650 research outputs found
Multi-Layer Cyber-Physical Security and Resilience for Smart Grid
The smart grid is a large-scale complex system that integrates communication
technologies with the physical layer operation of the energy systems. Security
and resilience mechanisms by design are important to provide guarantee
operations for the system. This chapter provides a layered perspective of the
smart grid security and discusses game and decision theory as a tool to model
the interactions among system components and the interaction between attackers
and the system. We discuss game-theoretic applications and challenges in the
design of cross-layer robust and resilient controller, secure network routing
protocol at the data communication and networking layers, and the challenges of
the information security at the management layer of the grid. The chapter will
discuss the future directions of using game-theoretic tools in addressing
multi-layer security issues in the smart grid.Comment: 16 page
The Transformation of Residency Recruitment in the era of COVID-19: Optimizing Residency Recruitment for Lehigh Valley Health Network
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A Rescorla-Wagner Drift-Diffusion Model of Conditioning and Timing
Computational models of classical conditioning have made significant contributions to the theoretic understanding of associative learning, yet they still struggle when the temporal aspects of conditioning are taken into account. Interval timing models have contributed a rich variety of time representations and provided accurate predictions for the timing of responses, but they usually have little to say about associative learning. In this article we present a unified model of conditioning and timing that is based on the influential Rescorla-Wagner conditioning model and the more recently developed Timing Drift-Diffusion model. We test the model by simulating 10 experimental phenomena and show that it can provide an adequate account for 8, and a partial account for the other 2. We argue that the model can account for more phenomena in the chosen set than these other similar in scope models: CSC-TD, MS-TD, Learning to Time and Modular Theory. A comparison and analysis of the mechanisms in these models is provided, with a focus on the types of time representation and associative learning rule used
Initiation of Medication-Assisted Treatment at a Resident Clinic Site Transitioning to a Federally Qualified Health Center
Medicine is patriarchal, but alternative medicine is not the answer
Women are over-represented within alternative medicine, both as consumers and as service providers. In this paper, I show that the appeal of alternative medicine to women relates to the neglect of women’s health needs within scientific medicine. This is concerning because alternative medicine is severely limited in its therapeutic effects; therefore, those who choose alternative therapies are liable to experience inadequate healthcare. I argue that while many patients seek greater autonomy in alternative medicine, the absence of an evidence base and plausible mechanisms of action leaves patients unable to realize meaningful autonomy. This seems morally troubling, especially given that the neglect of women’s needs within scientific medicine seems to contribute to preferences for alternative medicine. I conclude that the liberatory credentials of alternative medicine should be questioned and make recommendations to render scientific medicine better able to meet the needs of typical alternative medicine consumers
Supporting dynamic change detection: using the right tool for the task
Detecting task-relevant changes in a visual scene is necessary for successfully monitoring and managing dynamic command and control situations. Change blindness—the failure to notice visual changes—is an important source of human error. Change History EXplicit (CHEX) is a tool developed to aid change detection and maintain situation awareness; and in the current study we test the generality of its ability to facilitate the detection of changes when this subtask is embedded within a broader dynamic decision-making task. A multitasking air-warfare simulation required participants to perform radar-based subtasks, for which change detection was a necessary aspect of the higher-order goal of protecting one’s own ship. In this task, however, CHEX rendered the operator even more vulnerable to attentional failures in change detection and increased perceived workload. Such support was only effective when participants performed a change detection task without concurrent subtasks. Results are interpreted in terms of the NSEEV model of attention behavior (Steelman, McCarley, & Wickens, Hum. Factors 53:142–153, 2011; J. Exp. Psychol. Appl. 19:403–419, 2013), and suggest that decision aids for use in multitasking contexts must be designed to fit within the available workload capacity of the user so that they may truly augment cognition
One-Year Follow-up Data on Improving Rates of Pediatric Developmental Screening at Family Care Center and Family Practice Center
Early detection of COVID-19 in the UK using self-reported symptoms: a large-scale, prospective, epidemiological surveillance study
Background Self-reported symptoms during the COVID-19 pandemic have been used to train artificial intelligence
models to identify possible infection foci. To date, these models have only considered the culmination or peak of
symptoms, which is not suitable for the early detection of infection. We aimed to estimate the probability of an
individual being infected with SARS-CoV-2 on the basis of early self-reported symptoms to enable timely self-isolation
and urgent testing.
Methods In this large-scale, prospective, epidemiological surveillance study, we used prospective, observational,
longitudinal, self-reported data from participants in the UK on 19 symptoms over 3 days after symptoms onset and
COVID-19 PCR test results extracted from the COVID-19 Symptom Study mobile phone app. We divided the study
population into a training set (those who reported symptoms between April 29, 2020, and Oct 15, 2020) and a test set
(those who reported symptoms between Oct 16, 2020, and Nov 30, 2020), and used three models to analyse the selfreported
symptoms: the UK’s National Health Service (NHS) algorithm, logistic regression, and the hierarchical
Gaussian process model we designed to account for several important variables (eg, specific COVID-19 symptoms,
comorbidities, and clinical information). Model performance to predict COVID-19 positivity was compared in terms
of sensitivity, specificity, and area under the receiver operating characteristic curve (AUC) in the test set. For the
hierarchical Gaussian process model, we also evaluated the relevance of symptoms in the early detection of COVID-19
in population subgroups stratified according to occupation, sex, age, and body-mass index.
