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What drives some Islamists to become “Muslim Democrats,” downplaying religion and accepting secular democracy? This article hypothesizes that one channel of ideological change is migration to secular democracies. Drawing on an ideal point analysis of parliamentary votes from the Tunisian Islamist movement Ennahda, I find that MPs who had lived in secular democracies held more liberal voting records than their counterparts who had lived only in Tunisia. In particular, they were more likely to defend freedom of conscience and to vote against enshrining Islamic law in the constitution. Interviews with several of these MPs demonstrate that they recognize a causal effect of their experiences abroad on their ideologies, and provide support for three distinct mechanisms by which this effect may have occurred: socialization, intergroup contact, and political learning.
This chapter reviews what is known about the fate of carbon during early differentiation of inner solar system planets. It reviews the nature of carbon fractionation in a magma ocean as compared to the core, mantle, and atmosphere, and how this may have varied between planetary bodies in the solar system. It discusses whether magma ocean processes could have established the present-day budget of carbon in Earth’s bulk silicate, and also reviews possibilities for the early temporal evolution of the mantle carbon budget through core formation, later veneer addition, and magma ocean crystallization processes.
Background: Migraine is a common disorder most typically presenting as headache and often associated with vertigo and motion sickness. It is a genetically complex condition with multiple genes ultimately contributing to the predisposition and development of this episodic neurological disorder. We identified a large American family of 29 individuals of which 17 members suffered from at least one of these disorders, migraine, vertigo, or motion sickness. Many of these individuals suffered from several simultaneously. We hypothesized that vertigo and motion sickness may involve genes that are independent to those directly contributing to migraine susceptibility. Methods: Genome-wide linkage analysis performed using 400 microsatellite repeat markers spaced at 10 cM throughout the genome. The members of this family were phenotyped for each condition, migraine, vertigo, and motion sickness and analyzed separately. Statistical analysis was performed using two-point and multipoint linkage analysis employing a number of models including autosomal recessive or dominant patterns of inheritance with high and low genetic penetrance. Results: We identified a novel locus for migraine, 9q13-q22 (maximum two-point logarithm of odds [LOD] score-2.51). In addition, there are suggestive LOD scores that localize to different chromosomes for each phenotype; vertigo (chromosome 18, LOD score of 1.82) and motion sickness (chromosome 4, LOD score of 2.09). Conclusions: Our analysis supports our hypothesis that the migraine-associated vertigo and motion sickness may involve distinct susceptibility genes.
To characterize the association of longitudinal changes in maternal anthropometric measures with neonatal anthropometry and to assess to what extent late-gestational changes in maternal anthropometry are associated with neonatal body composition.
In a prospective cohort of pregnant women, maternal anthropometry was measured at six study visits across pregnancy and after birth, neonates were measured and fat and lean mass calculated. We estimated maternal anthropometric trajectories and separately assessed rate of change in the second (15–28 weeks) and third trimester (28–39 weeks) in relation to neonatal anthropometry. We investigated the extent to which tertiles of third-trimester maternal anthropometry change were associated with neonatal outcomes.
Women were recruited from twelve US sites (2009–2013).
Non-obese women with singleton pregnancies (n 2334).
A higher rate of increase in gestational weight gain was associated with larger-birth-weight infants with greater lean and fat mass. In contrast, higher rates of increase in maternal anthropometry measures were not associated with infant birth weight but were associated with decreased neonatal lean mass. In the third trimester, women in the tertile of lowest change in triceps skinfold (−0·57 to −0·06 mm per week) had neonates with 35·8 g more lean mass than neonates of mothers in the middle tertile of rate of change (−0·05 to 0·06 mm per week).
The rate of change in third-trimester maternal anthropometry measures may be related to neonatal lean and fat mass yet have a negligible impact on infant birth weight, indicating that neonatal anthropometry may provide additional information over birth weight alone.
