Von Koch and Thue-Morse revisited

We revisit the relation between the von Koch curve and the Thue-Morse sequence given in a recent paper of Ma and Goldener by relating their study to papers written by Coquet and Dekking at the beginning of the 80s. We also emphasize that more general links between fractal objects and automatic sequences can be found in the literature.Comment: Slight changes on the first version. Accepted by "Fractals

The Relevance of Transference during Medication Management: A Case of Erotized Transference

Forces existing in psychiatry may diminish the importance of psychotherapy training as psychiatrists are increasingly given the task of medication management. Psychotherapeutic relationships can be created in medication management settings, however, and the neglect of concepts such as transference could have deleterious consequences. The authors describe the case of a man with a traumatic brain injury referred for medication management who developed an erotized transference toward his female resident-physician. This case illustrates the concept that an understanding of transference is relevant to the setting of medication managemen

Protocol for a randomized controlled trial examining multilevel prediction of response to behavioral activation and exposure-based therapy for generalized anxiety disorder.

BACKGROUND:Only 40-60% of patients with generalized anxiety disorder experience long-lasting improvement with gold standard psychosocial interventions. Identifying neurobehavioral factors that predict treatment success might provide specific targets for more individualized interventions, fostering more optimal outcomes and bringing us closer to the goal of "personalized medicine." Research suggests that reward and threat processing (approach/avoidance behavior) and cognitive control may be important for understanding anxiety and comorbid depressive disorders and may have relevance to treatment outcomes. This study was designed to determine whether approach-avoidance behaviors and associated neural responses moderate treatment response to exposure-based versus behavioral activation therapy for generalized anxiety disorder. METHODS/DESIGN:We are conducting a randomized controlled trial involving two 10-week group-based interventions: exposure-based therapy or behavioral activation therapy. These interventions focus on specific and unique aspects of threat and reward processing, respectively. Prior to and after treatment, participants are interviewed and undergo behavioral, biomarker, and neuroimaging assessments, with a focus on approach and avoidance processing and decision-making. Primary analyses will use mixed models to examine whether hypothesized approach, avoidance, and conflict arbitration behaviors and associated neural responses at baseline moderate symptom change with treatment, as assessed using the Generalized Anxiety Disorder-7 item scale. Exploratory analyses will examine additional potential treatment moderators and use data reduction and machine learning methods. DISCUSSION:This protocol provides a framework for how studies may be designed to move the field toward neuroscience-informed and personalized psychosocial treatments. The results of this trial will have implications for approach-avoidance processing in generalized anxiety disorder, relationships between levels of analysis (i.e., behavioral, neural), and predictors of behavioral therapy outcome. TRIAL REGISTRATION:The study was retrospectively registered within 21 days of first participant enrollment in accordance with FDAAA 801 with ClinicalTrials.gov, NCT02807480. Registered on June 21, 2016, before results

Blink patterns and lid-contact times in dry-eye and normal subjects

Purpose To classify blinks in dry eye and normal subjects into six subtypes, and to define the blink rate and duration within each type of blink, as well as the total lid-contact time/minute. Materials and methods This was a single-centered, prospective, double-blind study of eleven dry-eye and ten normal subjects. Predefined subjects watched a video while blinks were recorded for 10 minutes. Partial blinks were classified by percentage closure of maximal palpebral fissure opening: 25%, 50%, 75%. Complete blinks were characterized as full (>0 seconds), extended (>0.1 seconds), or superextended (>0.5 seconds). The mean duration of each type of blink was determined and standardized per minute as total lid-contact time. Results: Total blinks observed were 4,990 (1,414 normal, 3,756 dry eye): 1,809 (50.59%) partial and 1,767 (49.41%) complete blinks among dry-eye subjects versus 741 (52.90%) partial and 673 (47.60%) complete blinks among normal subjects. Only superextended blinks of ≥0.5-second duration were significantly more frequent in dry-eye subjects than normals (2.3% versus 0.2%, respectively; P=0.023). Total contact time was seven times higher in dry-eye subjects than normals (0.565 versus 0.080 seconds, respectively; P0.1 second), the average contact time (seconds) was four times longer in dry-eye versus normal subjects (2.459 in dry eye, 0.575 in normals; P=0.003). Isolating only superextended blinks (>0.5 seconds), average contact time was also significantly different (7.134 in dry eye, 1.589 in normals; P<0.001). The contact rate for all full closures was 6.4 times longer in dry-eye (0.045 versus 0.007, P<0.001) than normal subjects. Conclusion: Dry-eye subjects spent 4.5% of a minute with their eyes closed, while normal subjects spent 0.7% of a minute with their eyes closed. Contact time might play a role in the visual function decay associated with increased blink rates

