Secure output consensus for multi-agent systems under edge-based event-trigger against denial-of-service.

This paper is concerned with the secure output consensus problem for the heterogeneous multi-agent systems under the event-triggered scheme in the presence of the denial-of-service attack. Without detecting the attack, the hold-input controller update strategy is adopted when some transmission data may be lost due to the effect of the attack. Based on the tolerable duration of the attack, a novel edge-based event-triggered scheme is developed. The scheme can avoid continuous communication and exclude Zeno behavior. With the aid of the switched system theory, output consensus is preserved. An example shows the effectiveness.

Examining factors influencing Turkish Jewish attitudes towards the Armenian genocide.

The most prominent issue influencing Turkish-Armenian relations is the international recognition of the Armenian genocide. However, there is a notable absence of empirical analyses regarding the perceptions of the genocide among the Turkish population. This study aims to fill this scholarly gap by exploring, for the first time, the perspectives of Turkish Jews. It analyses evidence collected from interviews conducted with 14 Turkish Jews, utilising Stanley Cohen's (2001) theoretical framework, which aids in delineating significant factors by a categorisation of types of acceptance and denial. The findings highlight a diversity of responses linked to political attitudes, which can be broadly categorised into Kayades and Avlaremoz mindsets. They also show that Turkish Jews' views on the Holocaust influence how they perceive the Armenian genocide. Additionally, the results indicate that Cohen's approach is useful in explaining non-denying responses. In conclusion, the study argues that Turkish Jews' perspectives appear to be strongly related to their stance towards the Turkish state and the Holocaust.

Joint non-fragile automatic generation control and multi-event driven mechanism co-design for wind integrated power system under denial of services attacks.

Denial of services (DoS) attacks exist in wind integrated power system. DoS attacks can cause network-induced delay and packages loss in information transmission. Meanwhile, considering the parameter perturbation of controller and system model uncertainty in wind integrated power system, these may cause the system dynamic performances degradation or even instability. Based on the above considerations, the joint non-fragile automatic generation robust control of wind integrated power system under DoS attacks is studied in this paper. In order to ensure the expected system performance and more effectively utilize the limited network communication resources under DoS attacks, a novel dynamic multi-event driven mechanism based joint non-fragile H∞ automatic generation control method is proposed. By constructing a suitable Lyapunov-Krasovskii functional and utilizing the Shur complement lemma to handle nonlinear matrix inequality, the sufficient conditions are derived to guarantee the asymptotic stability of wind integrated power system under DoS attacks. Furthermore, the performance of the proposed non-fragile regulator is demonstrated through a four-area wind integrated power system to show the feasibility and applicability. The analysis result indicates that the proposed scheme provides stronger robustness, higher wind energy utilization efficiency and more efficient communication mechanism.

Finite-horizon optimal secure tracking control under denial-of-service attacks.

The finite-horizon optimal secure tracking control (FHOSTC) problem for cyber-physical systems under actuator denial-of-service (DoS) attacks is addressed in this paper. A model-free method based on the Q-function is designed to achieve FHOSTC without the system model information. First, an augmented time-varying Riccati equation (TVRE) is derived by integrating the system with the reference system into a unified augmented system. Then, a lower bound on malicious DoS attacks probability that guarantees the solutions of the TVRE is provided. Third, a Q-function that changes over time (time-varying Q-function, TVQF) is devised. A TVQF-based method is then proposed to solve the TVRE without the need for the knowledge of the augmented system dynamics. The developed method works backward-in-time and uses the least-squares method. To validate the performance and features of the developed method, simulation studies are conducted in the end.

Resilient event-triggered observer-based control of non-linear systems under denial-of-service attacks with actuator saturation.

This paper studies the control problem for a continuous-time networked system with non-linearity in the state equation as well as in the input, as saturation. The system is considered under denial-of-service (DoS), attacks which cause the blockage of input and/or output components in the overall closed-loop model. An event-triggering scheme that is resilient in nature, along with an observer-based control, has been considered under DoS attacks. The resultant scheme ensures efficient network resources and excludes Zeno behavior naturally due to the presence of a minimum positive interevent delay. Then, an event-based switched non-linear model is presented to address both the event-triggering scheme and the presence of DoS blocking attacks. A piece-wise Lyapunov-Krasovskii functional method on the described non-linear model, resulting in the switched system, is considered for achieving an exponentially stable response by driving the required feasibility conditions. In the presence of a non-linear system with saturation in the actuator, the presented design establishes quantitative relationships among the exponential decay rate, active/sleeping intervals of attacks, parameters of the event-triggering condition, and sampling period of the system. After that, linear matrix inequalities are presented for designing an event-triggered controller with an observer, while the design also includes the region of convergence for dealing with the input non-linearity. Finally, comparative results for an offshore structure model with non-linearity in states as well as in actuator, are demonstrated to verify the results of the control scheme that is developed. It has been verified that our design is less conservative than the previous designs, and can handle the non-linearities in the dynamics of plant and actuator saturation more efficiently, while DoS attacks are also present. By applying our proposed method, the overshoot and undershoot are less than ±2.5 percent, while system states converge to the origin within 55 s.

