and other cellular infiltrates in the epidermis. Recipient sera IgM and IgG demonstrated significant antibody immune response to non‐α‐1,3‐galactose porcine xenoantigens. Separately, specific wound healing mediators were quantified. Neither porcine cell migration nor PERV were detected in circulation or any visceral organs. Conclusions: These results provide a detailed analysis of vital skin xenotransplants utilizing a non‐human primate model to predict the anticipated immunological response of human patients. The lack of adverse rejection even in the presence of elevated Ig indicates this is a prospective therapeutic option. The findings reported here directly supported regulatory clearance for a first‐in‐man, Phase I xenotransplantation clinical trial. [ABSTRACT FROM AUTHOR]

The article discusses The British Shipboard Narratives and the Romantic Authorship of the Chinese Coast. Topics include As British authors began to write personal accounts of their travels to China in increasing numbers after the Macartney Embassy, nearly all chose the common setting of their ship of transport as the starting point of their story. Some traveler-authors to China seemed to never physically or narratively disembark from ships, producing narratives centered rather than a ground.

The requirement specification process is an important part of a project and has the potential to prevent problems that may last for years after a project is delivered. Previous studies on the requirement specification process have focused on clarifying stated fuzzy terms in software requirement engineering. However, in many projects there is information that is not stated, but it is implied and can be inferred. This hidden information is usually ignored due to the assumption that 'the provider understands what they mean/need'. This assumption is not always true. Such information, if extracted, may include fuzzy terms, namely hidden fuzzy terms (HFTs), which need specification. Therefore, these fuzzy terms have to be identified and then specified to avoid potential future consequences. This study proposes an algorithm to extract the hidden fuzzy terms, utilises a fuzzy inference system (FIS) to specify them, and applies the best worst multi-criteria decision making method (BWM) to evaluate the delivered product and measure the performance of the provider. The model is then used to examine a case from Defence Housing Australia. Such evaluation and measurement enable the project owner/manager to have a transparent basis to support decisions later in different phases of the project, and to ultimately reduce the likelihood of conflict and the receipt of an unsatisfactory product. [ABSTRACT FROM AUTHOR]

Although Multi Criteria Decision Making (MCDM) methods have been applied in numerous case studies, many companies still avoid employing these methods in making their decisions and prefer to decide intuitively. There are studies claiming that MCDM methods provide better rankings for companies than intuitive approaches. This study argues that this claim may have low validity from a company's perspective. For this purpose, it focuses on one of the MCDM methods referred to as the Analytic Hierarchy Process (AHP) and shows that AHP is very likely to provide a ranking of options that would not be acceptable by a rational person. The main reason that many companies do not rely on current MCDM methods can be due to the fact that managers intuitively notice ranking errors. Future studies should end the promotion of outdated approaches, pay closer attention to the deficiencies of the current MCDM processes, and develop more useful methods. [ABSTRACT FROM AUTHOR]

Traditional Intrusion Detection Systems (IDS) cannot cope with the increasing number and sophistication of cyberattacks such as Advanced Persistent Threats (APT). Due to their high false-positive rate and the required effort of security experts to validate them, incidents can remain undetected for up to several months. As a result, enterprises suffer from data loss and severe financial damage. Recent research explored data provenance for Host-based Intrusion Detection Systems (HIDS) as one promising data source to tackle this issue. Data provenance represents information flows between system entities as Direct Acyclic Graph (DAG). Provenance-based Intrusion Detection Systems (PIDS) utilize data provenance to enhance the detection performance of intrusions and reduce false-alarm rates compared to traditional IDS. This survey demonstrates the potential of PIDS by providing a detailed evaluation of recent research in the field, proposing a novel taxonomy for PIDS, discussing current issues, and potential future research directions. This survey aims to help and motivate researchers to get started in the field of PIDS by tackling issues of data collection, graph summarization, intrusion detection, and developing real-world benchmark datasets. [ABSTRACT FROM AUTHOR]

Background and Objective Objective Structured Clinical Examination (OSCE) has been used in many areas of healthcare training over the years. However, it constantly needs to be upgraded and enhanced due to technological and teaching changes. We aim at implementing an integrative OSCE method which employs informatics via the virtual patient within the pharmacy education curriculum at Taipei Medical University to enhance the pharmacy students’ competence for using and disseminating information and to also improve critical thinking and clinical reasoning. Methods We propose an integrated pharmacy OSCE which uses standardized patients and virtual patients (DxR Clinician). To evaluate this method, we designed four simulated stations and pilot tested with 19 students in the first year of the Master in Clinical Pharmacy program. Three stations were simulated as the inpatient pharmacy: 1) History and lab data collection; 2) Prescription review; 3) Calling physician to discuss potential prescription problems. The fourth was simulated as the patient ward station to provide patient education. A satisfaction questionnaire was administered at the end of the study. Results Students rated their ability of 2.84, 2.37, 2.37, and 3.63 of 5 for each of the four stations, with the second and third being the most difficult stations. The method obtained an average rating of 4.32 of 5 for relevance, 4.16 for improving clinical ability, 4.32 for practicality in future healthcare work, and 4.28 for willing to have another similar learning experience. Conclusion The integration of Virtual Patient in this study reveals that this assessment method is efficient and practical in many aspects. Most importantly, it provides the test taker with a much closer real-life clinical encounter. Although it is in many ways more difficult, it also provides for better “learning from mistakes” opportunities for test-takers. [ABSTRACT FROM AUTHOR]

