Objective: Project ECHO (Extension for Community Healthcare Outcomes), a telementoring program, utilizes lectures, case-based learning, and an “all teach–all learn” approach to increase primary care provider (PCP) knowledge/confidence in managing chronic health conditions. The American Academy of Pediatrics (AAP) Epilepsy and Comorbidities ECHO incorporated quality improvement (QI) methodology to create meaningful practice change, while increasing PCP knowledge/self-efficacy in epilepsy management using the ECHO model. Methods: Monthly ECHO sessions (May 2018 to December 2018) included lectures, case presentations/discussion, and QI review. Pediatric practices were recruited through the AAP. Practices engaged in ECHO sessions and improvement activities including monthly Plan-Do-Study-Act cycles, team huddles, chart reviews, and QI coaching calls to facilitate practice change. They were provided resource toolkits with documentation templates, safety handouts, and medication side effects sheets. QI measures were selected from the American Academy of Neurology Measurement Set for Epilepsy. The AAP Quality Improvement Data Aggregator was used for data entry, run chart development, and tracking outcomes. Participants completed retrospective surveys to assess changes in knowledge and self-efficacy. Results: Seven practices participated across five states. Average session attendance was 14 health professionals (range = 13-17). A total of 479 chart reviews demonstrated improvement in six of seven measures: health care transition (45.3%, P =.005), safety education (41.6%, P =.036), mental/behavioral health screening (32.2% P =.027), tertiary center referral (26.7%, not significant [n.s.]), antiseizure therapy side effects (23%, n.s.), and documenting seizure frequency (7.1%, n.s.); counseling for women of childbearing age decreased by 7.8%. Significance: This project demonstrated that integrating QI into an ECHO model results in practice change and increases PCP knowledge/confidence/self-efficacy in managing epilepsy.

L'objectif de cette thèse est d'étudier l'idée du tatouage dans le traitement du son.Les recherches en tatouage audio se sont principalement tournées vers des applications sécuritaires ou de transmission de données auxiliaires. Une des applications visées par ce concept consiste à améliorer la qualité du signal hôte ayant subi des transformations et ceci en exploitant l'information qu'il véhicule. Le tatouage audio est donc considéré comme mémoire porteuse d'informations sur le signal originel. La compression à bas débit des signaux audio est une des applications visée par ce concept. Dans ce cadre, deux objectifs sont proposés : la réduction du pré-écho et de l'amollissement d'attaque, deux phénomènes introduits par les codeurs audio perceptifs, en particulier les codeurs AAC et MP3; la préservation de l'harmonicité des signaux audio dégradée par les codeurs perceptifs à extension de bande, en particulier le codeur HE-AAC.La première partie de ce manuscrit présente les principes de base des systèmes de codage bas débit et étudie les différentes distorsions introduites par ces derniers. Fondées sur cette étude, deux solutions sont proposées. La première, visant principalement la réduction du pré-écho, consiste à corriger l'enveloppe temporelle du signal après réception en exploitant la connaissance a priori de l'enveloppe temporelle du signal original, supposée transmise par un canal auxiliaire à faible débit (< 500 bits/s). La seconde solution vise à corriger les ruptures d'harmonicité générées par les codeurs à extension de bande. Ce phénomène touche essentiellement les signaux fortement harmoniques (exemple : violon) et est perçu comme une dissonance. Une préservation de l'harmonicité des signaux audio par des opérations de translation spectrale est alors proposée, les paramètres étant là encore transmis par un canal auxiliaire à faible débit.La seconde partie de ce document est consacrée à l'intégration du tatouage audio dans les techniques de renforcement de la qualité des signaux audio précitées. Dans ce contexte, le tatouage audio remplace le canal auxiliaire précédent et œuvre comme une mémoire du signal originel, porteuse d'informations nécessaires pour la correction d'harmonicité et la réduction de pré-écho. Cette seconde partie a été précédée par une étape approfondie de l'évaluation des performances de la technique de tatouage adoptée en terme de robustesse à la compression MPEG (MP3, AAC et aacPlus). / The goal of this thesis is to explore the idea of watermark for sound enhancement. Classically, watermark schemes are oriented towards security applications or maximization of the transmitted bit rates. Our approach is completely different. Our goal is to study how an audio watermarking can improve the quality of the host audio signal by exploiting the information it conveys. The audio watermarking is considered as a memory that carries information about the original signal.The low bitrate compression of audio signals is one of the applications covered by this concept. In this context, two objectives are proposed: reducing the pre-echo and the attack softening, two phenomena introduced by the perceptual audio coders, particularly AAC and MP3 encoders ; preserving the harmonicity of audio signals, distorted by coders with bandwidth extension, especially HE-AAC encoder. These coders are limited in the reconstruction of the high-frequency spectrum mainly because of the potential unpredictability of the fine structure of the latter, as well as imperfect