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To model the potential value-for-money of implementing proposed unhealthy food advertising restrictions on Western Australian (WA) transport-owned assets to prevent obesity-related diseases.
Design:
A cost-benefit analysis using a societal perspective was undertaken to model the policy intervention over a 30-year time horizon. The effectiveness of the intervention was based on a similar policy implemented in the United Kingdom by Transport for London, adapted to the WA context. The ACE-Obesity Policy model, a validated multi-state lifetable Markov model, was used to assess the expected health (quantified as health-adjusted life years (HALY)) and economic outcomes of the intervention’s impact on unhealthy food consumption. The potential cost of policy development and monitoring and revenue impacts on government and industry (outdoor advertising companies) were included in the modelled analysis.
Setting:
Western Australia.
Participants:
Greater Perth population.
Results:
The cost of implementing the policy was estimated at A$28 million (95% UI [Uncertainty Intervals]: $23-$35), 71% borne by government and the remaining by outdoor advertisers. A mean population weight reduction of 0.58kg (95%UI: 0.28-0.90) was estimated, which translated to 5,906 HALYs gained (95%UI: 2,750-9,084) with a monetary value of A$1,374 million (95%UI: $642-$2,112). Eight percent of the monetised benefits were attributed to healthcare cost savings, while 92% were associated with monetised health gains. The intervention was estimated to generate a net-present value of $1,346 million (95%UI: $614-$2,082) and benefit-cost ratio of 50 (95%UI: 23-81).
Conclusion:
Policy to restrict advertising of unhealthy foods on WA transport owned assets is likely to represent excellent value-for-money.
Does the location of a state relative to others matter? We argue that a state’s location can affect its bargaining power, and thus multilateral relations if trade costs depend on trade routes that pass through other states. This is an important, yet neglected aspect of economic history. We show how an exogenous border change—caused by Britain’s intervention at Vienna in 1815—affected the location and trade routes of Prussia and other German states. We find that this border change led to the formation of the first customs union in history, the German Zollverein of 1834.
Three great waves of public anxiety about census privacy swept over the United States in the twentieth century. In 1940, 1970, and 2000, newspapers reported on fears of the public and politicians about invasive census questions. This article focuses on the second wave of privacy concerns surrounding the 1970 census, which focused on Big Brother and government overreach. The Census Bureau response stressed the confidentiality of census responses, but it failed to address the public concerns and sources of resistance to census inquiries. In addition to analyzing newspaper reports and congressional testimony, we examine individual refusals to respond to the census by members of the public and the Census Bureau’s responses to such refusals. By focusing on specific individual complaints instead of the general characterizations of concern found in newspaper coverage, we can gain a clearer understanding of the motives of the objectors.
In the digital information age, artificial intelligence is increasingly being applied to national governance and judicial decision-making assistance. Existing studies lack case studies and empirical analyses of the effectiveness of large models in aiding judicial decisions. To address this research gap, this study designs a comprehensive evaluation framework encompassing five core task dimensions: Task-oriented Information Extraction, Legal Article Citation, Event Extraction, Judicial Decision Generation, and Legal Opinion Generation. By using carefully crafted prompts to activate the legal reasoning capabilities of the models, we conducted extensive testing on 13 mainstream large language models (LLMs). The experimental results demonstrate that large models perform excellently in processing legal texts and providing preliminary legal opinions, but still exhibit shortcomings in complex legal reasoning and precise decision-making. On this basis, we applied a weakly supervised learning strategy to fine-tune the LLMs for targeted improvements. The results indicate that introducing a small amount of task-specific learning can significantly enhance the performance of LLMs in judicial tasks. This further underscores the critical role of data and the acquisition of domain-specific knowledge in applying AI technology to judicial tasks. Additionally, this study briefly discusses the issue of the boundaries of AI’s involvement in judicial activities, aiming to provide theoretical foundations and practical guidance for the deep integration of AI technology with legal practice.
The clinical outcomes associated with using commercial versus open ISDTs (initial specimen diverting techniques) remain unclear. This multicenter study showed that switching from the commercial to open ISDT did not change blood culture contamination rates, length of stay, or days of therapy with antibiotics, but did reduce laboratory-associated costs.
Parenteral nutrition (PN) is used when sufficient oral or enteral nutrition is not possible or feasible. Current guidelines provide limited practical guidance in emergency surgical patients, and the evidence is sparse.
The EATERS trial aims to investigate the effect of early supplemental parenteral nutrition on postoperative infections in major emergency abdominal surgery patients.
The EATERS trial is an investigator-initiated, multicenter, randomized controlled trial. The trial will include 342 adults with reduced oral intake after emergency abdominal surgery, randomizing them in a 1:1 ratio to early or postponed supplemental PN. The intervention group (early) will receive supplemental PN starting on postoperative day (POD) 2 for up to five days. The control group (postponed) will receive standard care and, if oral intake remains insufficient, will begin supplemental PN on POD5 for up to five days.