Automated grading system for evaluation of ocular redness associated with dry eye

Background: We have observed that dry eye redness is characterized by a prominence of fine horizontal conjunctival vessels in the exposed ocular surface of the interpalpebral fissure, and have incorporated this feature into the grading of redness in clinical studies of dry eye. Aim To develop an automated method of grading dry eye-associated ocular redness in order to expand on the clinical grading system currently used. Methods: Ninety nine images from 26 dry eye subjects were evaluated by five graders using a 0–4 (in 0.5 increments) dry eye redness (Ora Calibra™ Dry Eye Redness Scale [OCDER]) scale. For the automated method, the Opencv computer vision library was used to develop software for calculating redness and horizontal conjunctival vessels (noted as “horizontality”). From original photograph, the region of interest (ROI) was selected manually using the open source ImageJ software. Total average redness intensity (Com-Red) was calculated as a single channel 8-bit image as R – 0.83G – 0.17B, where R, G and B were the respective intensities of the red, green and blue channels. The location of vessels was detected by normalizing the blue channel and selecting pixels with an intensity of less than 97% of the mean. The horizontal component (Com-Hor) was calculated by the first order Sobel derivative in the vertical direction and the score was calculated as the average blue channel image intensity of this vertical derivative. Pearson correlation coefficients, accuracy and concordance correlation coefficients (CCC) were calculated after regression and standardized regression of the dataset. Results: The agreement (both Pearson’s and CCC) among investigators using the OCDER scale was 0.67, while the agreement of investigator to computer was 0.76. A multiple regression using both redness and horizontality improved the agreement CCC from 0.66 and 0.69 to 0.76, demonstrating the contribution of vessel geometry to the overall grade. Computer analysis of a given image has 100% repeatability and zero variability from session to session. Conclusion: This objective means of grading ocular redness in a unified fashion has potential significance as a new clinical endpoint. In comparisons between computer and investigator, computer grading proved to be more reliable than another investigator using the OCDER scale. The best fitting model based on the present sample, and usable for future studies, was C4=−12.24+2.12C2HOR+0.88C2RED:C4 is the predicted investigator grade, and C2HOR and C2RED are logarithmic transformations of the computer calculated parameters COM-Hor and COM-Red. Considering the superior repeatability, computer automated grading might be preferable to investigator grading in multicentered dry eye studies in which the subtle differences in redness incurred by treatment have been historically difficult to define