indicators of tonal to noise.The first part of this manuscript presents the basic principles of low rate coding systems and studies the various distortions introduced by the latter. Based on this study, two solutions are proposed. The first one, principally aimed at reducing the pre-echo, consist in correcting the time envelope of the signal after reception by exploiting the prior knowledge of the temporal envelope of the original signal, which is assumed transmitted by an auxiliary channel at low bitrates (<500 bps). The second solution is to correct the harmonicity generated by coders with bandwidth extension. This primarily affects strongly harmonic signals (e.g. violin) and is perceived as a dissonance. We propose then to preserve the harmonicity of audio signals by spectral translations. The parameters being passed again by an auxiliary channel at low bitrates.The second part of this document is dedicated to the integration of audio watermarking techniques in the solution presented in the first part. In this context, the audio watermarking replaces the previous auxiliary channel and is regarded as a memory of the original signal, carrying information necessary for the correction of harmonicity and the pre-echo reduction.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第20564号 / 医博第4249号 / 新制||医||1022(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 増永 慎一郎, 教授 妹尾 浩, 教授 鈴木 実 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

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Denna studie undersöker hur individer och grupper uttrycker sina åsikter om klimatförändringar i svenska nyhetsmedier och om det finns echo-chambers i klimatdiskursen. I studien användes en kritisk diskursanalys för att undersöka ett riktat urval av 13 nyhetsartiklar från svenska tidningar. Artiklarna analyserades för att förstå hur argument om klimatförändringar konstrueras, vilka argument som används för att stödja olika narrativ och hur svensk media kan påverka medborgarnas åsikter och uppfattningar om klimatförändringar. Analysen avslöjade två distinkta echo-chambers inom diskursen. Den första echo-chambern ramar in klimatförändringarna som en brådskande fråga relaterad till politisk inkompetens, globala företag och banker. Denna echo-chamber beskriver ofta ett domedagsperspektiv, vilket kan ge läsarna en känsla av hjälplöshet eller förnekelse. En andra echo-chamber visar skepsis mot antagandet att klimatförändringarna är ett resultat av antropogen verksamhet. Skepticismen grundar sig på förnekelse, brist på kunskap och politiska ideologier, vilket har hindrat ansträngningarna att ta itu med klimatförändringars effekter. Misstron mot informationskällor, inklusive media och vetenskapliga organisationer, påverkar denna grupps uppfattningar, vilket leder till skepticism mot de vetenskapliga bevisen för klimatförändringarna. Studien belyser de positiva och negativa effekterna av echo-chambers i diskurser kring komplexa ämnen, dessa understryker vikten av att bedöma tillförlitliga informationskällor (i), aktivt söka nya perspektiv (ii) och främja öppna, respektfulla dialoger för att minska polariseringen och för att effektivt ta itu med klimatkrisen (iii). Studien lyfter fram den avgörande roll som kollektiva åtgärder och kritiskt tänkande spelar för att lösa klimatkrisen, samtidigt som man erkänner de utmaningar som är förknippade med lösningarna. Vidare utforskar studien potentialen i konceptet The power of ten och mediernas roll som uppmuntrar proaktiv och konstruktiv informationsdelning. / This thesis examines how individuals and groups express their views on climate change in Swedish news media and whether there are echo chambers in the climate discourse. The study used a critical discourse analysis to examine a targeted sample of 13 news articles from Swedish newspapers. The articles were analysed to understand how arguments about climate change are constructed, which arguments are used to support different narratives, and how Swedish media coverage can influence citizens opinions and perceptions about climate change.The analysis revealed two distinct echo chambers in the discourse. The first echo-chamber framed climate change as an urgent matter related to political incompetence, global corporations, and banks. This echo-chamber often described a doomsday perspective, which can leave readers with feelings of helplessness or denial. The second echo-chamber showed scepticism towards the assumption that climate change is a result of anthropogenic activities. The scepticism is based on denial, lack of knowledge, and political ideologies, which hindered efforts to address the impacts of climate change. Mistrust in information sources, including the media and scientific organizations, influence this group's perceptions, leading to scepticism towards the scientific evidence of climate change. This study highlights the positive and negative effects of echo chambers in discourses around complex topics, these underlines the importance of assessing reliable information sources (i), actively seeking new perspectives (ii), and promoting open, respectful dialogues to reduce polarization and to effectively address the climate crisis (iii). The study highlights the crucial role that collective action and critical thinking play in solving the climate crisis, while recog-nizing the challenges associated with the solutions. Furthermore, the study explores the poten-tial of The power of ten concept and the role of the media encouraging proactive and con-structive information sharing.