The primary outcome is the incidence of postoperative nosocomial infections during admission. Outcome assessors and the statistician will be blinded to the treatment allocation. The secondary outcomes include non-infectious complications during admission, length of stay, mortality risk at 30 and 90 days, energy and protein intake, serious adverse events, and readmission risk within 30 and 90 days of surgery.
Analyses will follow the intention-to-treat principle, and logistic regression used for primary outcome analysis.
The EATERS trial will provide novel insights into the timing of parenteral nutrition in a high-risk patient population. This protocol and statistical analysis plan will reduce bias and increase transparency in the conduct and analysis of the trial.
The roles of structural and lexical similarity in cross-linguistic influence in the L3 at higher proficiency levels are under researched. This study investigates the L3 Norwegian of such speakers. In alignment with the Linguistic Proximity Model (Westergaard et al., 2017), we assume that L3 structures are initially weak representations, becoming increasingly target-like with further input and use. We investigate what target this represents – the prescriptive rules of the language or movement towards L1-like use from community interaction and input. The properties investigated are the indefinite article and third person and reflexive possessives, by L1 Polish–L2 English and L1 English speakers. These categories provide fertile ground for investigation due to the (dis)similarities with the target language. The methodology consisted of an Acceptability Judgement Task. Results indicated possible structural-similarity based CLI and adherence to grammatical rules in intermediate-to-advanced proficiency L3ers – though this does not necessarily equal L1-like choices.
Psychedelic therapies are gaining attention as a novel therapy for existential distress in cancer patients. However, such treatments are often stigmatized and the views of support networks are unknown. Caregivers play an essential role in supporting the wellbeing and decision-making of people with cancer. In the context of a trial investigating psychedelic therapy for cancer patients, understanding the experience of the caregiver is important.
Objectives
The objectives of this research were to investigate the hopes, beliefs, perceptions, and experience of caregivers for advanced cancer patients undergoing a trial investigating a psychedelic-assisted therapy.
Methods
Semi-structured interviews asked 15 caregivers about their experience at baseline and 1 month after their close associate had completed treatment in a feasibility trial where participants were randomized to receive either lysergic acid diethylamide (LSD) microdoses or placebo alongside meaning-centered psychotherapy (MCP). Blinded to condition, reflexive thematic analysis was used to analyze interview transcripts.
Results
This study demonstrates the importance of bidirectional influences between caregiver and patient; the experience of one influences the experience of both. Caregivers were generally supportive of their close associate participating in a psychedelic-assisted trial, although some admitted hesitancy in them taking part. Caregivers described a desire to make the most of now, referring to the role of LSD microdose-assisted MCP as a means of accessing hope, improving the dyad relationship, and reducing existential distress.
Significance of Results
Participation in trials investigating psychedelic-assisted MCP may offer hope for patients and their caregivers. Given the bidirectional relationship in wellbeing between cancer dyads, caregivers should be included alongside patients in such trials.
The dhole Cuon alpinus was historically one of the most widespread large carnivores in Asia, but it has declined across its range as a result of habitat loss, hunting and prey depletion. There are few recent confirmed records of the species in Vietnam, and it has been reported as possibly extirpated. Here, we report a new camera-trap record of a dhole in Pu Hoat Nature Reserve, in Nghe An province, north-central Vietnam. To our knowledge, this is the first confirmed record of the dhole in Vietnam in > 20 years. We are unable to determine whether the record represents a vagrant animal or a remnant population. However, this new record should be viewed in the wider context of the species’ decline across Vietnam. During 2014–2024, in addition to our study, 3,231 camera-traps were set in 1,657 stations across 31 sites that would have been within the species’ historical range but the dhole was not recorded. We conclude that, despite this new record, the species is likely extirpated across most protected areas in Vietnam.
This study aims to identify the factors affecting the development of complications and to present the necessary data to the literature in order to reduce the frequency of complications as a result of some measures that can be taken against them.
Methods:
This retrospective study included 609 patients between the ages of 0 and 18 who underwent cardiac catheterisation between 2012 and 2020 by our Department of Paediatric Cardiology. The patient’s demographic data, cardiac catheterisation-related data, laboratory results, and all data in the post-procedure records are scanned and evaluated.
Results:
Of the patients aged between 0 and 216 months (mean 67.1 ± 55.8 months), 371 were female (60.9%). Interventional catheterisation was performed in 419 (68.4%) of the patients, and diagnostic catheterisation was performed in 193 (31.6%). Complications were detected in 39 patients (6.4%). The most frequent complications were vascular complications in 16 patients (41%), bleeding in 5 patients (12.8%), anaemia in 4 patients (10.3%), and arrhythmia in 3 patients (7.7%). Mortality occurred in 2 patients (0.3%). Risk factors for the development of complications were determined as <10 kg (p = 0.001) and <1 year of age (p = 0.002).
