Automatic dialog systems have become a mainstream part of online customer service. Many such systems are built, maintained, and improved by customer service specialists, rather than dialog systems engineers and computer programmers. As conversations between people and machines become commonplace, it is critical to understand what is working, what is not, and what actions can be taken to reduce the frequency of inappropriate system responses. These analyses and recommendations need to be presented in terms that directly reflect the user experience rather than the internal dialog processing.

This paper introduces and explains the use of Actionable Conversational Quality Indicators (ACQIs), which are used both to recognize parts of dialogs that can be improved and to recommend how to improve them. This combines benefits of previous approaches, some of which have focused on producing dialog quality scoring while others have sought to categorize the types of errors the dialog system is making. We demonstrate the effectiveness of using ACQIs on LivePerson internal dialog systems used in commercial customer service applications and on the publicly available LEGOv2 conversational dataset. We report on the annotation and analysis of conversational datasets showing which ACQIs are important to fix in various situations.

The annotated datasets are then used to build a predictive model which uses a turn-based vector embedding of the message texts and achieves a 79% weighted average f1-measure at the task of finding the correct ACQI for a given conversation. We predict that if such a model worked perfectly, the range of potential improvement actions a bot-builder must consider at each turn could be reduced by an average of 81%.

A survey was conducted among Canadian tertiary neonatal intensive care units. Of the 27 sites who responded, 9 did not have any form of antimicrobial stewardship, and 11 used vancomycin for empirical coverage in late-onset-sepsis evaluations. We detected significant variations in the diagnostic criteria for urinary tract infection and ventilator-associated pneumonia.

Global biodiversity is at a heightened risk of extinction and we are losing species faster than at any other time. It is important to understand the threats that drive a species towards extinction in order to address those drivers. In this paper, we assess our knowledge of the threats faced by 24 Himalayan Galliformes species by undertaking a review of the threats reported in the published literature and the supporting evidence that the threat is having an impact on the species’ populations. Only 24 papers were deemed suitable to be included in the study. We found that biological resource use and agriculture and aquaculture are the predominant threats to the Galliformes in the Greater Himalaya but the evidence available in the studies is quite poor as only one paper quantified the impact on species. This study shows that major gaps exist in our understanding of threats to species, and it is imperative to fill those gaps if we want to prevent species from going extinct.

The context- and person-specific nature of the Mental Capacity Act 2005 (MCA) in England and Wales means inherent indeterminacy characterises decision-making in the Court of Protection (CoP), not least regarding conflicting values and the weight that should be accorded to competing factors. This paper explores how legal professionals frame and influence the MCA's deliberative and adjudicative processes in the social space of the courtroom through a thematic analysis of semi-structured interviews with legal practitioners specialising in mental capacity law and retired judges from the CoP and the Courts of Appeal with specific experience of adjudicating mental capacity disputes. The concept of the ‘human element’ offers important new insight into how legal professionals perform their roles and justify their activities in the conduct of legal proceedings. The ‘human element’ takes effect in two ways: first, it operates as an overarching normative prism that accounts for what good practice demands of legal professionals in mental capacity law; secondly, it explains how these professionals orientate these norms in the day-to-day conduct of their work. The ‘human element’ further presents challenges that demand practical negotiation in relation to countervailing normative commitments to objectivity and socio-institutional expectations around professional hierarchies, expertise, and evidential thresholds.

The availability of colonizable substrate is an important driver of the temporal dynamics of sessile invertebrates on coral reefs. Increased dominance of algae and, in some cases, sponges has been documented on many coral reefs around the world, but how these organisms benefit from non-colonized substrate on the reef is unclear. In this study, we described the temporal dynamics of benthic organisms on an Indonesian coral reef across two time periods between 2006 and 2017 (2006–2008 and 2014–2017), and investigated the effects of colonizable substrate on benthic cover of coral reef organisms at subsequent sampling events. In contrast with other Indonesian reefs where corals have been declining, corals were dominant and stable over time at this location (mean ± SE percentage cover 42.7 ± 1.9%). Percentage cover of turf algae and sponges showed larger interannual variability than corals and crustose coralline algae (CCA) (P < 0.001), indicating that these groups are more dynamic over short temporal scales. Bare substrate was a good predictor of turf cover in the following year (mean effect 0.2, 95% CI: 0–0.4). Algal cover combined with bare space was a good predictor of CCA cover the following year generally, and of sponge cover the following year but only at one of the three sites. These results indicate that turf algae on some Indonesian reefs can rapidly occupy free space when this becomes available, and that other benthic groups are probably not limited by the availability of bare substrate, but may overgrow already fouled substrates.