Procurement, the act of buying goods or services from an external supplier, plays an important role in any organisation. To measure how well an organisation undertakes this activity, it needs to measure all associated Key Performance Indicators (KPIs). The current literature's major drawback in performing such a measurement is how to integrate the different KPIs, each of which captures a specific aspect of the organisation's performance. In this paper, we highlight this drawback and present our proposed Smart Buyer framework that is based on a Bayesian Network (BN) model capable of capturing and integrating the different KPIs. The measured procurement performance value can then be used by organisations to identify the areas in which they need to improve and develop plans to achieve this. Four scenarios are presented to show how the proposed BN model can be further used for analysis and decision making within organisations. Finally, a recent real-world procurement example is studied to demonstrate the applicability of the proposed Smart Buyer framework. [ABSTRACT FROM AUTHOR]

Background The PharmaCloud system, a cloud-based medication system, was launched by the Taiwan National Health Insurance Administration (NHIA) in 2013 to integrate patients’ medication lists among different medical institutions. The aim of the preliminary study was to evaluate satisfaction with this system among physicians and pharmacists at the early stage of system implementation. Methods A questionnaire was developed through a review of the literature and discussion in 6 focus groups to understand the level of satisfaction, attitudes, and intentions of physicians and pharmacists using the PharmaCloud system. It was then administered nationally in Taiwan in July to September 2015. Descriptive statistics and multiple regression were performed to identify variables influencing satisfaction and intention to use the system. Results In total, 895 pharmacist and 105 physician questionnaires were valid for analysis. The results showed that satisfaction with system quality warranted improvement. Positive attitudes toward medication reconciliation among physicians and pharmacists, which were significant predictors of the intention to use the system (β= 0.223, p  < 0.001). Most physicians and pharmacists agreed that obtaining signed patient consent was needed but preferred that it be conducted by the NHIA rather than by individual medical institutions (4.02 ± 1.19 vs. 3.49 ± 1.40, p  < 0.01). Conclusions The preliminary study results indicated a moderate satisfaction toward the PharmaCloud system. Hospital pharmacists had a high satisfaction rate, but neither are physicians and community pharmacists. Continuously improvement on system quality has been performing based on the results of this preliminary survey. Policies and standardization processes, including privacy protection, are still warranted further actions to make the Taiwan PharmaCloud system a convenient platform for medication reconciliation. [ABSTRACT FROM AUTHOR]

An essay is presented on hollow earth fiction and environmental form in the late 19th-century. It looks at the use of hollow earth narrative by several authors, including Willis Emerson, John Uri Lloyd and Edgar Rice Burroughs, as a generic form to bring together adventure fiction and utopian fantasy to the operations of near-planetary ecosystems.

Mental health disparities impacting Korean Americans are multifaceted. Although encouraging developments have been made in the knowledge of mental health prevalence and professional help-seeking behaviours of Asian Americans, Korean Americans continue to experience many challenges and unique needs that require more ethnic- and culture-specific knowledge. Given the prominent role that religion, particularly Christianity, plays in the Korean American context, we conducted exploratory interviews with 10 Korean American pastors regarding their perspectives on mental health issues impacting the Korean American community. Using consensual qualitative research, we found four salient domains: (a) Barriers to seeking mental health services, (b) Challenges that pastors experience, (c) Pastor’s assessment of church’s current climate in approaches to mental health issues, and (d) What is needed. Implications for research and practice in addressing mental health disparities are discussed. [ABSTRACT FROM PUBLISHER]

Microwave-assisted synthetic (MAS) preparation of cyclopentadienyl iridium halide dimers. Complexes can be access directly through the iridium halide salts and pentamethylcyclopentadiene as well as through halide metathesis from the iridium chloride dimer and a potassium halide salt. All complexes can be accessed using MAS in less than fifteen minutes without loss of yield or purity. [Display omitted] [Cp*IrCl 2 ] 2 is a common precursor used to synthesize a large family of organometallic catalysts. While [Cp*IrCl 2 ] 2 is commercially available, dimers featuring other halides are not, although they can be accessed through [Cp*IrCl 2 ] 2. Published synthetic methods for the preparation of these halide dimers are time consuming, requiring reflux for 48 h. We have developed a new synthetic approach utilizing microwave-assisted synthesis (MAS) that significantly decreases the time required to prepare [Cp*IrX 2 ] 2 (X = Cl, Br, I). Reagents were heated beyond their normal boiling point in sealed reactors for 15 min at 120 °C and products were isolated using traditional methods with yields comparable or exceeding literature methods. [Cp*IrX 2 ] 2 dimers synthesized using MAS were characterized by NMR spectroscopy, UV–Visible spectroscopy, and elemental analysis. These dimers were then used to synthesize a series of mononuclear iridium bipyridyl complexes, [Cp*Ir(bpy)X]X. This series of complexes was explored spectroscopically and electrochemically to identify potential electrocatalysts for future studies. [ABSTRACT FROM AUTHOR]

This essay uses the example of the Chinese tree peony, a flower much desired by British gardeners at the start of the nineteenth century as well as a flower much reproduced in horticultural periodicals and on consumer commodities, to explain the era's interconnected understanding of the process of cultivation. Organic cultivations, foreign and domestic, were not separated from social and personal cultivations in verbal and visual discourse but rather mutually reinforced each other. Following these connections helps explain the ever-growing estrangement between nineteenth-century subjects and the nature that surrounded them in terms that connect environmental, aesthetic, and literary history. [ABSTRACT FROM AUTHOR]