Conclusion:
The most common complications were vascular complications, followed by bleeding and anaemia. Low body weight (<10 kg) and being under 12 months of age are risk factors for the development of complications. Considering that most studies only include certain age groups or certain types of procedures, our study will make a significant contribution to the literature as it includes a larger scale and different types of procedures.
Maternal hyperglycemia is associated with higher risk of metabolic diseases in offspring. Despite various hypotheses, the exact mechanisms remain unclear and the neural implication is yet to be fully investigated. The hypothalamus plays a critical role in energy regulation. In utero exposure to maternal hyperglycemia might selectively affect the developing hypothalamus. To test this hypothesis, we investigated associations between in utero exposure to maternal hyperglycemia and hypothalamic volume at 10–12 years of age. We included 82 mother–child pairs from the Gen3G prospective birth cohort, followed up 10–12 years after birth. Women underwent a 75g Oral Glucose Tolerance Test (OGTT) at 24–30 weeks of gestation, and we calculated the area-under-the-curve of glucose (AUCgluc) from maternal glucose measurements at fasting, 1h and 2h during OGTT to reflect prenatal hyperglycemia exposure. During the follow-up visit at 10–12 years of age, a subsample of children (n = 82) completed 3 T brain magnetic resonance imaging (MRI) to quantify brain volumes with FreeSurfer 7. We used Pearson correlations and partial correlations with adjustments to test associations between the AUCgluc and offspring hypothalamic brain volumes. We found that higher maternal AUCgluc was associated with greater total offspring hypothalamic volume (r = 0.30; p = 0.006). In comparison, no other brain region was significantly correlated with the maternal AUCgluc. Correlations remain significant when adjusted for maternal or offspring’s variables. Overall, we found that higher maternal glycemic response following OGTT in pregnancy appears associated with larger offspring hypothalamic volume. Our results suggest that prenatal exposure to hyperglycemia may lead to hypothalamic programming.
We present a three-dimensional numerical study of the splashing dynamics of non-spherical droplets impacting a quiescent liquid film, covering a wide range of aspect ratios ($A_r$) and Weber numbers ($ \textit{We}$). The simulations reveal distinct impact dynamics, such as spreading, splashing type-1, splashing type-2 and canopy formation, which are delineated in a regime map constructed in the $A_r$–$ \textit{We}$ parameter space. Our results demonstrate that droplet morphology during the impact significantly influences crown evolution and splash initiation, with oblate drops promoting finger growth and fragmentation due to enhanced rim deceleration, while prolate drops tend to form canopies. We observe that the hole instability, which becomes more prominent at higher Weber numbers, arises from lamella rupture in the thinnest region of the film, located just beneath the crown rim. A linear stability analysis, supplemented by the temporal evolution of the crown obtained from the numerical simulations, adequately predicts the number of fingers formed along the crown rim by accounting for both Rayleigh–Plateau (RP) and Rayleigh–Taylor (RT) instabilities. The theoretical analysis demonstrates the dominant role of the RP instability in determining the number and wavelength of early undulations, with the RT instability serving to amplify the growth rate of the disturbances. Our findings highlight the critical role of the droplet shape in splash dynamics, which is relevant to a range of applications involving droplet impact.
Social anxiety is a common and impairing condition that often emerges in adolescence.
Aims
This study aimed to examine the prevalence and severity of social anxiety among Chinese youths in the post-COVID-19 era, and to develop a predictive model identifying key factors associated with social anxiety severity.
Method
A total of 555 youths aged 15–25 years completed an online survey via WeChat on social anxiety (Social Phobia Inventory), depressive symptoms (Patient Health Questionnaire), sleep problems (Pittsburgh Sleep Quality Index), social support (Multidimensional Scale of Perceived Social Support) and internalised stigma (Internalized Stigma of Mental Illness Scale). Social anxiety severity and rates were described, and comparisons were made across sociodemographic groups. Hierarchical multiple regression was used to predict social anxiety severity from depression, sleep, social support and stigma. An additional regression examined which components of social anxiety (fear, avoidance, physical symptoms) predict internalised stigma.
Results
In total, 69.55% of participants reported at least mild social anxiety, with 20% reaching severe or very severe levels. Female, younger participants and those with fewer close friends reported significantly higher anxiety. Depressive symptoms (β = 0.31, P < 0.05) and internalised stigma (β = 0.40, P < 0.05) were strong predictors of anxiety severity, while sleep problems and social support were not significant after controlling for these factors. Among social anxiety dimensions, only avoidance significantly predicted higher stigma (β = 0.17, P < 0.01).