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Technological advancements and affordability enable voicing of social injustice, feelings of deprivation, and oppression. Spatial barriers no longer pose obstacles to connecting with like-minded (or dissimilar) others to define and refine ingroup and outgroup. Some scholars anticipate that the internet liberates the discussion of opinions, others claim social networking platforms play a role in the polarisation of the public by creating echo chambers. However, it is recognised that ideas, ideologies, and social movements spread across the internet at an unprecedented pace. Connecting with others with whom one shares deprivation in a support network offers a sense of belonging. Broad scholarly literature addresses opinion polarisation and potential radicalisation in online social media platforms. However, quantifying radicalisation trajectories in fringe online communities like the misogynist incels are still to be done. In this thesis I study the online presence of the incel community. Incels are mostly young men who feel stigmatised and need to hide their incel existence. Incels voice their feelings of deprivation of a relationship and sex with a willing partner. This unfulfilled masculinity and sense of entitlement to sex cause frustration and anger which are vented in online forums blaming primarily women and feminism. Calls for action to social change, even for violence is common. However, incels do not unanimously consider violence a solution, many demonstrate the tame side of the so-called blackpilled mindset, the acceptance of powerlessness, and nihilism. Regardless, some scholars view the community as potentially dangerous to society, labelling them as terrorists. This study investigates whether participating registered users of the Incels.is website display increasing tendency toward expressing utterances with the themes of misogyny, harassment, nihilism, and moral outrage in their posted messages, and whether users gradually become more aligned with the general perception of incels in previous scholarly work. In other words, this work tests whether active participation increases the frequency of utterances of misogyny, harassment, and moral outrage, thus demonstrating a radicalisation tendency or increased nihilism. To answer the research question, I first scraped the Incels.is website, and retained ~5.38M posts published over 4 years for analysis. Next, a subset of posts was manually labelled to train a supervised text classification model (BERT). Finally, the results of the classification task were complemented with Ordinary Least Squares regression (n = 4623). The analyses uncover temporal user-level radicalisation trajectories, and increased nihilism. More specifically, the duration of active participation (in days) and the number of posted messages positively predict the count of moral outrage, misogynistic, harassing, and nihilistic content.

The current research project mainly aims to investigate the corrosion resistance and bond performance of steel reinforced recycled aggregate concrete incorporating nano-silica under both normal and corrosive environmental conditions. The experimental part includes testing of 180 pull-out specimens prepared from 12 different mixtures. The main parameters studied were the amount of recycled aggregate (RCA) (i.e. 0%, 25%, 50% and 100%), nano silica (1.5% and 3%), steel embedment length as well as steel bar diameter (12 and 20mm). Different levels of corrosion were electrochemically induced by applying impressed voltage technique for 2, 5, 10 and 15 days. The experimental observations mainly focused on the corrosion level in addition to the ultimate bond, failure modes and slips occurred. Experimental results showed that the bond performance between un-corroded steel and recycled aggregate concrete slightly reduced, while a significant degradation was observed after being exposed to corrosive conditions, in comparison to normal concrete. On the other hand, the use of nano silica (NS) showed a reasonable bond enhancement with both normal and RCA concretes under normal conditions. However, much better influence in terms of bond and corrosion resistance was observed under advancing levels of corrosion exposure, reflecting the improvement in corrosion resistance. Therefore, NS was superbly effective in recovering the poor performance in bond for RCA concretes. More efficiency was reported with RCA concretes compared to the conventional concrete. The bond resistance slightly with a small amount of corrosion (almost 2% weight loss), then a significant bond degradation occurs with further corrosion. The influence of specific surface area and amount of nano silica on the performance of concrete with different water/binder (w/b) ratios has been also studied, using 63 different mixtures produced with three different types of colloidal NS having various surface areas and particle sizes. The results showed that the performance of concrete is heavily influenced by changing the surface area of nano silica. Amongst the three used types of nano silica, NS with SSA of 250 m2 /g achieved the highest enhancement rate in terms of compressive strength, water absorption and microstructure analysis, followed by NS with SSA of 500 m2/g, whilst NS with SSA of 51.4 m2 /g was less advantageous for all mixtures. The optimum nano silica ratio in concrete is affected by its particle size as well as water to binder ratio. The feasibility of the impact-echo method for identifying the corrosion was evaluated and compared to the corrosion obtained by mass loss method. The results showed that the impact echo testing can be effectively used to qualitatively detect the damage caused by corrosion in reinforced concrete structures. A significant difference in the dominant frequencies response was observed after exposure to the high and moderate levels of corrosion, whilst no clear trend was observed at the initial stage of corrosion. Artificial neural network models were also developed to predict bond strength for corroded/uncorroded steel bars in concrete using the main influencing parameters (i.e., concrete strength, concrete cover, bar diameter, embedment length and corrosion rate). The developed models were able to predict the bond strength with a high level of accuracy, which was confirmed by conducting a parametric study. / Higher Education Institute of the Libyan Government

