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A few years after Singapore was founded, Lady Sophia Raffles sponsored a school for girls started by the wife of a London Missionary Society (LMS) missionary. This and several other early attempts at female education by missionary women linked to LMS or the American Board of Commissioners for Foreign Missions (ABCFM) were largely forgotten by historians. Then there were girls’ schools operated by the Protestant Society for Promoting Female Education in the East (SPFEE) in Britian; the secular Singapore Institution founded by Sir Thomas Stamford Raffles; and the Catholic Convent of Holy Infant Jesus (CHIJ) linked to Sœurs de l’Enfant Jésus-Nicolas Barré (EJNB) in France, followed by others. As there were many pioneering schools and some better-known ones tend to overshadow others, recent studies often contain inconsistent information as to which were the earliest schools, when they started, and who and which organisations were involved. This article uses primary sources from several archives to reconstruct the stories of the first Western-style girls’ schools on the island to hopefully clarify matters and close some knowledge gaps for readers interested in the history of female education in the early decades of colonial Singapore.
To characterise hospital-treated multimorbidity patterns in people who subsequently died a drug-related death in Scotland, and to identify clinically meaningful associations among conditions and decedent to inform prevention and care.
Methods:
A register-based retrospective cohort study using nationally linked hospital admission (1996–2019) and mortality (2008–2019) records for 5,749 decedents. We identified hospital admissions for Elixhauser comorbidities using ICD-10 codes. Correlation analysis, network analysis, and Bayesian clustering were used to describe co-occurring conditions and identify patient clusters with distinct comorbidity profiles.
Results:
Over half (50.9%) of decedents had at least one admission for an Elixhauser comorbidity. The most frequent were related to alcohol use (38.2%), drug use (29.1%), other neurological disorders (18.0%, mainly epilepsy/seizures/anoxic brain injury), depression (15.2%), and psychoses (12.5%). Network analysis highlighted drug use, alcohol use, psychoses, depression, and neurological disorders as central conditions. Bayesian clustering identified seven distinct patient clusters, including groups characterised by: high psychiatric and drug-use admissions; extensive physical comorbidities; alcohol and liver disease; dominant neurological issues and depression.
Conclusions:
Individuals experiencing drug-related deaths exhibit substantial multimorbidity with distinct patterns often dominated by substance use and mental ill-health but also including significant physical health clusters. These distinct profiles underscore the need for integrated, tailored care strategies addressing substance use, psychiatric, and physical health needs to mitigate mortality risk.
Spinal CSF leaks are a known cause of spontaneous intracranial hypotension, often presenting with orthostatic headaches and other neurological symptoms. While epidural blood patches are commonly used as initial treatment, many patients require surgery due to persistent symptoms. This study integrates a retrospective institutional cohort and a systematic literature review to evaluate the safety and efficacy of surgical dural repair for spontaneous spinal CSF leaks.
Methods:
A retrospective chart review included all patients who underwent surgery for spontaneous spinal CSF leak at a Canadian center between June 2017 and December 2023. Clinical presentation, imaging findings, surgical approach and postoperative outcomes were assessed. A PRISMA-compliant systematic review identified studies reporting surgical management and outcomes for spinal CSF leaks.
Results:
Forty patients (21 females, 19 males; mean age 50.48 ± 11.88 years) were included. Type 1 ventral dural CSF leaks predominated (72.5%), most commonly in the thoracic spine. Spinal longitudinal extradural collection and cranial stigmata were present in 70% and 75%, respectively. Microscopic direct dural repair led to clinical improvement in 82.5%, with headache resolution or improvement in 85.72%. The complication rate was 7.5% with all complications being transient. The systematic review included 20 studies (483 patients), reporting an 84.06% pooled surgical success rate, with transient complications most common in direct suturing techniques.
Conclusion:
Surgical repair is a safe and effective treatment for spontaneous spinal CSF leaks, particularly in patients with failed conservative treatment. Favorable outcomes support early, anatomically guided surgical intervention.
Timely blood cultures (BCx) are required by SEP-1. The recent BCx bottle shortage necessitated enhanced BCx stewardship. At two hospitals during the shortage, SEP-1 metric compliance declined related to BCx utilization. Review of cases where BCx were not obtained demonstrated most BCx were safely avoided without demonstrable patient harm.