In the fields of networking and communication, wireless sensor networks are a commonly used technology. Although Mobility in Wireless Networks or Mobile Ad hoc Networks (MANETs) were developed to solve most critical problems in a disaster scenario. However, data transmission in a disaster area is a difficult operation due to irregular connections between sensing devices and the sink. Opportunistic network-based MANETs are utilized to overcome this problem. There are many routing issues such as communication overhead ratio, packet loss, and packet delivery ratio at mobile nodes. There are several traditional approaches used in opportunistic networks for node localization and routing. The drawback of these traditional routing methods is their poor reliability. A Markov chain-based opportunistic routing protocol is proposed in this paper. A Markov chain model is used to predict the node mobility for the random mobility model, and a neighbor table-based relay node selection procedure is proposed. A Markov prediction model uses the history of a node’s movement without requiring additional information. By analyzing simulation metrics including delay, overhead rate, packet drop, and packet delivery rate, the proposed routing protocol is evaluated and verified based on the Packet Delivery Ratio (PDR) in an opportunistic network environment (ONE) simulator. In addition, existing routing protocols such as Spray and Wait (SNW), Epidemic, Prophet, and MaxPro differ from the proposed routing protocol in terms of buffer size, node count, and message generation rate. Corresponding result analysis demonstrates the superior performance of the proposed routing protocol over existing protocols. [ABSTRACT FROM AUTHOR]

The Semantic Web envisions a Web where information is accessible and processable by computers as well as humans. Ontologies are the cornerstones for realizing this vision of the Semantic Web by capturing domain knowledge through the defined terms and the relationship between them to provide a formal representation of the domain with machine-understandable semantics. Given the importance of ontologies, a significant amount of work in the literature has been done on knowledge representation on the Web which includes ontology development (ontology engineering), ontology evaluation, ontology population and ontology evolution. As a result, numerous domain ontologies have been developed however, not much attention has been given to the area of ontology usage analysis that shows how the developed ontologies are being used. Such a study is very important as we explain in this paper by using some motivational scenarios of a Semantic Web user in different roles. The discussion is followed by a summary of the state-of-the-art of the existing literature on ontology usage to highlight gaps in this area. We define Ontology Usage Analysis and discuss our proposed Ontology Usage Analysis Framework (OUSAF) to measure the usage of an ontology on the web from different perspectives. On a real-world collected dataset, the results obtained from OUSAF demonstrate the practical utilization of OUSAF in measuring ontology usage analysis. [ABSTRACT FROM AUTHOR]

Multivalent interactions occur frequently in nature, where they mediate high-affinity interactions between cells, proteins, or molecules. Here, we report on a method to generate multivalent aptamers (Multi-Aptamers) that target L-selectin function using rolling circle amplification (RCA). We find that the L-selectin Multi-Aptamers have increased affinity compared to the monovalent aptamer, are specific to L-selectin, and are capable of inhibiting interactions with endogenous ligands. In addition, the Multi-Aptamers efficiently inhibit L-selectin mediated dynamic adhesion in vitro and homing to secondary lymphoid tissues in vivo. Importantly, our method of generating multivalent materials using RCA avoids many of the challenges associated with current multivalent materials in that the Multi-Aptamers are high affinity, easily produced and modified, and biocompatible. We anticipate that the Multi-Aptamers can serve as a platform technology to modulate diverse cellular processes. [ABSTRACT FROM AUTHOR]

Background: Although the pharmacokinetics of everolimus, an oral mammalian target of rapamycin inhibitor, have been characterized in patients with moderate hepatic impairment, they have not been assessed in those with mild or severe hepatic impairment. Objective: The goal of this study was to assess the pharmacokinetics and safety of everolimus in healthy volunteers with normal hepatic function and patients with mild (Child- Pugh class A), moderate (Child-Pugh class B), and severe (Child-Pugh class C) hepatic impairment in otherwise good health to inform dosing in the clinical setting. Methods: A multicenter, open-label, Phase I study in which all enrollees received a single, 10-mg, oral everolimus dose was conducted. Blood samples for pharmacokinetic assessment were collected at predetermined time points up to 168 hours postdosing. Safety was also assessed. Proposed dose recommendations based on Child-Pugh status at baseline and day 8 were calculated based on AUC0-∞ geometric mean ratios and their associated 90% CIs. Post hoc analysis of the relationship between pharmacokinetic parameters and markers of hepatic function was also performed to identify thresholds for dose adjustment. Results: Thirteen subjects with normal hepatic function and 7 patients with mild, 8 patients with moderate, and 6 patients with severe hepatic impairment were enrolled. Compared with normal subjects, everolimus AUC0-∞ for patients with mild, moderate, and severe hepatic impairment increased by 1.60-, 3.26-, and 3.64-fold, respectively. Based on Child-Pugh classification at day 8, the everolimus doses required to adjust the exposure of patients with mild, moderate, and severe hepatic impairment to that of normal subjects were 6.25, 3.07, and 2.75 mg, respectively. Thresholds for 2-fold everolimus dose reduction were 15.0μmol/L for bilirubin, 43.1 g/L for albumin, and 1.1 for the international normalized ratio; using these thresholds could lead to underdosing or overdosing in some patients. Most adverse events were of grade 1 severity,⩽1 day in duration, and not everolimus related. Conclusions: Everolimus exposure after a single 10-mg dose was influenced by the degree of hepatic impairment. Child-Pugh classification was found to be the most conservative means of guiding dose adjustment in patients with hepatic impairment. Based on these data, as well as previously reported data for patients with moderate hepatic impairment, everolimus once-daily dosing should be 7.5 mg and 5 mg in patients with mild and moderate impairment, respectively. Everolimus is not recommended in patients with severe hepatic impairment unless benefits outweigh risks; in that case, 2.5mgonce daily should not be exceeded [ABSTRACT FROM AUTHOR]