Cyber Operational Risk: Cyber risk is routinely cited as one of the most important sources of operational risks facing organisations today, in various publications and surveys. Further, in recent years, cyber risk has entered the public conscience through highly publicised events involving affected UK organisations such as TalkTalk, Morrisons and the NHS. Regulators and legislators are increasing their focus on this topic, with General Data Protection Regulation (“GDPR”) a notable example of this. Risk actuaries and other risk management professionals at insurance companies therefore need to have a robust assessment of the potential losses stemming from cyber risk that their organisations may face. They should be able to do this as part of an overall risk management framework and be able to demonstrate this to stakeholders such as regulators and shareholders. Given that cyber risks are still very much new territory for insurers and there is no commonly accepted practice, this paper describes a proposed framework in which to perform such an assessment. As part of this, we leverage two existing frameworks – the Chief Risk Officer (“CRO”) Forum cyber incident taxonomy, and the National Institute of Standards and Technology (“NIST”) framework – to describe the taxonomy of a cyber incident, and the relevant cyber security and risk mitigation items for the incident in question, respectively.Summary of Results: Three detailed scenarios have been investigated by the working party:
∙Employee leaks data at a general (non-life) insurer: Internal attack through social engineering, causing large compensation costs and regulatory fines, driving a 1 in 200 loss of £210.5m (c. 2% of annual revenue).
∙Cyber extortion at a life insurer: External attack through social engineering, causing large business interruption and reputational damage, driving a 1 in 200 loss of £179.5m (c. 6% of annual revenue).
∙Motor insurer telematics device hack: External attack through software vulnerabilities, causing large remediation / device replacement costs, driving a 1 in 200 loss of £70.0m (c. 18% of annual revenue).
Limitations: The following sets out key limitations of the work set out in this paper:
∙While the presented scenarios are deemed material at this point in time, the threat landscape moves fast and could render specific narratives and calibrations obsolete within a short-time frame.
∙There is a lack of historical data to base certain scenarios on and therefore a high level of subjectivity is used to calibrate them.
∙No attempt has been made to make an allowance for seasonality of renewals (a cyber event coinciding with peak renewal season could exacerbate cost impacts)
∙No consideration has been given to the impact of the event on the share price of the company.
∙Correlation with other risk types has not been explicitly considered.
Conclusions: Cyber risk is a very real threat and should not be ignored or treated lightly in operational risk frameworks, as it has the potential to threaten the ongoing viability of an organisation. Risk managers and capital actuaries should be aware of the various sources of cyber risk and the potential impacts to ensure that the business is sufficiently prepared for such an event. When it comes to quantifying the impact of cyber risk on the operations of an insurer there are significant challenges. Not least that the threat landscape is ever changing and there is a lack of historical experience to base assumptions off. Given this uncertainty, this paper sets out a framework upon which readers can bring consistency to the way scenarios are developed over time. It provides a common taxonomy to ensure that key aspects of cyber risk are considered and sets out examples of how to implement the framework. It is critical that insurers endeavour to understand cyber risk better and look to refine assumptions over time as new information is received. In addition to ensuring that sufficient capital is being held for key operational risks, the investment in understanding cyber risk now will help to educate senior management and could have benefits through influencing internal cyber security capabilities.
This paper presents latest thinking from the Institute and Faculty of Actuaries’ Model Risk Working Party and follows on from their Phase I work, Model Risk: Daring to Open the Black Box. This is a more practical paper and presents the contributors’ experiences of model risk gained from a wide range of financial and non-financial organisations with suggestions for good practice and proven methods to reduce model risk. After a recap of the Phase I work, examples of model risk communication are given covering communication: to the Board; to the regulator; and to external stakeholders. We present a practical framework for model risk management and quantification with examples of the key actors, processes and cultural challenge. Lessons learned are then presented from other industries that make extensive use of models and include the weather forecasting, software and aerospace industries. Finally, a series of case studies in practical model risk management and mitigation are presented from the contributors’ own experiences covering primarily financial services.
Vertigo is common in the emergency department (ED). Most aetiologies are peripheral and do not require hospitalization, but many patients still fear falling. Some patients may be taking opioid analgesic medications (for other reasons); the risk of falls leading to fractures among patients with vertigo could be potentiated by the simultaneous use of opioids.
To examine the risk of fractures in discharged ED patients with peripheral vertigo who were being prescribed opioids during the same time period.
Linked administrative databases from Ontario were used to compare discharged ED patients aged ≥65 with peripheral vertigo to patients with urinary tract infection (UTI) from 2006 to 2011. We used Cox regression analysis with an interaction term to estimate the modifying effect of an opioid prescription on the hazard of fracture within 90 days.
There were 13,012 patients with a peripheral vertigo syndrome and 76,885 with a UTI. Thirteen percent of the vertigo cohort and 25% of the UTI cohort had access to a filled opioid prescription. Compared to vertigo patients who did not fill an opioid prescription, the adjusted hazard of fracture among vertigo patients who did fill a prescription was 3.59 (95% CI 1.97–6.13). Among UTI patients who filled an opioid prescription the hazard ratio was 1.68 (95% CI 1.43–1.97) compared to UTI patients who did not.