Surface patterns on ablating materials are known to appear in both high-speed ground and flight tests, but the mechanisms behind their formation are not known. In this paper, the origins of surface patterns are investigated via a local linear stability analysis of compressible laminar boundary layers over a flat camphor plate. The effects of sublimation and conjugate heat transfer are included on both the baseflow and the linear fluctuations. This newly developed framework identifies a single mode that fully characterises the stability of the surface, and this surface mode becomes unstable under laminar conditions only when the wall temperature exceeds that of an adiabatic wall, $T_{\textit{ad}}$. These findings are consistent with experimental observations, where laminar flow conditions at adiabatic wall temperatures are observed to be stable. The present analysis also reveals that the nature of this surface mode varies as a function of the oblique angle $\psi = \tan ^{-1}({\beta /\alpha })$, where $\alpha$ and $\beta$ are the streamwise and spanwise wavenumbers. As the wall temperature increases, the most unstable orientation of the surface mode shifts from streamwise alignment ($\psi = 0$), towards the sonic angle ($\psi = \psi _s = \cos ^{-1}(1/M_e)$) and then towards spanwise alignment ($\psi = 90^\circ$). Finally, a critical wavenumber is identified (i.e. one at which the temporal growth rate reaches a maximum) which implies the formation of a surface pattern of a specific wavelength and orientation.
This paper examines the prescription stimulant shortage in the United States, a crisis that has intensified since the FDA’s 2022 announcement of an Adderall shortage. The regulatory, systemic, and societal factors driving the shortage are analyzed — including the surge in attention-deficit/hyperactivity disorder (ADHD) diagnoses, expanded use of telehealth services, and disproportionate impact of the shortage on marginalized communities. It’s argued that existing health inequities are exacerbated by barriers to medication access as current regulatory frameworks are ill-equipped to address the growing demand for prescription stimulants, causing substantial harm to patients. A series of reforms are proposed — including modernizing the DEA’s quota system, strengthening interagency collaboration between the DEA, FDA, and HHS, and diversifying pharmaceutical supply chains to enhance resilience. These reforms aim to balance the dual imperatives of preventing misuse and ensuring equitable access to medications for patients with legitimate medical needs. By offering a comprehensive analysis of the prescription stimulant shortage and actionable policy recommendations, this paper seeks to inform regulatory reform, foster a more adaptive, patient-centered approach to ADHD care, and provide a roadmap for addressing one of the most pressing healthcare challenges of our time.
This article argues that the global Business and Human Rights movement demonstrates a push towards a human-rights type of sustainable corporation, reconciling economic development and human rights. It explains the necessity for and significance of a definition of a sustainable corporation at the intersection of traditional international human rights and sustainable development instruments. It argues, inter alia, that an internationally recognised definition of a sustainable corporation can settle fundamental questions and create a minimal framework for meaningful discourse on corporate accountability for human rights, climate change and the environment. It identifies difficulties of defining a sustainable corporation such as the integration problem. It suggests ‘direct human rights obligation’ as a minimally sufficient normative criterion for the definitional correctness of a sustainable corporation. The suggested definition of sustainable corporation requires taking a normative position which makes the term ‘essentially contested’ resulting in discursive and behavioural norm contestation in the search for definitional determinacy and consensus within the divide between international and domestic law.
This study presents the control of an omnidirectional automated guided vehicle (AGV) with mecanum wheels using a hybrid optimization algorithm that combines a modified A* algorithm and the dynamic window approach (ADWA-HO). The method ensures efficient and precise navigation in both static and dynamic environments. The modified A* algorithm generates global paths, removes redundant nodes, and refines trajectories to improve efficiency and smoothness. At the same time, the dynamic window approach (DWA) enables real-time local path planning and obstacle avoidance. By evaluating the AGV’s motion commands in real time, ADWA-HO selects optimal velocity commands within a dynamically updated window, thereby reducing route conflicts and ensuring stable movement. Compared with benchmark methods including dynamic A* (D*), artificial potential field (APF), DWA, probabilistic roadmap (PRM) & rapidly exploring random tree (RRT) fusion, and PRM & DWA fusion, the proposed ADWA-HO achieves improvements in average path length of 28.10%, 22.95%, 21.16%, 17.35%, and 10.71% and in average motion time of 23.48%, 17.85%, 15.47%, 11.86%, and 7.53% on both Map 1 and Map 2, respectively. The difference between simulation and real-world experiments is limited to 5.35% in path length and 4.38% in motion time, confirming the method’s practical reliability. Furthermore, the algorithm achieves lower standard deviation in both metrics, indicating higher consistency of performance. This work also introduces a novel map-building strategy based on geometric and semantic data modules, which enhances the adaptability of real-world AGV deployment.
