Prognosis following acute coronary syndromes according to prior coronary artery bypass grafting: Meta-analysis

PURPOSE: Conduct a meta-analysis to study the prognostic influence of a previous coronary artery bypass grafting (CABG) in patients admitted for an acute coronary syndrome (ACS). METHODS: A systematic review of the literature was performed using electronic reference databases through January 2013 (MEDLINE, Cochrane Library, Web of Knowledge, Google Scholar and references cited in other studies). Studies in which ACS outcomes with a previous history of CABG were compared with ACS outcomes with no history of previous CABG were considered for inclusion. The main endpoints of interest were mortality and non-fatal acute myocardial infarction. Data was aggregated at three follow-up times using random-effects meta-analysis models. RESULTS: Twenty-four studies were included which provided 387,181 patients for analysis. Previous CABG ACS patients were older, more diabetic and had a more frequent history of a previous myocardial infarction. Pooled in-hospital mortality was higher for the previous CABG ACS patients (OR 1.22 [1.04-1.44], p<0.01, I(2) 88%). The pooled adjusted OR showed no significant differences for the two groups (adjusted OR 1.13 [0.93-1.37], p=0.22, I(2) 92%). Previous CABG ACS patient had a higher pooled 30-day mortality (OR 1.28 [1.05-1.55], p=0.02, I(2) 74%); a higher non-adjusted (OR 1.61 [1.38-1.88], p<0.01, I(2) 70%) and adjusted (adjusted OR 1.37 [1.15-1.65], p<0.01, I(2) 0%) long-term mortality. Both the in-hospital and the long-term re-infarction rates were higher for the previous CABG ACS patients. CONCLUSIONS: According to our data, ACS patients with previous CABG history had a higher risk for short- and long-term adverse events.

Os paradoxos de Prior e o calculo proposicional deôntico relevante E¹.

Cruz, Ângela Maria Paiva. Os paradoxos de Prior e o cálculo proposicional deôntico relevante. Princípios, Natal, v. 4, p. 05-18, 1996.

Cultural and Social Cognitive Predictors of Academic Satisfaction in Southeast Asian American College Students

This study examined the predictive utility of Lent’s (2004) social cognitive model of well-being in the context of academic satisfaction with a sample of Southeast Asian American college students using a cross-sectional design. Path analysis was used to examine the role of perceived parental trauma, perceived parental acculturative stress, intergenerational family conflict, and social cognitive predictors to academic satisfaction. Participants were 111 Southeast Asian American and 111 East Asian American college students who completed online measures. Contrary to expectations, none of the contextual cultural variables were significant predictors of academic satisfaction. Also contrary to expectations, academic support and self-efficacy were not directly linked to academic satisfaction and outcome expectation was not linked to goal progress. Other social cognitive predictors were related directly and indirectly to academic satisfaction, consistent with prior research. Limitations and implications for future research and practice are addressed.

Organizational responses to technological discontinuities: the case of the American College of Radiology (ACR)

A long history of organizational research has shown that organizations are affected significantly by changes in technology. Scholars have given particular attention to the effects of so-called disruptive or discontinuous technological changes. Studies have repeatedly shown that established, incumbent organizations tend to suffer deep performance declines (and even complete demise) in the face of such changes, and researchers have devoted much attention to identifying the organizational conditions and processes that are responsible for this persistent and widespread pattern of adaptation failure. This dissertation, which examines the response of the American College of Radiology (ACR) to the emergence of nuclear magnetic resonance imaging technology (NMR), aims to contribute to this well-established research tradition in three distinct and important ways. First, it focuses on a fundamentally different type of organization, a professional association, rather than the technology producers examined in most prior research. Although technologies are well known to be embedded in “communities” that include technology producers, suppliers, customers, governmental entities, professional societies, and other entities, most prior research has focused on the responses and ultimate fate of producers alone. Little if any research has explored the responses of professional organizations in particular. Second, the study employs a sophisticated process methodology that identifies the individual events that make up the organization’s response to technological change, as well as the overall sequence through which these events unfold. This process approach contrasts sharply with the variance models used in most previous studies and offers the promise of developing knowledge about how adaptation ultimately unfolds (or fails to). Finally, the project also contributes significantly through its exploration of an apparently successful case of adaptation to technological change. Though nuclear magnetic resonance imaging posed a serious threat to the ACR and its members, this threat appears to have been successfully managed and overcome. Although the unique nature of the organization and the technology under study place some important limits on the generalizablity of this research, its findings nonetheless provide some important basic insights about the process through which social organizations can successfully adapt to discontinuous technological changes. These insights, which may also be of substantial relevance to technology producer organizations, will also be elaborated.