Survivin, a member of the IAP (inhibitor of apoptosis protein) family, plays important roles in maintaining cellular homoeostasis and regulating cell-cycle progression. This IAP is overexpressed in oesophageal cancer cells, leading to uncontrolled cell growth and resistance to apoptosis. CUG-BP1 (CUG-binding protein 1) is an RNA-binding protein that regulates the stability and translational efficiency of target mRNAs. In the present paper, we report that CUG-BP1 is overexpressed in oesophageal cancer cell lines and human oesophageal cancer specimens. CUG-BP1 associates with the 3′-untranslated region of survivin mRNA, thereby stabilizing the transcript and elevating its expression in oesophageal cancer cells. Our results show that overexpression of CUG-BP1 in oesophageal epithelial cells results in increased survivin mRNA stability and consequently survivin protein expression. Conversely, silencing CUG-BP1 in oesophageal cancer cells destabilizes survivin mRNA, lowering the level of survivin protein. In addition, we have found that altering CUG-BP1 expression modulates susceptibility to chemotherapy-induced apoptosis. Overexpression of CUG-BP1 in oesophageal epithelial cells increases resistance to apoptosis, whereas silencing CUG-BP1 makes oesophageal cancer cells more susceptible to chemotherapy-induced apoptosis. Co-transfection experiments with small interfering RNA directed against survivin suggest that the anti-apoptotic role for CUG-BP1 is not entirely dependent on its effect on survivin expression. [ABSTRACT FROM AUTHOR]

We define a digital ecosystem (DES) as the dynamic and synergetic complex of digital communities consisting of interconnected, interrelated, and interdependent digital species situated in a digital environment that interact as a functional unit and are linked together through actions, information, and transaction flows. The design of DESs requires the integration of a number of different and complementary technologies, including agent-based and self-organizing systems, ontologies, swarm intelligence, ambient intelligence, data mining, genetic algorithms, etc. The integration of multiple technologies and the resulting synergetic effects contribute to the creation of highly complex, dynamic, and powerful systems. The application of DESs within different domains has the power to transform these domains by giving them a more intelligent and a more dynamic nature. In this paper, we illustrate how a DES design methodology can be used to systematically create a Digital Health Ecosystem (DHES). We address the key steps associated with the DES design and focus specifically on the use of the electronic health records within the DHES. The design methodology framework illustrated in this paper serves as a navigating tool during the design of DHESs. [ABSTRACT FROM AUTHOR]

Introduction Here we present an unusual case of DNA ligase IV deficiency syndrome without dysmorphic facial findings and microcephaly complicated with Epstein–Barr virus-associated large B-cell lymphoma with the right lung involvement and a massive brain tumor lesion in a two-year-old female. Methods PID panel was used for sequencing 55 genes. Most genes have > 98% exon coverage including splicing sites. LIG4 gene has 100% exon and splicing site coverage. This was used in Ion Torrent PGM system, the library kit was made by Agilent with Haloplex technology. The sequence analysis software was Alamut, direct sequencing of LIG4 gene was performed after NGS results. Result We identified three heterozygous mutations in LIG4 gene c.2736 + 3delC and c.8 C > T (p.A3V) inherited from mother and c.26C > T (p.T9I) – from father after PID panel sequencing and some additional polymorphisms in ATM , NOD2 and NLRP3 genes. Conclusion This case broadens the clinical spectrum of DNA ligase IV deficiency. [ABSTRACT FROM AUTHOR]

In digital business ecosystem architecture it is rational for the trusting agent to analyse the possible risk according to its demand before interacting with a probable trusted agent. Doing so would assist the trusting agent in its decision process and would also give the trusting agent a hint of the direction in which the interaction might head. The possible risk in an interaction is a combination of the probability of failure and the possible consequences of failure of an interaction. In this paper, we propose a methodology by which the trusting agent determines the probability of failure in interacting with a probable trusted agent. The determined probability of failure by the trusting agent is according to the specific demand of its future interaction with the probable trusted agent. [Copyright &y& Elsevier]

Usability of software should measure both user preference and user performance. The notion of usability involves several dimensions. These dimensions include: system feedback, consistency, error prevention, performance/efficiency, user like/dislike, and error recovery. Each of these dimensions are characterized by fuzzy aspects and linguistic terms. This paper develops a model for each of the dimensions using fuzzy-set theory. It then uses the Takagi-Sugeno fuzzy-inference approach for developing an overall measure of usability. Results are presented for several different user interfaces. [ABSTRACT FROM AUTHOR]

Describes a design methodology for XML documents which is aimed to enforce XML conceptual modeling power and bridge the gap between software development and XML document structures. Discussion on design levels of the proposed methodology; Review of XML document structure; Description of a semantic data model for XML based on a semantic network.

