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The application of digital monitoring biomarkers in health, wellness and disease management is reviewed. Harnessing the near limitless capacity of these approaches in the managed healthcare continuum will benefit from a systems-based architecture which presents data quality, quantity, and ease of capture within a decision-making dashboard.
A framework was developed which stratifies key components and advances the concept of contextualized biomarkers. The framework codifies how direct, indirect, composite, and contextualized composite data can drive innovation for the application of digital biomarkers in healthcare.
The de novo framework implies consideration of physiological, behavioral, and environmental factors in the context of biomarker capture and analysis. Application in disease and wellness is highlighted, and incorporation in clinical feedback loops and closed-loop systems is illustrated.
The study of contextualized biomarkers has the potential to offer rich and insightful data for clinical decision making. Moreover, advancement of the field will benefit from innovation at the intersection of medicine, engineering, and science. Technological developments in this dynamic field will thus fuel its logical evolution guided by inputs from patients, physicians, healthcare providers, end-payors, actuarists, medical device manufacturers, and drug companies.
We present a diagnostic glacier flowline model parameterized and constrained by new velocity data from ice-surface GPS installations and speckle tracking of TerraSAR-X satellite images, newly acquired airborne-radar data, and continental gridded datasets of topography and geothermal heat flux, in order to better understand two outlet glaciers of the East Antarctic ice sheet. Our observational data are employed as primary inputs to a modelling procedure that first calculates the basal thermal regime of each glacier, then iterates the basal sliding coefficient and deformation rate parameter until the fit of simulated to observed surface velocities is optimized. We find that the two glaciers have both frozen and thawed areas at their beds, facilitating partial sliding. Glacier flow arises from a balance between sliding and deformation that fluctuates along the length of each glacier, with the amount of sliding typically varying by up to two orders of magnitude but with deformation rates far more constant. Beardmore Glacier is warmer and faster-flowing than Skelton Glacier, but an up-glacier deepening bed at the grounding line, coupled with ice thicknesses close to flotation, lead us to infer a greater vulnerability of Skelton Glacier to grounding-line recession if affected by ocean-forced thinning and concomitant acceleration.
Hawaiian belongs to the Eastern Polynesian branch of the Austronesian language family and is indigenous to the islands of Hawaiʻi (see Pawley 1966, Marck 2000, Wilson 2012). Hawaiian is also an endangered language. Not only was the native population decimated after contact with foreigners and foreign diseases but the language itself came under attack after the occupation of the Hawaiian Kingdom in 1893 (for more on Hawaiian history, see Coffman 2009, Sai 2011). Children were thereafter banned from speaking Hawaiian at school and indeed ‘physical punishment for using it could be harsh’ (Native Hawaiian Study Commission 1983: 196). In the decades that followed, Hawaiian was gradually replaced by an English-based creole (HCE or Hawaiʻi Creole English) for practically all Hawaiʻi-born children (Bikerton & Wilson 1987, also Sakoda & Siegel 2003). By the end of the 1970s, most surviving Hawaiian speakers were over 70 years old and fewer than 50 speakers were under the age of 18 (Kawaiʻaeʻa, Housman & Alencastre 2007).
Obesity has been shown to be associated with depression and it has been suggested that higher body mass index (BMI) increases the risk of depression and other common mental disorders. However, the causal relationship remains unclear and Mendelian randomisation, a form of instrumental variable analysis, has recently been employed to attempt to resolve this issue.
To investigate whether higher BMI increases the risk of major depression.
Two instrumental variable analyses were conducted to test the causal relationship between obesity and major depression in RADIANT, a large case–control study of major depression. We used a single nucleotide polymorphism (SNP) in FTO and a genetic risk score (GRS) based on 32 SNPs with well-established associations with BMI.
Linear regression analysis, as expected, showed that individuals carrying more risk alleles of FTO or having higher score of GRS had a higher BMI. Probit regression suggested that higher BMI is associated with increased risk of major depression. However, our two instrumental variable analyses did not support a causal relationship between higher BMI and major depression (FTO genotype: coefficient −0.03, 95% CI −0.18 to 0.13, P = 0.73; GRS: coefficient −0.02, 95% CI −0.11 to 0.07, P = 0.62).
Our instrumental variable analyses did not support a causal relationship between higher BMI and major depression. The positive associations of higher BMI with major depression in probit regression analyses might be explained by reverse causality and/or residual confounding.
Depictions of race and gender stereotypes abound in various areas of Australian Aboriginal literature. This literature usually addresses the writers' responses to the injustice done to Aboriginal people by whites and the blatant racism that creeps into Australian society even today. Given the seriousness of these depictions, Aboriginal writers have seldom employed humor, making it a rather unexplored field in Aboriginal literature and criticism. Recently, though, an increasing number of Aboriginal authors have addressed issues of social injustice and racism by creating humorous situations that help readers recognize white Australians' immoral behavior. Memoirs by Kenny Laughton (Not Quite Men, No Longer Boys ), Robert Lowe (The Mish ), and Mabel Edmund (No Regrets ), novels by Mudrooroo (Doctor Wooreddy's Prescription for Enduring the Ending of the World , Doin Wildcat ), poetry by Samuel Wagan Watson (Of Muse, Meandering, and Midnight ), and plays by Kevin Gilbert (The Cherry Pickers ) and Jack Davis (No Sugar , The Dreamers ) are some of the genres in which Aboriginal authors have used humor. Leon Rappoport, a critic who writes on humor and stereotypes, praises those who address “sexual, racial, and other forbidden topics … by situating them in the context of humor, [because] the tensions that are aroused can be released as laughter” (50). Triggering an instant and natural reaction from readers, humor attracts a wide variety of audiences to Aboriginal literature because it presents the absurd and vicious nature of stereotypes, teaches lessons about the creativity of Aboriginal people, and suggests that hope and optimism characterize Aboriginal life.