This article discusses the official discourse that appeared in Macau’s Portuguese-language media and the documentaries that were shot there by Portuguese filmmakers in the 1960s and 1970s, especially focusing on the productions that followed the 123 Incident and which largely functioned as a response to it. These riots occurred in December 1966, when Chinese residents of Macau used Cultural Revolution-like protests to contest what they viewed as an inefficient and unfair Portuguese administration. They had a long-lasting and deep impact, weakening Portuguese colonial rule and increasing the influence of the People’s Republic of China (PRC) and local Maoists in Macau. In an attempt to counter the image-damage caused by the incident and legitimise Portuguese sovereignty in the territory during what was its worst crisis in the post-war period, Portuguese official discourse and these films came to promote Macau as a site of ‘miraculous’ development and modernisation that had as its basis Luso-Chinese partnership. Furthermore, Macau was advocated as an exemplary case of good neighbourhood policy towards the PRC and of coexistence at all levels, particularly ethnically and politically. This, it was suggested, made it a unique place and a model for the world in a time of cold war.
A general way to represent stochastic differential equations (SDEs) on smooth manifolds is based on the Schwartz morphism. In this manuscript, we are interested in SDEs on a smooth manifold $M$ that are driven by p-dimensional Wiener process $W_t \in \mathbb{R}^p$ and time $t$. In terms of the Schwartz morphism, such an SDE is represented by a Schwartz morphism that morphs the semimartingale $(t,W_t)\in\mathbb{R}^{p+1}$ into a semimartingale on the manifold $M$. We show that it is possible to construct such Schwartz morphisms using special maps that we call diffusion generators. We show that one of the ways to construct a diffusion generator is by considering the flow of differential equations. One particular case is the construction of diffusion generators using Lagrangian vector fields. Using the diffusion generator approach, we also give the extended Itô formula (also known as generalized Itô formula or Itô–Wentzell formula) for SDEs on manifolds.
Collaborative governance among multiple stakeholders is typically essential for conserving complex social-ecological systems. Mexico’s ‘biocultural landscapes’ – a territorial governance initiative – may be seen as pioneering models to promote this. However, actual outcomes depend on the initial conditions, institutional design, leadership and details of the collaborative process. We used a mixed-methods approach combining social network analysis and semi-structured interviews to analyse the structure of the collaboration network within Mexico’s Sierra Occidental Biocultural Landscape (SOBL). Our findings revealed a sparse, low-reciprocity network dominated by a few public managers, indicating potential power imbalances and challenges to building trust. Stakeholder interviews showed misalignments with theoretical collaborative governance including power imbalances, limited inclusiveness and a lack of trust among participants. While the SOBL has achieved collaborative results, such as the community forest fire brigades and the development of land management plans, achieving its full potential as a model for biocultural conservation requires addressing power dynamics and building a more equitable governance structure.
Transient thermocapillary convection flows near a suddenly heated vertical wire are widely present in nature and industrial systems. The current study investigates the dynamical evolution and heat transfer for these transient flows near a suddenly heated vertical wire, employing scaling analysis and axisymmetric numerical simulation methodologies. Scaling analysis indicates that there exist four possible scenarios of the dynamical evolution and heat transfer for these transient flows, dependent on the wire curvature, Marangoni number and Prandtl number. In a typical scenario of the dynamical evolution and heat transfer, heat is first conducted into the fluid after sudden heating, resulting in an annular vertical thermal boundary layer around the wire. The radial temperature gradient may generate a thermocapillary force on the liquid surface, dragging the liquid away from the wire. The pressure gradient also drives a vertical flow along the wire. Further, the current study analyses and derives the scaling laws of the velocity, thickness and Nusselt number for the surface and vertical flows in different scenarios. Additionally, a number of two-dimensional axisymmetric numerical simulations are performed. The flow structure around the suddenly heated vertical wire is characterised under different regimes and the validation for the proposed scaling laws in comparison with numerical results is presented.