OBJECTIVES/GOALS: Juvenile idiopathic arthritis (JIA) is the most common childhood rheumatologic disease childhood and a cause of pain and potential disability. JIA has a strong genetic component and no known cure. The goal of this study is to evaluate allele-dependent effects of a novel JIA risk variant at 1q24.3. METHODS/STUDY POPULATION: JIA patients meeting criteria for the two most common disease subtypes (oligoarticular and RF neg polyarthritis) were genotyped using the Immunochip, an Illumina array with dense coverage of the HLA region and 186 other loci previously reported in autoimmune diseases. Phase I association findings (Hinks, 2013) and Phase II analysis (unpublished) of an expanded cohort (4,271 JIA and 14,390 controls) identified new risk loci, including rs78037977 at 1q24.3. We prioritized rs78037977 and predicted possible impacted mechanisms based on Bayesian predictions of attributable risk, the surrounding chromatin landscape, and transcription factor binding data. A luciferase reporter assay was used to assess allele-dependent enhancer activity. RESULTS/ANTICIPATED RESULTS: rs78037977 is located between FASLG and TNFSF18 at chromosome 1q24.3 is associated with JIA (p = 6.3x10−09), and explains 94% of the posterior probability at this locus; no other SNPs in linkage disequilibrium (r2>0.6). The chromatin landscape around rs78037977 contains H3K4Me1 and H3K27Ac marks, which are indicative of enhancer activity. Further, >160 transcription factors have chromatin immunoprecipitation followed by sequencing (ChIP-seq) peaks overlapping rs78037977 in various cellular contexts. In luciferase reporter assays, the region around rs78037977 containing the reference A allele had ~2-fold increased enhancer activity compared to the non-reference allele. DISCUSSION/SIGNIFICANCE OF IMPACT: This work provides in vitro evidence to support allele-dependent enhancer activity of a novel JIA-risk variant at 1q24.3. Our ongoing work investigates the effect of the DNA-containing region of rs78037977 on gene expression and differential transcription factor binding at rs78037977.

In 2015, excavations at Stainton Quarry, Furness, Cumbria, recovered remains that provide a unique insight into Early Neolithic farming in the vicinity. Five pits, a post-hole, and deposits within a tree-throw and three crevices in a limestone outcrop were investigated. The latter deposits yielded potentially the largest assemblage of Carinated Bowl fragments yet recovered in Cumbria. Lipid analysis identified dairy fats within nine of these sherds. This was consistent with previous larger studies but represents the first evidence that dairying was an important component of Early Neolithic subsistence strategies in Cumbria. In addition, two deliberately broken polished stone axes, an Arran pitchstone core, a small number of flint tools and debitage, and a tuff flake were retrieved. The site also produced moderate amounts of charred grain, hazelnut shell, charcoal, and burnt bone. Most of the charred grain came from an Early Neolithic pit and potentially comprises the largest assemblage of such material recovered from Cumbria to date. Radiocarbon dating indicated activity sometime during the 40th–35th centuries cal bc as well as an earlier presence during the 46th–45th centuries. Later activity during the Chalcolithic and the Early Bronze Age was also demonstrated. The dense concentration of material and the fragmentary and abraded nature of the pottery suggested redeposition from an above-ground midden. Furthermore, the data recovered during the investigation has wider implications regarding the nature and use of the surrounding landscape during the Early Neolithic and suggests higher levels of settlement permanence, greater reliance on domesticated resources, and a possible different topographical focus for settlement than currently proposed.

The incident command system (ICS) provides a common structure to control and coordinate an emergency response, regardless of scale or predicted impact. The lessons learned from the application of an ICS for large infectious disease outbreaks are documented. However, there is scant evidence on the application of an ICS to manage a local multiagency response to a disease cluster with environmental health risks. The Sydney Local Health District Public Health Unit (PHU) in New South Wales, Australia, was notified of 5 cases of Legionnaires’ disease during 2 weeks in May 2016. This unusual incident triggered a multiagency investigation involving an ICS with staff from the PHU, 3 local councils, and the state health department to help prevent any further public health risk. The early and judicious use of ICS enabled a timely and effective response by supporting clear communication lines between the incident controller and field staff. The field team was key in preventing any ongoing public health risk through inspection, sampling, testing, and management of water systems identified to be at-risk for transmission of legionella. Good working relationships between partner agencies and trust in the technical proficiency of environmental health staff aided in the effective management of the response. (Disaster Med Public Health Preparedness. 2018;12:539–542)

Cancer patients undergoing chemotherapy frequently experience anticipatory distress before treatment sessions. Eighty-six cancer patients (ovarian, lymphoma and breast) were assessed to determine the prevalence of anticipatory nausea and vomiting (ANV). Approximately one patient in three reported anticipatory nausea (AN), and of these 6 also experienced anticipatory vomiting (AV). Several patients reported anticipatory anxiety without any sensation of nausea. Clinically the notion of anticipatory distress may be more fruitful so that the problem of pretreatment anxiety is also addressed. Generally, AN was rated as moderate or worse in severity, occurred fairly consistently, and often began well before arrival at hospital on treatment day. It is suggested that future research should endeavour to link more closely the topography of the problem and the intervention techniques employed, as well as evaluating a broader range of possible interventions.