Patients discharged from the ED with peripheral vertigo who were also being prescribed opioids had a higher hazard of subsequent fracture compared to those who were not, and the effect was much greater than among UTI patients. These results suggest that in the acutely vertiginous older patient, opioid analgesic medications should be modified, where possible.
To examine breast-feeding and complementary feeding practices during the first 6 months of life among Norwegian infants of Somali and Iraqi family origin.
A cross-sectional survey was performed during March 2013–February 2014. Data were collected using a semi-quantitative FFQ adapted from the second Norwegian national dietary survey among infants in 2006–2007.
Somali-born and Iraqi-born mothers living in eastern Norway were invited to participate.
One hundred and seven mothers/infants of Somali origin and eighty mothers/infants of Iraqi origin participated.
Breast-feeding was almost universally initiated after birth. Only 7 % of Norwegian-Somali and 10 % of Norwegian-Iraqi infants were exclusively breast-fed at 4 months of age. By 1 month of age, water had been introduced to 30 % of Norwegian-Somali and 26 % of Norwegian-Iraqi infants, and infant formula to 44 % and 34 %, respectively. Fifty-four per cent of Norwegian-Somali and 68 % of Norwegian-Iraqi infants had been introduced to solid or semi-solid foods at 4 months of age. Breast-feeding at 6 months of age was more common among Norwegian-Somali infants (79 %) compared with Norwegian-Iraqi infants (58 %; P=0·001). Multivariate analyses indicated no significant factors associated with exclusive breast-feeding at 3·5 months of age. Factors positively associated with breast-feeding at 6 months were country of origin (Somalia) and parity (>2).
Breast-feeding initiation was common among Iraqi-born and Somali-born mothers, but the exclusive breast-feeding period was shorter than recommended in both groups. The study suggests that there is a need for new culture-specific approaches to support exclusive breast-feeding and complementary feeding practices among foreign-born mothers living in Norway.
This article examines the memoirs of Indian Civil Service officers as they continued to work in what became the Indian Administrative Service after independence. Rather than being understood solely as historical archives, these texts constitute a genre that can be called the ‘bureaucratic memoir’ which reveals masculinities that are both colonial and post-colonial. These memoirs, and their publication decades after independence reveal attempts by elites to preserve the power of the bureaucracy into subsequent decades. The texts hope to disavow but instead also reveal the patriarchal intimacies of these elites, even as these were challenged by charges of corruption and failure which emerged almost from the first moments of independence.
Recent scholarship finds that new democracies are more likely than established democracies to make binding commitments to international human rights institutions. Are new democracies also better at following through on these commitments? Stated differently, does their greater willingness to join international institutions reflect a genuine commitment to human rights reform or is it just “cheap talk?” We analyze this question using a new data set of more than 1,000 leading European Court of Human Rights (ECtHR) cases. Since new democracies face judgments that are more difficult to implement than established democracies, we employ a genetic matching algorithm to balance the data set. After controlling for bureaucratic and judicial capacity, we find that new democracies do implement similar ECtHR judgments initially more quickly than established democracies, but this effect reverses the longer a judgment remains pending. Although new democracies have incentives to implement judgments quickly, they sometimes lack checks and balances that help ensure implementation should an executive resist.
This study aimed to compare the outcomes of two frequently employed interventions for the management of tinnitus: tinnitus retraining therapy and cognitive behavioural therapy.
A systematic review of literature published up to and including February 2013 was performed. Only randomised control trials and studies involving only human participants were included.
Nine high-quality studies evaluating the efficacy of tinnitus retraining therapy and cognitive behavioural therapy were identified. Of these, eight assessed cognitive behavioural therapy relative to a no-treatment control and one compared tinnitus retraining therapy to tinnitus masking therapy. Each study used a variety of standardised and validated questionnaires. Outcome measures were heterogeneous, but both therapies resulted in significant improvements in quality of life scores. Depression scores improved with cognitive behavioural therapy.
Both cognitive behavioural therapy and tinnitus retraining therapy are effective for tinnitus, with neither therapy being demonstrably superior. Further research using standardised, validated questionnaires is needed so that objective comparisons can be made.