With the rapidly increasing volume of cyber-attacks over the past years due to the new working-from-home paradigm, protecting hosts, networks, and individuals from cyber threats is in higher demand than ever. One promising solution are Provenance-based Intrusion Detection Systems (PIDS), which correlate host-based security logs to generate provenance graphs that describe the causal relationship between system entities. PIDS have shown significant potential in enhancing detection performance and reducing false alarms compared to traditional Intrusion Detection Systems (IDS). Rule-based approaches used in PIDS utilize expert-defined rule sets to identify known malicious patterns in provenance graphs. Although these rule-based techniques have been widely applied, they can only detect known attack patterns, are heavily dependent on the quality of the rules, and creating rules manually is time-consuming. To address these shortcomings, this study proposed two novel techniques: the Multi-level Attack Description Model (MADM) for describing attack patterns at multiple granularity levels and the Provenance-enabled Automated Rule Generation and Matching Framework (PARGMF) to generate rules deterministically and promptly. We evaluated the proposed approaches using the DARPA OpTC dataset, complemented by a practical case study. This case study involved a prototype extension for the CAPEv2 sandbox environment, demonstrating the real-world applicability of our approaches. Our results demonstrate, firstly, that PARGMF generates rules deterministically with an average processing time of only 13.11 s compared to multiple hours or even days for manual rule creation by security experts. Secondly, through generalization of attack descriptions, MADM enhanced the robustness of rules by 21.9% for Behavioural Attack Description (BAD) and 25% for Structural Attack Description (SAD) compared to approaches without generalization. Another added benefit compared to existing approaches is that PARGMF also generates differential graphs to support security experts' timely validation of security alarms. [ABSTRACT FROM AUTHOR]

Hard cider is growing in popularity throughout the United States (US). Though many scholars have investigated quality and trends in the expanding US cider industry, still little is known about cider producers’ opinions of the products that they make. How do American cider producers value and emplace value onto cider as the industry grows and competes with the broader alcoholic beverage market? This study explored producer perceptions of American hard cider by employing 21 semi-structured interviews with cider-makers throughout Virginia, Vermont, and New York – three leading cider producing states in the Northeast and Mid-Atlantic US. Interview sessions were subject to reflexive thematic analysis for themes related to preference, consumption, and cider-making. Results suggest that cider producers broadly prefer complex flavors and cider made with cider-specific apples. Yet, cider producers ascribe to a diverse spectrum of values related to the cider-making process, agriculture, and business goals, which influence their preferences and the experiences that they create for other consumers. This research also identifies a chasm in how American “cider” is being constructed and valued, offering broad implications for the domestic cider and apple agriculture industries as well as a template for bridging the divide between producer- and consumer-based food studies. [ABSTRACT FROM AUTHOR]

To assess rheumatologists' views and practices related to shared decision-making (SDM) in gout treatment. We performed a cross-sectional electronic survey of rheumatologists at U.S. Veterans Affairs (VA) medical centers, assessing views and practices related to SDM in gout. Of the 154 VA rheumatology providers eligible, 90 responded (response rate, 58%). Fifty-eight percent were female, the mean age was 51 years (standard deviation, 9.6), 42% had > 20 years of experience in medical practice. Rheumatologists reported routinely offering a choice to their patients for (1) starting urate-lowering therapy (ULT) for gout vs. doing nothing (70%); (2) choosing NSAIDs, corticosteroids, or colchicine for the treatment of acute flares (67%); and (3) choosing NSAIDs, corticosteroids, or colchicine for anti-inflammatory prophylaxis when starting ULT (51%). Very few rheumatologists offered choice regarding (4) choosing allopurinol vs. febuxostat as the first ULT (16%) and (5) taking daily ULT long-term vs. intermittently (15%). Rheumatologists perceived that a large proportion of patients were often or sometimes unsure of the best choice for these five decisions, 34%, 76%, 76%, 52%, and 54%, respectively. Similar proportions of rheumatologists felt that patients were uninformed about both medication benefits and risks, unclear about the personal importance of the benefits and risks, and unsupported in decision-making. For the five decisions respectively, rheumatologists supported SDM with patients in 76%, 56%, 58%, 27%, and 25%. The majority of VA rheumatologists incorporated SDM in several gout treatment decisions. Rheumatologists also recognized that patients need better support to participate in SDM in gout. Key Points: • Rheumatologists offered shared decision-making to gout patients for 3 key treatment decisions. • Rheumatologists perceived that many patients were unsure of the best choice for these decisions. • Rheumatologists felt that patients were uninformed about medication benefits/risks and unsupported in decision-making. [ABSTRACT FROM AUTHOR]

Headspace solid-phase microextraction (HS-SPME) coupled to gas chromatography–mass spectrometry (GC-MS) is widely employed for volatile analyses of plants, including mapping populations used in plant breeding research. Studies often employ a single internal surrogate standard, even when multiple analytes are measured, with the assumption that any relative changes in matrix effects among individuals would be similar for all compounds, i.e., matrix effects do not show Compound × Individual interactions. We tested this assumption using individuals from two plant populations: an interspecific grape (Vitis spp.) mapping population (n = 140) and a tomato (Solanum spp.) recombinant inbred line (RIL) population (n = 148). Individual plants from the two populations were spiked with a cocktail of internal standards (n = 6, 9, respectively) prior to HS-SPME-GC-MS. Variation in the relative responses of internal standards indicated that Compound × Individual interactions exist but were different between the two populations. For the grape population, relative responses among pairs of internal standards varied considerably among individuals, with a maximum of 249% relative standard deviation (RSD) for the pair of [U13C]hexanal and [U13C]hexanol. However, in the tomato population, relative responses of internal standard pairs varied much less, with pairwise RSDs ranging from 8% to 56%. The approach described in this paper could be used to evaluate the suitability of using surrogate standards for HS-SPME-GC-MS studies in other plant populations. [ABSTRACT FROM AUTHOR]