Three adults with haemophilia participated in a study designed to determine the effectiveness of cognitive-behavioural techniques in the alleviation of chronic arthritic pain. The intervention comprised cognitive-coping skills, primarily relaxation training and guided imagery techniques, as well as identifying and altering antecedents and consequences that may have influenced their pain experience. The dependent measures included visual analogue rating scales, the Arthritis Impact Measurements Scale, the Beck Depression Inventory and pedometer readings. All three men showed significant reductions in pain, which were largely maintained at six-month follow-up. This study supports earlier findings with this population, and highlights the importance of monitoring the implementation of independent measures.

The diet of Dissostichus mawsoni captured by bottom longline in the Ross Sea region was examined during 2003, 2005 and 2010. The diet of sub-adult toothfish was similar to adult toothfish, comprising mainly benthic fishes and cephalopods. Sub-adult toothfish ate a greater variety of smaller prey than adults, including smaller fish and prawns. Grenadiers (Macrourus spp.) were the most important fish and overall prey species. On the continental slope, icefish (Channichthyidae) and eel cods (Muraenolepididae) were also important fish prey, while Psychroteuthis glacialis was the most important cephalopod prey. On oceanic features, toothfish fed mainly on Macrourus spp. but also fed on Antimora rostrata, cephalopods and the occasional mesopelagic to epipelagic fish. Diet varied significantly with toothfish size and location on northern parts of the Mawson and Iselin banks of the Ross Sea continental slope. There was no significant temporal change in diet composition.

We describe an outbreak of Pseudomonas aeruginosa respiratory tract infections related to intrinsically contaminated ultrasound gel used for intraoperative transesophageal echocardiograms in cardiovascular surgery patients. This investigation led to a product safety alert by the Food and Drug Administration and the development of guidelines for appropriate use of ultrasound gel.

In this article we ask what kind of phenomenon is internet sex addiction. From the perspectives of two practising psychiatrists, one of whom has worked in a weekly sexual disorders clinic for 12 years, and an anthropologist we explore whether a moral panic is emerging over sexual behaviour and the internet, and whether internet sex addiction forms part of any such panic. We ask whether many individuals who diagnose themselves as addicted to internet-based sex do so more out of a media-activated sensibility than a clinical reality. We also consider what developments in DSM-5 hold for this area.

Seamounts throughout the world's oceans can support diverse and abundant fish communities. Many have been subject to commercial deep-sea bottom trawl fisheries and have exhibited ‘boom and bust’ characteristics. There is growing concern about the effect of fishing on fragile and vulnerable benthic invertebrate species. This review examines why deep-sea fisheries have generally failed, and recommends measures that are necessary to improve their sustainability. Much is based on lessons learned in the south-west Pacific that may be more generally applicable to global deep-sea fisheries. Sustainable fisheries require highly precautionary feature-based catch limits, and credible and timely stock assessment advice. Management also needs to consider fishing impacts on the benthic habitat, and while reducing and spreading fishing effort on seamounts is beneficial for fish stocks, it can have a negative effect on the benthos. To balance exploitation and conservation, elements of spatial management are required, whereby some seamounts are protected before any fishing has occurred. Protected areas should include entire seamounts, and multiple seamounts in a network. A management regime should incorporate closed seamounts, open seamounts for fishing, and management of adjacent slope areas where these are important for the productivity of fish and invertebrate populations.

Three-dimensional (3D) battery architectures have emerged as a new direction for powering microelectromechanical systems and other small autonomous devices. Although there are few examples to date of fully functioning 3D batteries, these power sources have the potential to achieve high power density and high energy density in a small footprint. This overview highlights the various architectures proposed for 3D batteries, the advances made in the fabrication of components designed for these devices, and the remaining technical challenges. Efforts directed at establishing design rules for 3D architectures and modeling are providing insight concerning the energy density and current uniformity achievable with these architectures. The significant progress made on the fabrication of electrodes and electrolytes designed for 3D batteries is an indication that a number of these battery architectures will be successfully demonstrated within the next few years.