Findings The training set comprised 182 991 participants and the test set comprised 15 049 participants. When trained
on 3 days of self-reported symptoms, the hierarchical Gaussian process model had a higher prediction AUC (0·80
[95% CI 0·80–0·81]) than did the logistic regression model (0·74 [0·74–0·75]) and the NHS algorithm (0·67
[0·67–0·67]). AUCs for all models increased with the number of days of self-reported symptoms, but were still high
for the hierarchical Gaussian process model at day 1 (0·73 [95% CI 0·73–0·74]) and day 2 (0·79 [0·78–0·79]). At
day 3, the hierarchical Gaussian process model also had a significantly higher sensitivity, but a non-statistically lower
specificity, than did the two other models. The hierarchical Gaussian process model also identified different sets of
relevant features to detect COVID-19 between younger and older subgroups, and between health-care workers and
non-health-care workers. When used during different pandemic periods, the model was robust to changes in
populations.
Interpretation Early detection of SARS-CoV-2 infection is feasible with our model. Such early detection is crucial to
contain the spread of COVID-19 and efficiently allocate medical resources.
Funding ZOE, the UK Government Department of Health and Social Care, the Wellcome Trust, the UK Engineering
and Physical Sciences Research Council, the UK National Institute for Health Research, the UK Medical Research
Council, the British Heart Foundation, the Alzheimer’s Society, the Chronic Disease Research Foundation, and the
Massachusetts Consortium on Pathogen Readiness
Diet and lifestyle behaviour disruption related to the pandemic was varied and bidirectional among US and UK adults participating in the ZOE COVID Study
Evidence of the impact of the COVID-19 pandemic on health behaviours in the general population is limited. In this retrospective longitudinal study including UK and US participants, we collected diet and lifestyle data pre-pandemic (896,286) and peri-pandemic (291,871) using a mobile health app, and we computed a bidirectional health behaviour disruption index. Disruption of health behaviour was higher in younger, female and socio-economically deprived participants. Loss in body weight was greater in highly disrupted individuals than in those with low disruption. There were large inter-individual changes observed in 46 health and diet behaviours measured peri-pandemic compared with pre-pandemic, but no mean change in the total population. Individuals most adherent to less healthy pre-pandemic health behaviours improved their diet quality and weight compared with those reporting healthier pre-pandemic behaviours, irrespective of relative deprivation; therefore, for a proportion of the population, the pandemic may have provided an impetus to improve health behaviours. Public policies to tackle health inequalities widened by the pandemic should continue to prioritize diet and physical activity for all, as well as more targeted approaches to support younger females and those living in economically deprived areas
Detecting COVID-19 infection hotspots in England using large-scale self-reported data from a mobile application: a prospective, observational study
BACKGROUND: As many countries seek to slow the spread of COVID-19 without reimposing national restrictions, it has become important to track the disease at a local level to identify areas in need of targeted intervention. METHODS: In this prospective, observational study, we did modelling using longitudinal, self-reported data from users of the COVID Symptom Study app in England between March 24, and Sept 29, 2020. Beginning on April 28, in England, the Department of Health and Social Care allocated RT-PCR tests for COVID-19 to app users who logged themselves as healthy at least once in 9 days and then reported any symptom. We calculated incidence of COVID-19 using the invited swab (RT-PCR) tests reported in the app, and we estimated prevalence using a symptom-based method (using logistic regression) and a method based on both symptoms and swab test results. We used incidence rates to estimate the effective reproduction number, R(t), modelling the system as a Poisson process and using Markov Chain Monte-Carlo. We used three datasets to validate our models: the Office for National Statistics (ONS) Community Infection Survey, the Real-time Assessment of Community Transmission (REACT-1) study, and UK Government testing data. We used geographically granular estimates to highlight regions with rapidly increasing case numbers, or hotspots. FINDINGS: From March 24 to Sept 29, 2020, a total of 2 873 726 users living in England signed up to use the app, of whom 2 842 732 (98·9%) provided valid age information and daily assessments. These users provided a total of 120 192 306 daily reports of their symptoms, and recorded the results of 169 682 invited swab tests. On a national level, our estimates of incidence and prevalence showed a similar sensitivity to changes to those reported in the ONS and REACT-1 studies. On Sept 28, 2020, we estimated an incidence of 15 841 (95% CI 14 023-17 885) daily cases, a prevalence of 0·53% (0·45-0·60), and R(t) of 1·17 (1·15-1·19) in England. On a geographically granular level, on Sept 28, 2020, we detected 15 (75%) of the 20 regions with highest incidence according to government test data. INTERPRETATION: Our method could help to detect rapid case increases in regions where government testing provision is lower. Self-reported data from mobile applications can provide an agile resource to inform policy makers during a quickly moving pandemic, serving as a complementary resource to more traditional instruments for disease surveillance. FUNDING: Zoe Global, UK Government Department of Health and Social Care, Wellcome Trust, UK Engineering and Physical Sciences Research Council, UK National Institute for Health Research, UK Medical Research Council and British Heart Foundation, Alzheimer's Society, Chronic Disease Research Foundation
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