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The Best Strategy for Dealing with al-Qaeda

Paul Cruickshank: I think the best strategy for the United States and the allies of the United States in this struggle or war on terrorism moving nder.  Abu Ghraib was a regrettable blunder.  It really gave Al Qaeda a powerful recruiting tool in trying to get the volunteers which are necessary for its global jihad.  So “Do no harm” would be a very good mantra for the next U.S. president to take on.  Beyond that, I think that the next U.S. president really has to make a sort of symbolic break with past policies.  The paradigm with which the U.S. is viewed at the moment is a very negative one.  That needs to be broken by whoever the next U.S. candidate to become president is gonna be.

 

Question:  What would an effective policy break look like?

 

Paul Cruickshank: George W. Bush is a very unpopular figure in the Islamic world.  Some of that is obviously unfair, but the reality is the President of the United States and the United States is viewed very negatively right now.  That needs to change.  The most important part of that is for the United States to think very carefully about how it comes up with the foreign policy decisions in the years to come.  It really has to put the views of a billion Muslims around the world in as a factor in calculating the foreign policy that it needs to pursue.  So these are very important things to consider when you’re moving forward.  Clearly the United States also has to be seen as really trying for peace between Israel and Palestine, which has been a very, very important issue in the Muslim world.  It’s been the cause of a lot of anti-Americanism in past years; because America – rightly or wrongly – is seen as not being evenhanded in that dispute in the last years, and certainly during the Bush administration.  So the President obviously now is making a push for peace.  There’s an enormous amount of skepticism in the Arab world and the Muslim world about his motives.  I think the next president really needs to be able to persuade Muslims around the world that the United States really is engaged in an evenhanded attempt to create peace in the Middle East.  The Kashmir disputes between India and Pakistan is another issue which the United States and the next president really should get involved with as an arbiter between Pakistan and India.  The Kashmir dispute is also something which causes radicalization.  It’s an issue which is destabilizing for Pakistan, which right now is terror central, unfortunately.  The Kashmiri dispute has been allowed to fester for decades.  And it’s a dispute where you’re getting generations of jihadists involved in Pakistan who are sort of going from the tribal areas of the country to go and fight in the disputed territories in Kashmir.  So that’s another area the United States President really needs to address moving forward in an evenhanded way.  Those are the sorts of departures which are very, very important, and the next U.S. president really has to sort of concentrate on.  But a lot of it also will be in terms of rhetoric.  Suddenly the United States has certain interests in the Middle East which are non-negotiable; and which should not be given up.  But the next U.S. President really has to engage in a rhetoric which is gonna explain what the United States is doing; that the United States is not a colonial power.  There’s a great deal of suspicion in the Middle East and beyond that the United States is a colonial power because of the history of colonial subjugation of western powers in the region.  So the next U.S. President . . .  And this is for the U.S. President.  This is not for State Department.  It’s not a question of public diplomacy.  It’s the question of what the United States President is seen as saying moving forward.

 

Recorded on: Jan 14 2008

 

How American policy can be more effective under the next administration?

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A new hydrogel might be strong enough for knee replacements

Duke University researchers might have solved a half-century old problem.

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  • Duke University researchers created a hydrogel that appears to be as strong and flexible as human cartilage.
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Predicting PTSD symptoms becomes possible with a new test

An algorithm may allow doctors to assess PTSD candidates for early intervention after traumatic ER visits.

Image source: camillo jimenez/Unsplash
Technology & Innovation
  • 10-15% of people visiting emergency rooms eventually develop symptoms of long-lasting PTSD.
  • Early treatment is available but there's been no way to tell who needs it.
  • Using clinical data already being collected, machine learning can identify who's at risk.

The psychological scars a traumatic experience can leave behind may have a more profound effect on a person than the original traumatic experience. Long after an acute emergency is resolved, victims of post-traumatic stress disorder (PTSD) continue to suffer its consequences.

In the U.S. some 30 million patients are annually treated in emergency departments (EDs) for a range of traumatic injuries. Add to that urgent admissions to the ED with the onset of COVID-19 symptoms. Health experts predict that some 10 percent to 15 percent of these people will develop long-lasting PTSD within a year of the initial incident. While there are interventions that can help individuals avoid PTSD, there's been no reliable way to identify those most likely to need it.

That may now have changed. A multi-disciplinary team of researchers has developed a method for predicting who is most likely to develop PTSD after a traumatic emergency-room experience. Their study is published in the journal Nature Medicine.

70 data points and machine learning

nurse wrapping patient's arm

Image source: Creators Collective/Unsplash

Study lead author Katharina Schultebraucks of Columbia University's Department Vagelos College of Physicians and Surgeons says:

"For many trauma patients, the ED visit is often their sole contact with the health care system. The time immediately after a traumatic injury is a critical window for identifying people at risk for PTSD and arranging appropriate follow-up treatment. The earlier we can treat those at risk, the better the likely outcomes."

The new PTSD test uses machine learning and 70 clinical data points plus a clinical stress-level assessment to develop a PTSD score for an individual that identifies their risk of acquiring the condition.

Among the 70 data points are stress hormone levels, inflammatory signals, high blood pressure, and an anxiety-level assessment. Says Schultebraucks, "We selected measures that are routinely collected in the ED and logged in the electronic medical record, plus answers to a few short questions about the psychological stress response. The idea was to create a tool that would be universally available and would add little burden to ED personnel."

Researchers used data from adult trauma survivors in Atlanta, Georgia (377 individuals) and New York City (221 individuals) to test their system.

Of this cohort, 90 percent of those predicted to be at high risk developed long-lasting PTSD symptoms within a year of the initial traumatic event — just 5 percent of people who never developed PTSD symptoms had been erroneously identified as being at risk.

On the other side of the coin, 29 percent of individuals were 'false negatives," tagged by the algorithm as not being at risk of PTSD, but then developing symptoms.

Going forward

person leaning their head on another's shoulder

Image source: Külli Kittus/Unsplash

Schultebraucks looks forward to more testing as the researchers continue to refine their algorithm and to instill confidence in the approach among ED clinicians: "Because previous models for predicting PTSD risk have not been validated in independent samples like our model, they haven't been adopted in clinical practice." She expects that, "Testing and validation of our model in larger samples will be necessary for the algorithm to be ready-to-use in the general population."

"Currently only 7% of level-1 trauma centers routinely screen for PTSD," notes Schultebraucks. "We hope that the algorithm will provide ED clinicians with a rapid, automatic readout that they could use for discharge planning and the prevention of PTSD." She envisions the algorithm being implemented in the future as a feature of electronic medical records.

The researchers also plan to test their algorithm at predicting PTSD in people whose traumatic experiences come in the form of health events such as heart attacks and strokes, as opposed to visits to the emergency department.

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