Background and objective: Patients with cancer taking oral antineoplastic medications may encounter problems including suboptimal adherence as well as physical and psychological disease burden. Despite increase in the use of oncology pharmacy services, there are wide variations between healthcare professionals and patient perceptions of patients' medication experiences. The objective of the study was to explore the medication experience of taking oral targeted therapy in patients with advanced non-small cell lung cancer (NSCLC). Method: We purposively sampled advanced stage (stage III or IV) NSCLC patients taking epidermal growth factor receptor-tyrosine kinase inhibitors (EGFR-TKIs) in a medical center in Taiwan. Face-to-face interviews using semi-structured interview guides were conducted. Interviews were transcribed verbatim and thematic analysis was applied. A phenomenological methodology was adopted to explore the underlying meaning of patients' lived experience. Results: A total of 19 participants with a mean age of 68.2 years were interviewed. The duration of EGFR-TKIs use ranged from 2 weeks to 5 years. When first learned about the unexpected yet 'treatable' cancer, participants expressed strong emotional responses based on their intrinsic beliefs of the terminal disease and therapy. They walked along an unfamiliar trail while confronting physical and psychological challenges and made compromises to treatment. Gaining experiences from cancer journey, patients with cancer continuously seek the ultimate goals–'return to normal'. Conclusions: This study also revealed medication experiences of participants' journey from seeking information in the initial phase and living with cancer, to taking back control of their own lives. Healthcare professionals could better empathize with patients' loss of control and understand their perspectives when making clinical decisions. These findings can guide interdisciplinary teams to integrate patients' beliefs and conduct pre-screening assessments of health literacy levels to tailor communication. Subsequent interventions should be developed to identify barriers to medication self-management and empower patients by building social networks. [ABSTRACT FROM AUTHOR]

Highlights • Extracting features using syntactic rules from pros/cons reviews. • Determining the opinion's polarity according to their emotion strength. • Comparing results with state-of-the-art approaches in different tasks. Abstract Sentiment knowledge extraction is a growing area of research in the literature. It helps in analyzing users’ opinions about different entities or events, which can then be utilized by analysts for various purposes. Particularly, feature-based sentiment analysis is one of the challenging research areas that analyzes users’ opinions on various features of a product or service. Of the three formats for the product reviews, our focus in this paper is limited to analyzing the pros/cons type. Due to the nature of pros/cons reviews, they are mostly concise and follow a different structure from other review types. Therefore, specialized techniques are needed to analyze these reviews and extract the customers’ discussed product features along with their personal attitudes. In this paper, we propose the Pros/Cons Sentiment Analyzer (PCSA) framework that exploits dependency relations in extracting sentiment knowledge from pros/cons reviews. We also utilize two different lexicons to ascertain the polarity strength of the extracted features based on the customers’ opinions. Several experiments are conducted to evaluate the performance of PCSA in its different phases. [ABSTRACT FROM AUTHOR]

The author presents a personal narrative of his experiences as a doctor, in which he discusses a rape kit, which is used by medical personnel for gathering and preserving physical evidence following an allegation of sexual assault.

Real-time smart applications are now possible because to developments in communication and sensor technology. Wireless sensor networks (WSNs) are used to collect data from specific disaster sites, such as fire events, gas leaks, land mines, earthquake, landslides, etc., where it is necessary to know the exact location of the detected information to safely rescue the people. For instance, the detection and disposal of explosive materials is a difficult task because land mines consistently threaten human life. Here, the T-based Routing Topology (TRT) is suggested to gather data from sensors (metal detectors, Ground Penetrating Radars (GPR), Infra-Red sensors, etc.), Global Positioning System (GPS), and cameras in land mine-affected areas. Buried explosive materials can be found and located with high accuracy. Additionally, it will be simpler to eliminate bombs and reduce threats to humans. The efficiency of the suggested data collection method is evaluated using Network Simulator-2 (NS-2). Also, the proposed T-based routing topology requires a minimal number of nodes to cover the entire searching area and establish effective communication. In contrast, the number of nodes participating in the sensing area grows, as the depth of the tree increases in the existing tree topology-based data gathering. And for cluster topology, the number of nodes deployment depends on the transmission range of the sensor nodes. [ABSTRACT FROM AUTHOR]