Correlates of climate change skepticism.

While much research has examined the correlates of climate change beliefs from an alarmist perspective, less work has systematically measured climate change skepticism. This study aims to create a comprehensive tool capturing climate skeptics' beliefs and test its association with individual difference variables. 502 European adults completed a 22-item questionnaire on climate change (CC) skepticism as well as measures of ambiguity tolerance, belief in a just world (BJW), dark-side personality traits, and self-esteem. Principal components analysis revealed a four dimension structure of CC. Political ideology was the most consistent and significant predictor across the climate change skepticism factors. Dark-side traits, also played a role. Future research should further validate this measure and explore how climate change information could be tailored to different audiences. Understanding the nuances and causes of climate skepticism can enable more effective communication to promote sustainability.

When the one true faith trumps all: Low religious diversity, religious intolerance, and science denial.

Past theories have linked science denial to religiosity but have not explained its geographic variability. We hypothesize that it springs not only from religious intensity but also from religious intolerance, which depends greatly on the experience of religious diversity and hence on geography. The belief that one's religion trumps other faiths precipitates the stance that it trumps science too. This psychological process is most likely to operate in regions or countries with low religious heterogeneity. We measure the rejection of science not only in people's refusal to follow specific health recommendations, such as taking COVID-19 vaccines, but also in general measures of scientific engagement and attainment. We rule out alternative explanations, including reverse causality and spurious correlations, by conducting controlled experiments and running robustness checks on our statistical models.

Multi-Institutional Analysis of Insurance Denial Patterns Within Rhinology.

BACKGROUND: Obtaining insurance approval is a necessary component of healthcare in the United States and denials of these claims have been estimated to result in a loss of 3% to 5% of revenue. OBJECTIVE: Examine the trends in insurance denials for rhinological procedures. METHODS: A retrospective review of deidentified financial data of patients who were treated by participating physicians across 3 institutions from January 1, 2021, to June 30, 2023. The data was queried for rhinological and non-rhinological procedures via CPT codes. Cumulative insurance denials were calculated and stratified by procedure and insurance type. Write-offs were dollar amounts associated with final denials. RESULTS: A sample of 102,984 procedures and visits revealed a final denial rate between 2.2% and 2.9% across institutions (p = .72). The top three rhinological procedures for final write-offs were: nasal endoscopy (16.24%, $111,836.87), nasal debridement or polypectomy (6.48%, $79,457.51), and destruction of intranasal lesion (2.11%, $56,932.20). The write-off percentage for each procedure was highest among commercial insurance payers as opposed to Medicare or Medicaid. CONCLUSION: Final denial rates of rhinology procedures ranged between 2% and 3%. Common procedures such as nasal endoscopy and nasal debridement are among the highest written-off procedures. Insurance denials can lead to notable revenue loss. Rhinology practices must continue to remain knowledgeable of the changes and effects of insurance reimbursement on their practice.

Do Individual Differences in Perception Affect Awareness of Climate Change?

One significant obstacle to gaining a widespread awareness of the ongoing climate change is the nature of its manifestations in relation to our perception: climate change effects are gradual, distributed, and sometimes seemingly contradictory. These features result in a lag in collective climate action and sometimes foster climate skepticism and climate denial. While the literature on climate change perception and belief has thoroughly explored its sociocultural and sociopolitical aspects, research on the potential contribution of psychophysiological factors remains scarce. In this perspective paper, we outline evidence and arguments for the involvement of psychophysiological systems such as thermoception, hygroreception, and interoception in modulating climate change awareness. We discuss psychophysiological mechanisms of climate change awareness in animals and humans, as well as possible sources of individual variance in climate change perception. We conclude by suggesting novel research questions which would be worthwhile to pursue in future studies.

Denial of prescription pain medication among people who use drugs in Vancouver, Canada.