The liquid impingement erosion behavior of a zirconium-based bulk metallic glass (BMG), Zr44Ti11Cu10Ni10Be25, was evaluated in this study. For comparison, commonly used hydroturbine steel was evaluated under the same test conditions. BMG demonstrated more than four times higher resistance against cavitation erosion compared with hydroturbine steel. The unusually high erosion resistance for BMG is attributed to its uniform amorphous structure with no grain boundaries, higher hardness, and ability to accommodate strain through localized shear bands.
Head and neck squamous cell carcinoma (HNSCC) is the sixth most common cancer worldwide. In the USA it accounts for approximately 2% of all cancers and 2% of cancer-related deaths. Nevertheless, HNSCC is an important topic in oncologic imaging, because imaging findings can aid significantly in the detection, staging, and treatment evaluation of these tumors. Patients presenting with primary tumors that are confined at the time of initial diagnosis (T1/2N0M0) have an excellent cure rate. Unfortunately, at the time of initial diagnosis many patients already have regional nodal metastases (45%) or even distant metastases (10%). Also noteworthy is the approximately 5% annual rate of second primaries in HNSCC patients, mostly occurring in the upper aerodigestive tract. The most appropriate treatment approach for HNSCC varies with the disease stage and disease site in the head and neck. Concurrent chemoradiotherapy has become a widely used means for the definitive treatment of locoregionally advanced HNSCC.
Probably 98% of PET studies in patients with head and neck cancer are performed using FDG as the radiotracer. The widespread clinical introduction of FDG-PET/CT in the work-up of patients with HNSCC has improved staging accuracy and patient management (1). Today, essentially all patients are examined on combined PET/CT scanners. Studies have shown that combined PET/CT improves the detection of focal FDG uptake in the head and neck and its clear characterization as either benign or malignant. For the overall assessment of disease status, combined PET/CT is more accurate then either modality alone (2–4). This translates into improved patient care (2, 5). The clinical indications of PET/CT in head and neck cancer include: the detection of an unknown primary tumor in patients presenting with neck node metastases; tumor staging (lymph nodes, distant disease); radiotherapy planning; treatment response assessment, usually after concurrent chemoradiotherapy, and sometimes also in patients with advanced disease treated with targeted therapies; and the detection of recurrent disease.
We report an experimental investigation on employing Ag nanoparticles to provide electrical and mechanical contacts between transfer-printed semiconductor devices in the shape of micro/nano- wires and pillars. The Ag nanoparticles have diameters ranging between 200-800nm and are assembled on a 200nm Au film deposited on glass substrates. With a customized tool, an ensemble of silicon pillars were brought into contact with the silver (Ag) nanoparticles (AgNPs) by precisely controlling the displacement and applied force (pressure). Current-voltage measurements were done at force resolution of ~0.2N. The test method aims to illuminate the pillar-particle contact mechanism using the nanoparticles as conductive fillers for the next generation of high performance heteroepitaxial device transfer-printing applications.
Undernutrition is common among smear-positive pulmonary tuberculosis (PTB+) patients. Micronutrient supplementation may improve treatment outcomes, but it is unclear whether additional energy–protein would be beneficial. The present study aimed to assess the effect of energy–protein supplementation on weight, body composition and handgrip strength against a background of high micronutrient intake during tuberculosis (TB) treatment. A total of 377 PTB+ patients co-infected with HIV were randomly allocated one or six biscuits daily for 60 d during TB treatment. Weight, arm fat area, arm muscle area and handgrip strength were assessed at baseline and 2 and 5 months. There were no effects on any outcome at 2 months, but energy–protein supplementation was associated with a 1·3 (95 % CI − 0·1, 2·8) kg marginally significant gain in handgrip strength at 5 months. However, after 2 months, energy–protein supplementation led to a weight gain of 1·9 (95 % CI 0·1, 3·7) kg among patients with cluster of differentiation 4 (CD4) counts ≥ 350 cells/μl, but not among patients with low CD4 counts ( − 0·2 kg; 95 % CI − 1·3, 0·8, Pinteraction = 0·03). Similarly, at 5 months, energy–protein supplementation led to a 2·3 (95 % CI 0·6, 4·1) kg higher handgrip strength gain among patients with CD4 counts < 350 cells/μl, but not in those with high CD4 counts (Pinteraction = 0·04). In conclusion, energy–protein supplementation to PTB+ HIV-co-infected patients had no overall effects on weight and body composition, but was associated with marginally significant gain in handgrip strength. More research is needed to develop an effective supplement, before it is recommended to TB programmes.