Preventing encrypted traffic analysis

Many existing encrypted Internet protocols leak information through packet sizes and timing. Though seemingly innocuous, prior work has shown that such leakage can be used to recover part or all of the plaintext being encrypted. The prevalence of encrypted protocols as the underpinning of such critical services as e-commerce, remote login, and anonymity networks and the increasing feasibility of attacks on these services represent a considerable risk to communications security. Existing mechanisms for preventing traffic analysis focus on re-routing and padding. These prevention techniques have considerable resource and overhead requirements. Furthermore, padding is easily detectable and, in some cases, can introduce its own vulnerabilities. To address these shortcomings, we propose embedding real traffic in synthetically generated encrypted cover traffic. Novel to our approach is our use of realistic network protocol behavior models to generate cover traffic. The observable traffic we generate also has the benefit of being indistinguishable from other real encrypted traffic further thwarting an adversary's ability to target attacks. In this dissertation, we introduce the design of a proxy system called TrafficMimic that implements realistic cover traffic tunneling and can be used alone or integrated with the Tor anonymity system. We describe the cover traffic generation process including the subtleties of implementing a secure traffic generator. We show that TrafficMimic cover traffic can fool a complex protocol classification attack with 91% of the accuracy of real traffic. TrafficMimic cover traffic is also not detected by a binary classification attack specifically designed to detect TrafficMimic. We evaluate the performance of tunneling with independent cover traffic models and find that they are comparable, and, in some cases, more efficient than generic constant-rate defenses. We then use simulation and analytic modeling to understand the performance of cover traffic tunneling more deeply. We find that we can take measurements from real or simulated traffic with no tunneling and use them to estimate parameters for an accurate analytic model of the performance impact of cover traffic tunneling. Once validated, we use this model to better understand how delay, bandwidth, tunnel slowdown, and stability affect cover traffic tunneling. Finally, we take the insights from our simulation study and develop several biasing techniques that we can use to match the cover traffic to the real traffic while simultaneously bounding external information leakage. We study these bias methods using simulation and evaluate their security using a Bayesian inference attack. We find that we can safely improve performance with biasing while preventing both traffic analysis and defense detection attacks. We then apply these biasing methods to the real TrafficMimic implementation and evaluate it on the Internet. We find that biasing can provide 3-5x improvement in bandwidth for bulk transfers and 2.5-9.5x speedup for Web browsing over tunneling without biasing.

Reconsidering the relationship between early Gothic literature and the Greek classics: the cases of William Beckford and Matthew G. Lewis