BACKGROUND: People who use drugs experience pain at two to three times the rate of the general population and yet continue to face substantial barriers to accessing appropriate and adequate treatment for pain. In light of the overdose crisis and revised opioid prescribing guidelines, we sought to identify factors associated with being denied pain medication and longitudinally investigate denial rates among people who use drugs. METHODS: We used multivariable generalized estimating equations analyses to investigate factors associated with being denied pain medication among people who use drugs reporting pain in three prospective cohort studies in Vancouver, Canada. Analyses were restricted to study periods in which participants requested a prescription for pain from a healthcare provider. Descriptive statistics detail denial rates and actions taken by participants after being denied. RESULTS: Among 1168 participants who requested a prescription for pain between December 2012 and March 2020, the median age was 47 years and 63.0% were male. Among 4,179 six-month observation periods, 907 (21.7%) included a report of being denied requested pain medication. In multivariable analyses, age was negatively associated with prescription denial (adjusted odds ratio [AOR] = 0.98, 95% confidence interval [CI]:0.97-0.99), while self-managing pain (AOR = 2.48, 95%CI:2.04-3.00), experiencing a non-fatal overdose (AOR = 1.51, 95%CI:1.22-1.88), engagement in opioid agonist therapy (AOR = 1.32, 95%CI:1.09-1.61), and daily use of heroin or other unregulated opioids (AOR = 1.32, 95%CI:1.05-1.66) were positively associated with being denied. Common actions taken (n = 895) after denial were accessing the unregulated drug supply (53.5%), doing nothing (30.6%), and going to a different doctor/emergency room (6.1%). The period following the introduction of new prescribing guidelines was not associated with a change in denial rates. CONCLUSIONS: A substantial proportion of people who use drugs continue to be denied prescriptions for pain, with such denial associated with important substance use-related harms, including non-fatal overdose. Guidelines specific to the pharmaceutical management of pain among people who use drugs are needed.

Trauma: open concept.

This paper presents and discusses two sets of theories concerning trauma. The first involves a contemporary social theory of "cultural trauma" and the second refers to psychoanalytic theories on psychic trauma. We argue that these two groups of theories have some relevant elements in common, despite social theorists' critique of psychoanalytic understanding on the matter. In our view, the most important meeting points between these groups of theories concern (a) the possibility to think that trauma is not welded to events but has a formation process, one of attribution of meaning, (b) that this process has a temporality of its own, and (c) that the environment (the objects, actors, and agents that compose it) has a fundamental and determinant role in trauma formation. Further, we suggest that trauma is still an open concept in psychoanalysis.

Attack-resilient fault detection for interconnected systems under DoS attack.

In light of the expanding cyber-space applications, the imperative consideration of cyber-attack ramifications on system security is evident. This paper presents a resilient dynamic event-triggered fault detection scheme for a class of nonlinear interconnected systems subjected to denial of service (DoS) attacks. To counteract multifaceted threats, the co-design challenge involving switched-type fault detection filters and a resilient dynamic event-triggered transmission mechanism is addressed. In the design phase of the filters, the frequency information of the signal is considered comprehensively and linear solvable conditions ensuring desired augment system performance are delineated. Through a series of comparative simulation experiments, the findings support the conclusion that the proposed attack-tolerant fault detection mechanism not only conserves network resources but also demonstrates superior detection capabilities for specific frequency fault signals.

Addressing the gap of early intervention for eating disorders in primary health care.

AIM: Only one in four individuals with eating disorders (EDs) seek help, with many barriers to treatment-seeking present. Placing an early intervention model in primary mental health care settings is one approach to reducing these barriers. To date, only one model (emerge-ED) has been evaluated in the literature. METHODS: We aimed to replicate findings from the initial emerge-ED evaluation. We report on treatment outcomes in a new cohort and their views on barriers to treatment-seeking. We then examine how this early intervention model in primary health care has evolved to overcome the barriers to treatment delivery cited by health professionals in the initial evaluation. RESULTS: Eighty participants commenced treatment between July 2020 and March 2022 and completed a mean of 8.98 sessions, 70 (87.5%) completed >1 sessional measure on ED cognitions and behaviours, but only 31% (n = 24) completed lengthier assessments. Findings replicated initial emerge-ED outcomes, with small to moderate effect size decreases in the ED sessional measure at 70 days since treatment commencement for cognitions (d = .63) and ED behaviours (d = .09., .69). The most cited barrier by participants was "belief that my problem is not bad enough", reflective of denial of illness. Lastly, to overcome barriers to treatment delivery clinicians had to deviate from treatment protocols and work collaboratively with other healthcare providers. CONCLUSIONS: Our findings replicated the initial emerge-ED evaluation and highlight the importance of considering primary health care settings as an essential site in delivering early intervention services for EDs.

Ethical challenges in the treatment of psychotic pregnancy denial.