Blink patterns and lid-contact times in dry-eye and normal subjects

Purpose To classify blinks in dry eye and normal subjects into six subtypes, and to define the blink rate and duration within each type of blink, as well as the total lid-contact time/minute. Materials and methods This was a single-centered, prospective, double-blind study of eleven dry-eye and ten normal subjects. Predefined subjects watched a video while blinks were recorded for 10 minutes. Partial blinks were classified by percentage closure of maximal palpebral fissure opening: 25%, 50%, 75%. Complete blinks were characterized as full (>0 seconds), extended (>0.1 seconds), or superextended (>0.5 seconds). The mean duration of each type of blink was determined and standardized per minute as total lid-contact time. Results: Total blinks observed were 4,990 (1,414 normal, 3,756 dry eye): 1,809 (50.59%) partial and 1,767 (49.41%) complete blinks among dry-eye subjects versus 741 (52.90%) partial and 673 (47.60%) complete blinks among normal subjects. Only superextended blinks of ≥0.5-second duration were significantly more frequent in dry-eye subjects than normals (2.3% versus 0.2%, respectively; P=0.023). Total contact time was seven times higher in dry-eye subjects than normals (0.565 versus 0.080 seconds, respectively; P0.1 second), the average contact time (seconds) was four times longer in dry-eye versus normal subjects (2.459 in dry eye, 0.575 in normals; P=0.003). Isolating only superextended blinks (>0.5 seconds), average contact time was also significantly different (7.134 in dry eye, 1.589 in normals; P<0.001). The contact rate for all full closures was 6.4 times longer in dry-eye (0.045 versus 0.007, P<0.001) than normal subjects. Conclusion: Dry-eye subjects spent 4.5% of a minute with their eyes closed, while normal subjects spent 0.7% of a minute with their eyes closed. Contact time might play a role in the visual function decay associated with increased blink rates

Exacerbation of signs and symptoms of allergic conjunctivitis by a controlled adverse environment challenge in subjects with a history of dry eye and ocular allergy

Background: The goal of this study was to assess the effect of a controlled adverse environment (CAE) challenge on subjects with both allergic conjunctivitis and dry eye. Methods: Thirty-three subjects were screened and 17 completed this institutional review board-approved study. Subjects underwent baseline ocular assessments and conjunctival allergen challenge (CAC) on days 0 and 3. Those who met the ocular redness and itching criteria were randomized to receive either the controlled adverse environment (CAE) challenge (group A, n = 9) or no challenge (group B, n = 8) at day 6. Thirty minutes after CAE/no-CAE, subjects were challenged with allergen and their signs and symptoms graded. Exploratory confocal microscopy was carried out in a subset of subjects at hourly intervals for 5 hours post-CAC on days 3 and 6. Results: Seven minutes post-CAC, subjects exposed to the CAE had significantly greater itching (difference between groups, 0.55 ± 0.25, P = 0.028), conjunctival redness (0.59 ± 0.19, P = 0.002), episcleral redness (0.56 ± 0.19, P = 0.003) and mean overall redness (mean of conjunctival, episcleral, and ciliary redness, 0.59 ± 0.14, P < 0.001). The mean score at 7, 15, and 20 minutes post-CAC for conjunctival redness (0.43 ± 0.17, P = 0.012), episcleral redness (0.49 ± 0.15, P = 0.001), mean overall redness in all regions (0.43 ± 0.15, P = 0.005), and mean chemosis (0.20 ± 0.08, P = 0.017) were also all significantly greater in CAE-treated subjects. Confocal microscopic images of conjunctival vessels after CAC showed more inflammation in CAE-treated subjects. Conclusion: In subjects with both dry eye and allergic conjunctivitis, exposure to adverse environmental conditions causes an ocular surface perturbation that can intensify allergic reactions

Recycling bins, garbage cans or think tanks? Three myths regarding policy analysis institutes

The phrase 'think tank' has become ubiquitous – overworked and underspecified – in the political lexicon. It is entrenched in scholarly discussions of public policy as well as in the 'policy wonk' of journalists, lobbyists and spin-doctors. This does not mean that there is an agreed definition of think tank or consensual understanding of their roles and functions. Nevertheless, the majority of organizations with this label undertake policy research of some kind. The idea of think tanks as a research communication 'bridge' presupposes that there are discernible boundaries between (social) science and policy. This paper will investigate some of these boundaries. The frontiers are not only organizational and legal; they also exist in how the 'public interest' is conceived by these bodies and their financiers. Moreover, the social interactions and exchanges involved in 'bridging', themselves muddy the conception of 'boundary', allowing for analysis to go beyond the dualism imposed in seeing science on one side of the bridge, and the state on the other, to address the complex relations between experts and public policy