The current research project mainly aims to investigate the corrosion resistance and bond performance of steel reinforced recycled aggregate concrete incorporating nano-silica under both normal and corrosive environmental conditions. The experimental part includes testing of 180 pull-out specimens prepared from 12 different mixtures. The main parameters studied were the amount of recycled aggregate (RCA) (i.e. 0%, 25%, 50% and 100%), nano silica (1.5% and 3%), steel embedment length as well as steel bar diameter (12 and 20mm). Different levels of corrosion were electrochemically induced by applying impressed voltage technique for 2, 5, 10 and 15 days. The experimental observations mainly focused on the corrosion level in addition to the ultimate bond, failure modes and slips occurred. Experimental results showed that the bond performance between un-corroded steel and recycled aggregate concrete slightly reduced, while a significant degradation was observed after being exposed to corrosive conditions, in comparison to normal concrete. On the other hand, the use of nano silica (NS) showed a reasonable bond enhancement with both normal and RCA concretes under normal conditions. However, much better influence in terms of bond and corrosion resistance was observed under advancing levels of corrosion exposure, reflecting the improvement in corrosion resistance. Therefore, NS was superbly effective in recovering the poor performance in bond for RCA concretes. More efficiency was reported with RCA concretes compared to the conventional concrete. The bond resistance slightly with a small amount of corrosion (almost 2% weight loss), then a significant bond degradation occurs with further corrosion. The influence of specific surface area and amount of nano silica on the performance of concrete with different water/binder (w/b) ratios has been also studied, using 63 different mixtures produced with three different types of colloidal NS having various surface areas and particle sizes. The results showed that the performance of concrete is heavily influenced by changing the surface area of nano silica. Amongst the three used types of nano silica, NS with SSA of 250 m2 /g achieved the highest enhancement rate in terms of compressive strength, water absorption and microstructure analysis, followed by NS with SSA of 500 m2/g, whilst NS with SSA of 51.4 m2 /g was less advantageous for all mixtures. The optimum nano silica ratio in concrete is affected by its particle size as well as water to binder ratio. The feasibility of the impact-echo method for identifying the corrosion was evaluated and compared to the corrosion obtained by mass loss method. The results showed that the impact-echo testing can be effectively used to qualitatively detect the damage caused by corrosion in reinforced concrete structures. A significant difference in the dominant frequencies response was observed after exposure to the high and moderate levels of corrosion, whilst no clear trend was observed at the initial stage of corrosion. Artificial neural network models were also developed to predict bond strength for corroded/uncorroded steel bars in concrete using the main influencing parameters (i.e., concrete strength, concrete cover, bar diameter, embedment length and corrosion rate). The developed models were able to predict the bond strength with a high level of accuracy, which was confirmed by conducting a parametric study. / Higher Education Institute in the Libyan Government MONE BROS Company in Leeds (UK) for providing recycled aggregates BASF and Akzonobel Companies for providing nano silica NS, Hanson Ltd, UK, for suppling cement

The political polarization is considered to have increased in recent decades, which is considered a threat to democracy. Polarization is the process by which the normal diversity of differences in a society conforms more closely to a single dimension, where people perceive and describe politics and society in terms of "us" and "them". There are two distinct forms of political polarization, which are affective and ideological polarization. Ideological polarization is the difference between political beliefs, attitudes and positions of political opponents and affective polarization asses the extent to which people like their political allies and dislike their political opponents. A higher level of polarization can be beneficial to society, as it can contribute to higher levels of political participation and a perception that there are choices. However, this process can also entail disadvantages for democracy, by increasing the centralization of power and making citizens more dissatisfied. In addition, there are also described interpersonal implications of polarization, which include a reluctance to interact with and dehumanization of poltical opponents. Previous research that investigated the political polarization on social media has mainly focused on Twitter and Facebook, thus it was considered relevant to what the polarization looks like on Reddit instead. This platform has a different structure and also describes itself as being at the forefront of the internet. It was focused on two communities, where on community was skeptic and the other convinced of the climate issue. It could be seen here that there were primarly traces of affective polarization, as there was a certain reluctance to interact with one's political opponents. The mechanism of polarization that could mainly be deciphered was confirmation bias, as a preference for interaction with those with like-minded views could be made clear. Traces of echo chambers and filter bubbles could also be discerned, which are alos mechanisms that can also lead to further polarization.