Background: There is a paucity of literature regarding ethical strategies for treating pregnant people with psychosis. While not uncommon, psychotic pregnancy denial is a psychotic illness in which patients have the delusion that they are not pregnant. The authors provide a literature review regarding psychotic pregnancy denial, present an unpublished case and its questions and dilemmas, and offer recommendations for resolving the ethical challenges these cases raise. Case: A 26-year-old, single, unemployed woman of no fixed residence was admitted for suicidal ideation. She had a history of psychosis, had multiple ER visits and at least one previous hospitalization, had minimal contact with psychiatric outpatient clinics, and had been poorly compliant with treatment recommendations. She was discovered to be about 31 weeks pregnant in the emergency room. Ultrasound exams revealed no fetal anomalies. This was the patient's second pregnancy; her previous pregnancy resulted in an abortion. Her sole psychotic symptom was the delusional belief that she was not pregnant. On the rare occasions when the patient acknowledged being pregnant, she requested termination of pregnancy. Despite intensive pharmacological treatment of her psychosis, the patient continued believing that she was not pregnant and repeatedly said she would not participate in the labor and delivery process. She disagreed with the induction of labor or a cesarean section if needed. The patient developed gestational hypertension, an obstetric indication for delivery. Induction of labor was offered to avoid potentially disastrous outcomes for the pregnant woman and the fetus. Conclusion: Psychotic pregnancy denial is potentially life-threatening. Delivery of the fetus requires carefully weighing risks and benefits and thoroughly considering the ethical framework. Teaching points: Treatment of birthing people with psychotic denial of pregnancy is complex; it requires special clinical and ethical skills to determine the patient's level of decision-making impairment and to find a middle ground between the pregnant person's right to autonomy and the physicians' beneficence-based duties. Using a well-coordinated, interdisciplinary approach and a solid ethical framework, the decision to deliver the fetus while engaging the pregnant person, to the extent possible, in the decision-making process is essential.

Association of area-level mortgage denial and guideline-concordant non-small-cell lung cancer care and outcomes in the United States.

BACKGROUND: Racial and socioeconomic disparities in receipt of care for non-small-cell lung cancer (NSCLC) are well described. However, no previous studies have evaluated the association between mortgage denial rates and receipt of timely and guideline-concordant care for NSCLC and patient outcomes. METHODS: We identified individuals ≥18 years diagnosed with NSCLC between 2014 and 2019 from the National Cancer Database. Using the Home Mortgage Disclosure Act database, we calculated the proportion of denied home loans to total loans at the zip-code level and categorized them into quintiles. Our outcomes included receipt of guideline-concordant care based on clinical and pathologic stage at diagnosis and the National Comprehensive Cancer Network guidelines, time from surgery to chemotherapy initiation, and overall survival. RESULTS: Of the 629,288 individuals diagnosed with NSCLC (median age 69; IQR 61-76 years, 49.1% female), 47.8% did not receive guideline-concordant care. Residing in areas with higher mortgage denial rates and lower income was associated with worse guideline-concordant care overall (aRR = 1.28; 95% CI = 1.25-1.32) and for each cancer treatment modality, worse receipt of timely chemotherapy (aHR = 1.14; 95% CI = 1.11-1.17) and worse overall survival (aHR = 1.21; 95% CI = 1.19-1.22), compared with residing in areas with the lowest mortgage denial rate and highest income. CONCLUSIONS: Area-level mortgage denial rate was associated with worse receipt of timely and guideline-concordant NSCLC care and survival. This highlights the critical need to understand and address systemic practices, such as mortgage denial, that limit access to resources and are associated with worse access to quality cancer care and outcomes.

Counteracting climate denial: A systematic review.

Despite scientific consensus on climate change, climate denial is still widespread. While much research has characterised climate denial, comparatively fewer studies have systematically examined how to counteract it. This review fills this gap by exploring the research about counteracting climate denial, the effectiveness and the intentions behind intervention. Through a systematic selection and analysis of 65 scientific articles, this review finds multiple intervention forms, including education, message framing and inoculation. The intentions of intervening range from changing understanding of climate science, science advocacy, influencing mitigation attitudes and counteracting vested industry. A number of divergent findings emerge: whether to separate science from policy; the disputed effects of emotions and the longitudinal impacts of interventions. The review offers guiding questions for those interested in counteracting denialism, the answers to which indicate particular strategies: identify the form of climate denial; consider the purpose of intervention and recognise one's relationship to their audiences.

Talking about death and dying: Findings from deliberative discussion groups with members of the public.