Objectives: This study was conducted to assess the utility of neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) in predicting radiographic sacroiliitis and active disease in axial spondyloarthritis (SpA) and to explore the association between use of a tumor necrosis factor inhibitor (TNFi) and these laboratory values compared with traditional inflammatory markers. Methods: Observational data from the Program to Understand the Longterm Outcomes in Spondyloarthritis (PULSAR) registry were analyzed. We generated receiver operating characteristic curves to calculate laboratory cutoff values; we used these values in multivariable logistic regression models to identify associations with radiographically confirmed sacroiliitis and active disease. We also used logistic regression to determine the likelihood of elevated laboratory values after initiation of TNFi. Results: Most study participants (n = 354) were White, male, and HLA–B27 positive. NLR (odds ratio [OR] 1.459, P = 0.034), PLR (OR 4.842, P < 0.001), erythrocyte sedimentation rate (OR 4.397, P < 0.001), and C‐reactive protein (CRP) level (OR 2.911, P = 0.001) were independent predictors of radiographic sacroiliitis. Models that included PLR with traditional biomarkers performed better than those with traditional biomarkers alone. NLR (OR 6.931, P = 0.002) and CRP (OR 2.678, P = 0.004) were predictors of active disease, but the model that included both NLR and CRP performed better than CRP alone. TNFi use reduced the odds of elevated NLR (OR 0.172, P < 0.001), PLR (OR 0.073, P < 0.001), erythrocyte sedimentation rate (OR 0.319, P < 0.001), and CRP (OR 0.407, P < 0.001), but models that included NLR or PLR and traditional biomarkers performed best. Conclusions: These findings demonstrate an association between NLR and PLR and sacroiliitis and disease activity, with NLR and PLR showing response after TNFi treatment and adding useful clinical information to established biomarkers, thus perhaps assisting in management of axial SpA. [ABSTRACT FROM AUTHOR]

1. Insect colour patterns serve a wide range of ecological functions and the biotic and abiotic factors mediating colour variation in nature have been well characterised. 2. Nonetheless, the majority of studies in this field have focused on adult insects (particularly butterflies). Almost nothing is known about the factors that mediate intra‐specific colour variation in juveniles in nature, even though they are often as conspicuously coloured as their adult counterparts. 3. Here we show that temperature predicts a small but significant amount of monarch (Danaus plexippus) caterpillar pigment variation in nature. Over a 650,000‐km2 region in Canada and the USA, caterpillars found in warmer locations or lower latitudes had thinner black stripes than those found in colder locations or higher latitudes. Caterpillars have also become less black over the last five years, a result consistent with observed short‐term increases in summer temperature in this region. 4. Our study demonstrates that the relationship between temperature and monarch caterpillar pigmentation seen in laboratory settings is also apparent in nature, although with considerable variation. Our study also highlights the utility of online biodiversity repositories such as iNaturalist for characterising pattern and colour variation in nature. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to translate, adapt, and validate the Satisfaction with Oral Anti-Diabetic Agent Scale (SOADAS) in type 2 diabetes mellitus (DM) patients taking oral antidiabetic drugs (OADs) in Taiwan. Patients and methods: The SOADAS was translated to Chinese and was modified based on reviews of two physicians, five diabetes educators, and two patient focus groups. A crosssectional interviewer-administered survey was conducted in adult patients with type 2 DM who were taking OADs. The Chinese version of the SOADAS (C-SOADAS), the EuroQol 5 dimensions 3-level (EQ-5D-3L) questionnaire, and a demographic questionnaire were administered to participants. Instrument structure, internal consistency, convergent validity, and known-group validity were assessed. Results: A total of 260 DM patients were recruited. The mean score of an individual item ranged from 3.6 to 3.9, while the mean total score (out of 25 possible points) was 18.7 points. Overall, floor and ceiling effects were negligible. The Cronbach’s α value was 0.81. All the four predetermined hypotheses for known-group validity assessment were fulfilled. In convergent validity testing, the C-SOADAS total scores were found to be correlated with EuroQol-Visual Analog Scale (EQ-VAS) scores (r = 0.2; p , 0.01) but not with EuroQol 5 dimensions (EQ-5D) index scores (r = 0.02; p = 0.81). Conclusion: The 5-item C-SOADAS appears to be a psychometrically acceptable measure of OAD treatment satisfaction among type 2 DM patients in Taiwan. The tool may be incorporated into clinical practice to quickly assess treatment outcomes from patients’ perspectives. [ABSTRACT FROM AUTHOR]

Background Despite the impact of medication literacy ( ML) on patients' safe use of medications, existing instruments are mostly for general health literacy measurement or designed for specific disease populations, with few specifically designed for ML. Objective To develop and validate the first Chinese medication literacy measure (Ch MLM). Methods The Ch MLM was developed by a multidisciplinary and bilingual expert panel and subsequently pilot-tested. The final version had 17 questions in four sections: vocabulary, non-prescription drug, prescription drug and drug advertisement. Face-to-face interviews were administered in a convenience sample of adults with diverse sociodemographic characteristics. Internal consistency was assessed by Cronbach's alpha. Content validity was confirmed by the expert panel, and hypothesis testing was performed to assess construct validity. Results A total of 634 adults were interviewed. The mean ( SD) total Ch MLM score was 13.0 (2.8). The internal validity was acceptable (Cronbach's alpha=0.72). Nine of the ten a priori hypotheses were fulfilled. Younger age, higher income and higher education levels were significantly associated with a higher Ch MLM score. Furthermore, higher scores on the Ch MLM were associated with higher confidence or less difficulty in writing, reading, speaking and listening abilities in a health-care encounter. No association was found between Ch MLM total scores and frequency of doctor's visits. Conclusion The Ch MLM is a valid and reliable ML measure. It may help pharmacists and other health-care providers to target patients and problem areas that need interventions with the ultimate goal of preventing medication errors and harm. [ABSTRACT FROM AUTHOR]