Dengue fever, a mosquito-borne viral illness, has varied systemic manifestations, but its auditory effects remain underexplored. The objective of this study was to assess the association between dengue infection and hearing loss.
Methods
A prospective case-control study was conducted on 79 patients—40 dengue-positive (NS1 antigen confirmed) and 39 with other febrile illnesses. All participants underwent otological examination and pure tone audiometry.
Results
Hearing loss was observed in 15.2 per cent of dengue patients, with none in controls (p < 0.001). The odds ratio for hearing loss in dengue was 34.6 (95 per cent confidence interval: 1.97–610). Dengue patients exhibited significantly elevated air and bone conduction thresholds (p < 0.001). Lower platelet counts and higher C-reactive protein levels correlated with hearing loss, suggesting vascular and inflammatory mechanisms.
Conclusion
Dengue fever may be associated with reversible sensorineural hearing loss, likely due to microvascular and inflammatory injury to the cochlea. Early audiological screening is recommended in dengue cases.
Different cutting intervals can influence crop development. Therefore, knowledge of the interaction between growth factors and soil-plant-atmosphere conditions can contribute to the efficient cultivation of forage cactus. The objective of this study was to evaluate morphophysiological characteristics, production and water and economic indicators in forage cactus clones subjected to different cutting interval. The study was conducted in Serra Talhada, Pernambuco, in a 3 × 4 factorial arrangement, with three forage cactus clones (‘Orelha de Elefante Mexicana, OEM’ – Opuntia stricta; ‘Miúda’ and ‘IPA Sertânia’ – Nopalea cochenillifera) and four cutting intervals (6, 9, 12 + 6 and 18 months) in randomised blocks, with four replications. Biometric and productive measurements were performed to determine the phenophases and cutting times. The components of the soil water balance (SWB) were considered at a depth of 0.60 m and the indicators were analysed. The Absolute Growth Rate – AGR and Relative Growth Rate – RGR were higher for the OEM clone at a interval of 18 months. The highest productions of fresh mass (FM) (286.4 Mg/ha) and dry matter (DM) (21.4 Mg/ha) occurred in the OEM clone regardless of the cutting interval. The MIU clone presented three phenophases. The water use efficiency indicator (*WUEc, 1.5 kg/m3) and crop water productivity (*WPc, 1.3 kg/m3) were improved in treatments with the OEM clone, as well as the gross economic productivity of water via irrigation (PBEAi, 2.98 US$/m3). It is recommended to cultivate the OEM clone of forage cactus, regardless of the cutting interval, to provide greater productivity and economic benefits.
Ultra-high dose rate (UHDR) radiation, popularly known as FLASH, has been demonstrated to selectively kill tumor cells with minimal or negligible effects on normal cells but the biological effects induced by UHDR are not fully understood.
Methods
In this study, cytogenetic damage induced by UHDR radiation was compared with conventional dose rate (CDR) in human peripheral blood lymphocytes. Human blood samples were irradiated with 3 Gy and 8 Gy doses using 9 MeV electrons at 2 different dose rates: CDR 1 Gy/min and UHDR 600 Gy/Sec. Unstable and stable chromosomal aberrations were detected by fluorescence in situ hybridization (FISH).
Results
Reduced yields of chromosomal aberrations were observed after UHDR radiation at both radiation doses and the extent of reduction was more in colcemid arrested metaphase chromosomes than in G2-PCCs.
Conclusions
The reduced yields of chromosomal aberrations detected after UHDR of electrons may be due to rapid delivery of radiation dose within seconds, resulting in a non-uniform exposure of lymphocytes with varying levels of DNA damage induction. Future studies using well defined human equivalent in vivo and in vitro model systems are required to determine the underlying mechanisms for the FLASH effects.
We exploit U.S. states’ staggered adoption of Universal Demand (UD) laws to study how the risk of shareholder lawsuits affects insider trading. UD laws, which make it harder for shareholders to bring derivative lawsuits against directors and officers, lead to more profitable insider trades, especially sales. This effect is stronger among smaller firms and firms with lower institutional monitoring. After UD laws, the timing of insiders’ trades also appears more opportunistic and riskier, for example, sales increase before negative earnings surprises. Overall, our study offers clean evidence that the threat of shareholder litigation deters opportunistic insider trading.