The view that Gothic literature emerged as a reaction against the prominence of the Greek classics, and that, as a result, it bears no trace of their influence, is a commonplace in Gothic studies. This thesis re-examines this view, arguing that the Gothic and the Classical were not in opposition to one another, and that Greek tragic poetry and myth should be counted among the literary sources that inspired early Gothic writers. The discussion is organised in three parts. Part I focuses on evidence which suggests that the Gothic and the Hellenic were closely associated in the minds of several British literati both on a political and aesthetic level. As is shown, the coincidence of the Hellenic with the Gothic revival in the second half of the eighteenth century inspired them not only to trace common ground between the Greek and Gothic traditions, but also to look at Greek tragic poetry and myth through Gothic eyes, bringing to light an unruly, ‘Dionysian’ world that suited their taste. The particulars of this coincidence, which has not thus far been discussed in Gothic studies, as well as evidence which suggests that several early Gothic writers were influenced by Greek tragedy and myth, open up new avenues for research on the thematic and aesthetic heterogeneity of early Gothic literature. Parts II and III set out to explore this new ground and to support the main argument of this thesis by examining the influence of Greek tragic poetry and myth on the works of two early Gothic novelists and, in many ways, shapers of the genre, William Beckford and Matthew Gregory Lewis. Part II focuses on William Beckford’s Vathek and its indebtedness to Euripides’s Bacchae, and Part III on Matthew Gregory Lewis’s The Monk and its indebtedness to Sophocles’s Oedipus Tyrannus. As is discussed, Beckford and Lewis participated actively in both the Gothic and Hellenic revivals, producing highly imaginative works that blended material from the British and Greek literary traditions.

Energy efficiency and appliance’s characteristics considered prior to purchase: Differences and similarities between the United Kingdom, Germany, Portugal, Greece, Poland, Spain and Italy

This article reports country differences in the consumer’s most considered characteristics when choosing electrical appliances, including but not restricted to the energy efficiency aspect. A survey was performed to store customers from 7 countries: the United Kingdom; Germany; Portugal; Greece; Poland; Spain; Italy. Results showed consistency between countries in the top three characteristics considered: cost; quality; and a balance between price and quality. Differences were found for reported environmental attitudes and behaviours, purchase motives, and store employees evaluation. The results may support national policies and store level energy efficiency interventions. Specifically, they can provide input for store employee’s training, in persuading customers towards the purchase of energy efficient appliances.

Two-dimensional Stokes flow driven by elliptical paddles

A fast and accurate numerical technique is developed for solving the biharmonic equation in a multiply connected domain, in two dimensions. We apply the technique to the computation of slow viscous flow (Stokes flow) driven by multiple stirring rods. Previously, the technique has been restricted to stirring rods of circular cross section; we show here how the prior method fails for noncircular rods and how it may be adapted to accommodate general rod cross sections, provided only that for each there exists a conformal mapping to a circle. Corresponding simulations of the flow are described, and their stirring properties and energy requirements are discussed briefly. In particular the method allows an accurate calculation of the flow when flat paddles are used to stir a fluid chaotically.

Bayesian analysis of a mastitis control plan to investigate the influence of veterinary prior beliefs on clinical interpretation

The fundamental objective for health research is to determine whether changes should be made to clinical decisions. Decisions made by veterinary surgeons in the light of new research evidence are known to be influenced by their prior beliefs, especially their initial opinions about the plausibility of possible results. In this paper, clinical trial results for a bovine mastitis control plan were evaluated within a Bayesian context, to incorporate a community of prior distributions that represented a spectrum of clinical prior beliefs. The aim was to quantify the effect of veterinary surgeons’ initial viewpoints on the interpretation of the trial results. A Bayesian analysis was conducted using Markov chain Monte Carlo procedures. Stochastic models included a financial cost attributed to a change in clinical mastitis following implementation of the control plan. Prior distributions were incorporated that covered a realistic range of possible clinical viewpoints, including scepticism, enthusiasm and uncertainty. Posterior distributions revealed important differences in the financial gain that clinicians with different starting viewpoints would anticipate from the mastitis control plan, given the actual research results. For example, a severe sceptic would ascribe a probability of 0.50 for a return of <£5 per cow in an average herd that implemented the plan, whereas an enthusiast would ascribe this probability for a return of >£20 per cow. Simulations using increased trial sizes indicated that if the original study was four times as large, an initial sceptic would be more convinced about the efficacy of the control plan but would still anticipate less financial return than an initial enthusiast would anticipate after the original study. In conclusion, it is possible to estimate how clinicians’ prior beliefs influence their interpretation of research evidence. Further research on the extent to which different interpretations of evidence result in changes to clinical practice would be worthwhile.