Conclusions
The high post-pandemic prevalence of social anxiety among youths highlights the need for early identification, stigma reduction and interventions targeting depression and avoidance to prevent long-term impairments.
While M. NourbeSe Philip is often regarded as a black-feminist language poet, her concern about place is equally significant and deserves more critical attention. This essay reads Philip as an Afro-Caribbean poet of place and ponders the geographical implications of her abstract, black-feminism-inspired poetry. Specifically, I focus on her reasoning about “center” and how it engenders formal or verbal matrices in her poems. For Philip, “center” denotes not only the metropole dominating the periphery, but also a place of sufficient being, wholeness, and self-becoming. The second sense of “center” marks the telos of her poetics of place, which, I argue, consists in prevalent and ambiguous uses of the preposition “in” in works like She Tries and Zong!. Center entails an inwardness in response to colonialism-begotten displacement, and Philip’s choreography of “in” affords possibilities for conceptualizing the “placedness” of the Caribbean as well as blackness and black femininity in place.
Silverleaf nightshade, a highly invasive perennial weed, poses a serious threat to crops and orchards in Mediterranean regions. This weed reproduces both sexually, through seeds, and asexually, via an extensive rhizome network, contributing to its persistence and spread. Managing silverleaf nightshade is particularly challenging, requiring integrated chemical and non-chemical approaches. This study evaluated the effectiveness of preemergence and postemergence herbicides and thermal control methods at three growth stages (2-3, 4-6, and 7-10 true-leaf stages [TL]) of silverleaf nightshade. Seven preemergence herbicides were tested in a dose-response experiment at rates between 0.0625X and 2X of the recommended label rate on seedling emergence from three populations. Metribuzin, pyroxasulfone, pendimethalin, and sulfosulfuron suppressed seedling emergence by 80-90% at 28 days after treatment. Seven postemergence herbicides were tested on the same three seed populations, and on plants grown from rhizomes. Treatments were applied at three rates: the recommended label rate (1X) and two exploratory rates 0.5X and 2X. At the 1X and 2X rates, aminopyralid and glufosinate reduced biomass by more than 90% at all growth stages. Fluroxypyr and imazapic reduced biomass by more than 95% at the 2-3 TL growth stage across all application rates. At the 4-6 and 7-10 TL growth stages, biomass reduction >90% was achieved only at the 2X rate. Propane flaming at 33.3, 50 and 100 kg ha⁻¹ and electrocution with 18, 45 and 90 J (correspond to 0.5X, 1X and 2X application rates) tested across the three growth stages. Both thermal methods were highly effective at the 2-3 TL stage, reduced biomass >95%. The results highlight the importance of early intervention, as both herbicide and thermal treatments efficacy declined significantly as the weeds matured. Integrating pre and postemergence herbicides with thermal treatment could improve the long-term management of silverleaf nightshade in Mediterranean cropping systems.
In June 1838, five female dancers and three male musicians left Pondicherry for France, from where they travelled onwards to England, Austria, Belgium, and Germany. As they travelled, the dancers became bayadères, a European hegemonic construct that shaped Indian women as both sexual property and morally debauched. Through this racialised construct, Europeans, in particular the British and French, became positioned as morally superior to India and therefore legitimate imperialists. Within this context, I am interested in how images of the languid arms of the Indian temple dancers function as a site of archival resistance to their co-optation as the bayadère. I suggest that a close reading of the newspaper illustrations and affiliated articles, noticing details and making connections, undercuts the dancers’ repeated sexualisation and their refusal to be confined to the space demarcated for them in European hegemonic narratives. I argue that this archival resistance also counters the later dominant caste appropriation and embodiment of the temple dancer’s artistic practice as a form of Indian classical dance.
Infertility and involuntary childlessness are often accompanied by psychological distress. Such distress exhibits gendered patterns: women typically experience greater infertility-related suffering, including while they undergo procedures like IVF, and when such procedures fail. Early feminist critics of reproductive technologies sought to locate and address this suffering in the totality of women’s experience under patriarchy. Contemporarily, a liberal approach to this issue emphasizes the importance of an individual’s reproductive autonomy to engage in infertility procedures as they see fit. In this paper, I suggest that a hidden assumption within this liberal argument, serving as an operant justification for the development and provision of assisted reproductive technologies (ARTs), is that ARTs promote welfare, or well-being, through the alleviation of infertility-related distress. I explore whether ARTs do appropriately attend to welfare and so meet this justificatory aim. I suggest that IVF, where it is not successful, that is, in the vast majority of cases, does not serve to promote well-being. A comprehensive picture of welfare requires examining the social context in which infertility-related distress operates and in which well-being is thus compromised. Such considerations are essential to forming a holistic picture of well-being and in assessing whether ARTs can meet their welfarist aims.