Towards the integration of functions, relations and types in an AI programming language

This paper describes the design and implementation of the programming language PC-Life. This language integrates the functional and the Logic-oriented programming style and feature types supporting inheritance. This combination yields a language particularly suited to knowledge representation, especially for application in computational linguistics

Evidence of the validity and accuracy of the Brazilian social attitude of students scale towards politics

Objetivou-se apresentar as evidências de validade e confiabilidade de uma escala brasileira para medir atitudes políticas de estudantes brasileiros de nível superior ante seus comportamentos políticos. O estudo teve uma amostra de abrangência nacional (N = 445), com estudantes brasileiros oriundos de distintos estados. Os resultados indicaram uma estrutura empírica sustentável (teste de Kaiser-Meyer-Olkin - KMO = 0,81), com indicadores psicométricos considerados adequados à mensuração das atitudes políticas. Três fatores empíricos foram identificados: grau de conhecimento sobre política (15 itens, cargas fatoriais entre 0,31 e 0,82, alfa = 0,82, eigenvalue = 5,07 e variância explicada = 18,78 %), afetos relativos à política (7 itens, cargas fatoriais entre 0,41 e 0,58, alfa = 0,72, eigenvalue = 3,17 e variância explicada = 11,73 %) e intenções de comportamento político (2 itens, cargas fatoriais entre 0,70 e 0,72, alfa = 0,80, eigenvalue = 1,8 e variância explicada = 6,8 %). Conclui-se que os resultados fortalecem a estrutura fatorial original da escala e mostram sua utilidade para a identificação de atitudes sociais ante comportamentos políticos.El objetivo de la presente investigación fue presentar las pruebas de confiabilidad y validez de una escala brasileña para medir las actitudes políticas de los estudiantes universitarios brasileños ante su comportamiento político. El estudio contó con una muestra nacional (N = 445) de estudiantes brasileños de diferentes Estados. Los resultados indicaron una estructura empírica sustentable (KMO = .81), con indicadores psicométricos que se consideran adecuados para la medición de las actitudes políticas. Específicamente, se identificaron tres factores empíricos: nivel de conocimiento sobre la política (15 ítems, cargas factoriales entre .31 y .82, alfa = .82, eigenvalue = 5.07 y varianza explicada = 18.78 %), sentimientos acerca de la política (7 ítems, factoriales de .41 y .58, alfa = .72, eigenvalue = 3.17 y varianza explicada = 11.73 °/o) e intenciones del comportamiento político (2 ítems, factoriales de .70 y .72, alfa = .80, eigenvalue = 1.8 y varianza explicada = 6.8 %). Se llegó a la conclusión de que los resultados apoyan la estructura factorial original de la escala y muestran su utilidad en la identificación de las actitudes sociales ante la conducta política.The objective of this study was to present the validity and reliability evidences of a Brazilian scale to measure the political attitudes of Brazilian higher education students regarding their political behavior. The study had a nationwide sample (N = 445), with Brazilian students from different states. The results indicated a sustainable empirical structure (KMO = 0.81), with psychometric indicators considered adequate to the measurement of political attitudes. Three empirical factors were identified: degree of political knowledge (15 items, factorial loads between 0.31 and 0.82, alpha = 0.82, eigenvalue = 5.07 and explained variance = 18.78%), feelings about politics (7 items, factorial loads between 0.41 and 0.58, alpha = 0.72, eigenvalue = 3.17 and explained variance = 11.73%) and intentions of political behavior (2 items, factorial loads between 0, 70 and 0.72, alpha = 0.80, eigenvalue = 1.8 and explained variance = 6.8%). It is concluded that the results strengthen the original factorial structure of the scale and show its utility for the identification of social attitudes regarding political behaviors