Talking about death and dying is promoted in UK health policy and practice, from a perception that to do so encourages people to plan for their end of life and so increase their likelihood of experiencing a good death. This encouragement occurs alongside a belief that members of the public are reluctant to talk about death, although surveys suggest this is not the case. This paper describes findings from a research study in which people participated in deliberative discussion groups during which they talked about a range of topics related to death, including talking about death, the good death, choice and planning and compassionate communities. Here we report what they had to say in relation to talking about death and dying. We identified three themes: 1. The difference between talking about death as an abstract concept and confronting the certainty of death, 2. how death and dying presents issues for planning and responsibility, and 3. approaches to normalising death within society. For our participants, planning was considered most appropriate in relation to wills and funerals, while dying was considered too unpredictable to be easy to plan for; they had complex ideas about the value of talking about death and dying.

Global coronavirus vaccination campaign: The role of religious workers in vaccine distribution, public mobilization and the eradication of nationalism.

BACKGROUND: Throughout history, the world has faced numerous health challenges and outbreaks, but through the dedication of medical professionals, solutions have been found. Despite this, the emergence of the coronavirus (COVID-19) has presented a new and dangerous threat. Nevertheless, with unwavering commitment, health experts have triumphantly discovered a remedy. OBJECTIVES: The study aimed to examine how religious workers worldwide could contribute positively to ensuring the fair distribution of COVID-19 vaccines, addressing vaccine hesitancy, encouraging people to get vaccinated, and preventing vaccine nationalism. METHOD: Our study employed a refined qualitative content analysis methodology to categorize factual information and pave the way for subsequent policymakers. We meticulously curetted the most trustworthy secondary data sources and utilized them to analyze the study. RESULTS: The content analysis reveals that religious workers played an active role in the global coronavirus vaccination drive by working towards better vaccine distribution, encouraging people to get vaccinated and countering hesitation and nationalism. CONCLUSION: In light of the discoveries, it would be prudent for policymakers to engage religious workers in advancing the cause of public health, regardless of whether the health matters are localized, national, or global in scale. This strategy has the potential to be both alluring and convincing.

The role of self-reliance and denial in the help-seeking process for eating disorders among university students.

OBJECTIVE: This study investigated how self-reliance and denial influence the relationship between help-seeking attitudes and behaviour. METHOD: Australian university students (N = 406) completed an online survey and females with elevated eating disorder (ED) concerns and high impairment were included in the study (N = 137). Participants completed measures of help-seeking attitudes, perceived barriers, and actual help-seeking behaviour. Via moderated logistic regression, we examined self-reliance and denial as perceived barriers to help-seeking. RESULTS: Of the total sample, over 33.7% of university students reported substantial ED concerns and impairment of whom 65.0% believed they needed help. While a majority reported that help-seeking would be useful (85.4%), only a minority of participants had sought professional help for their concerns (38.7%). Self-reliance and denial were frequently endorsed barriers and moderated the relationship between help-seeking attitudes and behaviours. CONCLUSION: ED concerns are common among university students and perceived barriers play a moderating role between attitudes and help-seeking. Future prevention and early intervention programs should address students' denial, while the importance of reaching out for professional help (rather than relying on themselves) could be highlighted with peer support.

Turned away and sleeping apart: A qualitative study on women's perspectives and experiences with family planning denial in Malawi.

INTRODUCTION: Barriers to family planning for potential clients have been explored in the literature, but rarely from the perspective of the women themselves in a low-income setting. This research aimed to understand clients' perspectives on being turned away from receiving a method of family planning at a facility on the day it was sought. METHODS: Three focus group discussions were held in two districts of Malawi in 2019 with clients who had been turned away approximately three to six months prior. RESULTS: The reasons for turnaway participants mentioned fell into eight categories: no proof of not being pregnant, method and/or supply stock-outs, arriving late, provider unavailable, provider refusal, needing to wait longer after delivery of a child, financial constraints, and medical reasons. Participants were often turned away more than once before finally being able to initiate a method, in some cases returning to the same facility and in others finding it through community health workers, traditional healers, or private facilities. Clients often resorted to sleeping apart from their husbands until they could initiate a method and reported stress and worry resulting from being turned away. CONCLUSIONS: Clients are turned away without a method of FP on the day they seek one for multiple reasons, nearly all of which are preventable. Many examples given by the participants showed a lack of knowledge and respect for clients on the part of the providers. Changing attitudes and behaviour, however, may be difficult and will require additional steps. Increasing the availability and use of pregnancy tests, having a more reliable supply of methods and materials, increasing the number of providers-including those trained well in all methods-and providing daily FP services would all help reduce turnaway. Improved access to family planning will help counties achieve their Sustainable Development Goals.