What does it mean to “write of life”? And how does Aboriginal writing position itself in relation to the politics of life itself? The opening stanza to Jack Davis's poem about sixteen-year-old John Pat, brutally beaten by police in 1983, troubles the relation between the Aboriginal custom of not speaking the name of the dead and the necessary task of memorializing such trauma. One way to read the stanza is to identify the pious as a double category: the pious may be those whites who insist Davis “forget the past”; yet, paradoxically, the pious may equally refer to those voices of tradition from within the Aboriginal community that insist upon maintaining the taboo against speaking the name of the dead. John Pat's death is a tragedy, like that of so many Aboriginal victims of Australia's (post)colonial inheritance of trauma and continued structural violence and systematic dispossession. Speaking Pat's name is not only tragic because of his death in police custody, on “a concrete floor / a cell door,” but also because of Davis's necessary compulsion to continue to speak his name and thereby break a traditional taboo.
The genre of Australian Indigenous life writing has, particularly in the 1990s, proliferated into a large critical field that, mirroring the quantity, popularity, and diversity of published life stories, examines various aspects of these narratives. One of these aspects is the nature of collaboration among participants, both Indigenous and non-Indigenous, in the process of eliciting, recording, writing, editing, and publishing such accounts. A number of scholarly studies have examined the complexities of this process and noted the long and notorious history of editorial intervention in the production of mostly orally transmitted life stories, an intervention that frequently led to some degree of misrepresenting Indigenous voices and cultural values (Jacklin, “Critical,” 56). From earlier “as-told-to” autobiographies to variously negotiated and complex collaborative oral history projects integrating multiple voices, the issues of power relations, authority, authenticity, representation, accommodation, and resistance come to the surface in any attempt to examine the mechanics of producing Indigenous life writing. One may wonder about the motives for paying such close attention to the ways in which Indigenous life stories are produced. Not surprisingly, this has to do with the genre itself: it has been widely acknowledged that Indigenous life writing has become an important vehicle for retrieving previously repressed histories of colonial violence, forced assimilation, and state intervention, and, therefore, it has been identified as a site of resistance (Brewster, Reading, 2–3; Nettlebeck, 43; Grossman, 174).
When Mary Ann Hughes complained in 1998 that critics were preoccupied with the process of editorial collaboration that shaped Australian Aboriginal texts, she argued that this focus led to the neglect of the literary merit of the work. While the collaboration of mainstream writers with editors primarily went unremarked, “in the case of an Aboriginal writer, the role of the editor in constructing the work is the issue which most readily springs to the fore” (56). Hughes remarked upon the then decade-long critical determination to materialize the traditionally invisible craft of editing. This critical preoccupation ran parallel with the second wave of Aboriginal life writing (Brewster, 44), which witnessed the transformation of Aboriginal publishing from marginal to mainstream, reaching beyond the local to global audiences (Haag, 12). The exponential increase in the publication of Aboriginal life writing was accompanied by the politicization of publication processes, including coproduction, that have conventionally been kept from public view.
Sally Morgan's best-selling life narrative My Place (1987), a watershed in Australian Aboriginal publishing, also prompted critical interest in the politics of collaboration. Australian critics responded with skepticism to the mass-market appeal of this multivoiced life story, which capitalized on burgeoning interest in Aboriginal affairs fostered by the celebration of the bicentenary of white settlement in Australia. Aboriginal scholars found a “soft analysis” (Huggins and Tarrago, 143) of the colonial past that allowed for a “catharsis” of white settler guilt (Langton, 31).
Aboriginal poetry enjoyed a tremendously rapid evolution during the latter half of the twentieth century. In 1964, Oodgeroo Noonuccal published We Are Going, the first book of poetry by an Aboriginal author. Since the 1970s, poetry has been at the forefront of Aboriginal political expression. poets like Noonuccal, Kevin Gilbert, and Lionel Fogarty have used the medium to forge new possibilities for the expression of contemporary Aboriginal thought. At the beginning of the twenty-first century, established poets like Fogarty and emerging talents like Samuel Wagan Watson and Ali Cobby Eckermann are some of the most widely read and exciting poets in Australia. However, while these poets are gaining increased attention, their position within Western critical discourse remains somewhat awkward. Literary critics have seldom rigorously engaged with oral Aboriginal poetry, thereby failing to acknowledge the extensive indigenous cultural heritage of contemporary Aboriginal writers. instead, musicologists and anthropologists have been left to research oral Aboriginal poetics, but within an empirical framework that generally denudes the songpoems of their poetic qualities. Consequently, there is an enormous lacuna in Australian literary studies about the relationship of contemporary Aboriginal poetry to traditional forms of songpoetry. This relates to a larger, more willful ignorance of the relationship between the voice of the poet and the text that is printed on the page. I will argue in this essay that to separate these two modalities is to deny the importance of much of the Aboriginal poetic tradition.