The emergence of the so-called gig economy has reshaped the labor market and, potentially, the politics of the safety net. Much of the American welfare state is based on a traditional model of employment, excluding most gig workers from benefits like subsidized employer-provided health insurance and unemployment insurance. Despite these trends, there is little research on how these changes might affect politics. Are gig workers likely to become a relevant constituency on social welfare and other issues? To address this, we conducted a unique online survey examining policy attitudes and political behaviors among gig workers compared with traditional workers. Our findings indicate that people who view gig work as their “main job” tend to lack access to traditional social insurance and employer-provided benefits, as expected, and rely more on means-tested assistance programs (e.g., food stamps). Consequently, gig workers exhibit higher support than traditional workers for expanding social welfare programs, and are more engaged on issues that affect gig workers. In terms of participation, gig workers are less likely to vote but more likely to engage in nonvoting political activities like protest than traditional workers. This study contributes to the understanding of social welfare politics in the new era of the labor market and highlights a growing constituency for expanding the safety net.
This article provides an overview of Korea’s National Radiological Emergency Medical System, which coordinates medical responses to radiological emergencies through specialized infrastructure, training, and research.
Methods
The system’s recent advancements are outlined, focusing on a nationwide network of emergency medical institutions and improvements in education, training, and research to enhance preparedness for radiological emergencies.
Results
The National Radiation Emergency Medical Center (NREMC) manages 31 designated emergency medical institutions, providing specialized training for first responders and medical personnel. Virtual reality tools have been integrated into training programs to improve instructional effectiveness. A hotline offers immediate support for radiation exposure cases and public consultations during non-emergency periods. Additionally, the NREMC employs internationally accredited physical and biological dosimetry methods and strengthens its expertise through collaborations with global organizations.
Conclusions
Continuous advancements in medical response, training, and international cooperation enhance Korea’s radiological emergency preparedness. Ongoing research and technology integration ensure effective emergency interventions and long-term public health protection.
The European Radiation Dosimetry Group (EURADOS) and the WHO’s Radiation Emergency Medical Preparedness and Assistance Network (REMPAN) have collaborated to review best practices for managing radionuclide intakes through wounds. Rapid response and decisions on wound decontamination, tissue excision, and chelation therapy are based on measurements of the exposed individual and preliminary dose assessments using reasonable default assumptions. The goal is to minimize exposure, prevent tissue reactions, and reduce the risk of stochastic effects.
The management of a contaminated wound is always case-specific, but some general procedures typically apply for a proper evaluation of the contamination case. Medical doctors (surgeons and toxicologists) and internal dosimetrists should work together in the management of the contaminated wound case, with internal dosimetrists providing expert advice to aid clinical decision-making and communication with the patient and his/her family. The ISO standard 20031:2020 provides guidelines on the monitoring and dosimetry for internal exposures due to wound contamination with radionuclides. The Clinical Decision Guide was proposed by the National Council on Radiation Protection and Measurements in its Report 161 to assist physicians in making treatment decisions for individuals with internal radionuclide intakes. Best practices for medical treatment, based on previous experience, are presented here.
On June 6, 2017, an accident occurred at the JAEA’s Oarai Research and Development Center, where 5 workers inhaled plutonium. This study aims to evaluate the validity of the internal dose assessments conducted by the QST and to share the findings with the dosimetry community.
Methods
In vivo measurements (lungs and liver) and bioassays were performed. The particle size of the inhaled material was estimated based on the ratio of early fecal excretion to residual lung content. The absorption types of Pu and 241Am were evaluated using urinary excretion levels from bioassay results of early fecal and pre-Ca- DTPA urine samples.
Results
The estimated particle sizes of the inhaled materials were over 10 μm and several micrometers for 2 workers, respectively. The absorption types were evaluated as intermediate between M (Moderate) and S (Slow). A change in urinary excretion levels between before and after Ca-DTPA administration was observed, with the most significant reduction occurring after the initial treatment, followed by smaller changes.
Conclusions
The internal dose assessments for the 5 workers were confirmed to be conservatively conducted within a reasonable range. Comprehensive individual monitoring in cases of internal contamination by actinide is crucial to reducing uncertainties in dose assessment.