In current competitive times, product manufacturers need not only to retain their existing customer base, but also to increase their market share. One way they can achieve this is by generating new ideas and developing novel products with new features. As highlighted in the literature, in generating new ideas to develop novel and innovative products, it is important that product designers satisfy the needs of both current customers and new customers. However, despite the large number of existing studies that identify novel features in the ideation phase, product designers do not have a systematic framework that utilises additional information relating to products from either far-field or related domains to generate such new ideas in the ideation phase. This paper presents our proposed framework FEATURE which provides just such a systemic framework for product designers in the ideation phase of new product development. FEATURE has three phases. The first phase identifies and recommends to the product designers novel features that can be added to the next version of a reference product. In order to incorporate the customer's voice into the ideation phase, the second phase ascertains the popularity of the proposed features by using social media. The third phase ranks the proposed features based on the designer's decision criteria to select those that should be considered further in the next phases of new product development. We explain the importance of each phase of FEATURE and show the working of its first module in detail. [ABSTRACT FROM AUTHOR]

What Is Known and Objective: Low treatment persistence and adherence in patients with dementia results in a rapid loss of disease control. This pilot study evaluated the impact of pharmacist‐provided caregiver counselling on treatment persistence, adherence, quality of life (QoL) in patients with dementia, as well as caregiver's knowledge of dementia, and caregiver burden. Methods: This prospective, randomized controlled study was performed at a hospital‐based pharmacist‐managed clinic from December 2017 to December 2019. Patients with mild‐to‐moderate Alzheimer's disease (AD), initiating cholinesterase inhibitors within 3 months, and coming with their caregivers were included and randomized 1:1 to intervention or control group. The intervention group received pharmacist counselling and education sheets about AD, whereas the control group only received standard of care. Patients' treatment persistence and adherence were assessed at months 3, 6, 9, and 12; QoL, and caregiver burden were assessed at baseline and month 12. Caregiver's knowledge of dementia was assessed at baseline and 2 weeks after counselling in the intervention group. Nonparametric statistics and generalized estimating equation models were used for statistical analysis. Results and Discussion: A total of 40 patients and 40 caregivers were included, with 20 pairs for each group. One‐year medication persistence (16/20 vs. 16/20) and adherence rates (87%–99%) were high in both groups without significant differences. Dementia knowledge scores improved significantly after counselling in the intervention group (77.5 vs. 95.8, p < 0.01). Although the change of caregiver burden was non‐significant between groups, the score decreased in the intervention group (−0.89; p = 0.78) but increased in the control group (+6.01; p = 0.07). What Is New and Conclusion: In this pilot study, pharmacist's counselling for patients with dementia and their caregivers is feasible and can enhance caregiver knowledge of dementia. Further study with larger scale is needed to confirm the impact on these outcomes. [ABSTRACT FROM AUTHOR]

Symptoms and medication use in patients with Parkinson's disease (PD) affect the quality of life of patients and caregivers, yet prior research seldom focused on their experiences with medications. This study explored comprehensive living and medication experience from patients with PD and their caregivers. Patients diagnosed with PD for ≥2 years, with or without their caregivers, were recruited from an outpatient clinic in Taiwan. Semi-structured in-depth interviews were conducted based on the Common Sense Model. A qualitative content analysis was used to identify salient themes from verbatim transcripts. In total, 15 patients and eight caregivers were interviewed. Five themes were derived: (1) symptoms and help-seeking behaviours before a diagnosis, (2) emotional impacts and life adaptations after a PD diagnosis, (3) life affected by medications, (4) experiences of caregivers in taking care of PD patients, and (5) communication between doctors and patients. Patients frequently adjusted their daily schedules to live with PD and the medication side effects. Caregivers struggle to overcome caring burdens and to stay positive to support patients. More attention on providing medication information, mental support, and communication between stakeholders is needed to improve the quality of life of patients and caregivers. [ABSTRACT FROM AUTHOR]

Although tumor necrosis factor inhibitors (TNFi) have favorably altered the treatment landscape for patients with axial spondyloarthritis (axSpA), there is limited data regarding TNFi persistence and reasons for discontinuation. This is an observational time-to-event study utilizing data collected for a prospective multiple-disease registry of US Veterans with axSpA treated with TNFi therapies and recruited over a 10 year period. Clinical, serological, and comorbid parameters were collected. Corporate Data Warehouse Pharmacy files provided courses of the 5 TNFi agents, and response to treatment was documented. Individual TNFi persistence was established utilizing univariate and multivariate Cox proportional models, and reasons for discontinuation were obtained by physician chart review. Two-hundred and fifty-five axSpA patients received 731 TNFi courses. A majority of patients (84.3%) had TNFi persistence at 12 months; 63.5% and 47.1% at 24 and 36 months, respectively. Compared to adalimumab, infliximab demonstrated greater persistence, certolizumab the least. Age, smoking status, BMI, comorbidity burden, inflammatory markers and HLA-B27 did not predict TNFi persistence or discontinuation. Stroke and peripheral arterial disease increased the probability of TNFi discontinuation. Secondary non-response (SNR) was the most common reason for discontinuation (46% of all courses); non-adherence (6%) and clinical remission (2%) were uncommon. Pain score at enrollment, myocardial infarction, African American race and inflammatory bowel disease (IBD) predicted TNFi response. While initial persistence of TNFi treatment was high, a large proportion of the patients discontinued initial TNFi therapy by 3 years, primarily due to loss of efficacy. While further research identifying potential predictors of TNFi discontinuation in axSpA is warranted, access to alternate disease-modifying therapies is needed. [ABSTRACT FROM AUTHOR]

This article discusses the advances in computing and communication technologies and software that have resulted in computer-based systems and applications.