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We use Stein’s method to establish the rates of normal approximation in terms of the total variation distance for a large class of sums of score functions of samples arising from random events driven by a marked Poisson point process on $\mathbb{R}^d$. As in the study under the weaker Kolmogorov distance, the score functions are assumed to satisfy stabilisation and moment conditions. At the cost of an additional non-singularity condition, we show that the rates are in line with those under the Kolmogorov distance. We demonstrate the use of the theorems in four applications: Voronoi tessellations, k-nearest-neighbours graphs, timber volume, and maximal layers.
To evaluate the efficacy of a new continuously active disinfectant (CAD) to decrease bioburden on high-touch environmental surfaces compared to a standard disinfectant in the intensive care unit.
Design:
A single-blind randomized controlled trial with 1:1 allocation.
Setting:
Medical intensive care unit (MICU) at an urban tertiary-care hospital.
Participants:
Adult patients admitted to the MICU and on contact precautions.
Intervention:
A new CAD wipe used for daily cleaning.
Methods:
Samples were collected from 5 high-touch environmental surfaces before cleaning and at 1, 4, and 24 hours after cleaning. The primary outcome was the mean bioburden 24 hours after cleaning. The secondary outcome was the detection of any epidemiologically important pathogen (EIP) 24 hours after cleaning.
Results:
In total, 843 environmental samples were collected from 43 unique patient rooms. At 24 hours, the mean bioburden recovered from the patient rooms cleaned with the new CAD wipe (intervention) was 52 CFU/mL, and the mean bioburden was 92 CFU/mL in the rooms cleaned the standard disinfectant (control). After log transformation for multivariable analysis, the mean difference in bioburden between the intervention and control arm was −0.59 (95% CI, −1.45 to 0.27). The odds of EIP detection were 14% lower in the rooms cleaned with the CAD wipe (OR, 0.86; 95% CI, 0.31–2.32).
Conclusions:
The bacterial bioburden and odds of detection of EIPs were not statistically different in rooms cleaned with the CAD compared to the standard disinfectant after 24 hours. Although CAD technology appears promising in vitro, larger studies may be warranted to evaluate efficacy in clinical settings.
Let G be a group that is either virtually soluble or virtually free, and let ω be a weight on G. We prove that if G is infinite, then there is some maximal left ideal of finite codimension in the Beurling algebra $\ell^1(G, \omega)$, which fails to be (algebraically) finitely generated. This implies that a conjecture of Dales and Żelazko holds for these Banach algebras. We then go on to give examples of weighted groups for which this property fails in a strong way. For instance, we describe a Beurling algebra on an infinite group in which every closed left ideal of finite codimension is finitely generated and which has many such ideals in the sense of being residually finite dimensional. These examples seem to be hard cases for proving Dales and Żelazko’s conjecture.
Collaborative care (CC) and consultation liaison (CL) are two conceptual models aiming to improve mental healthcare in primary care. The effects of these models have not been compared in a Danish setting.
Aims
To examine the effects of CC versus CL for persons with anxiety and depression in Danish general practices (trial registration: NCT03113175 and NCT03113201).
Method
Two randomised parallel superiority trials for anxiety disorders and depression were carried out in 2018–2019. In the CC-group, care managers collaborated with general practitioners (GPs) to provide evidence-based treatment according to structured treatment plans. They followed up and provided psychoeducation and/or cognitive–behavioural therapy. The GPs initiated pharmacological treatment if indicated, and a psychiatrist provided supervision. In the CL-group, the intervention consisted of the GP's usual treatment. However, the psychiatrist and care manager could be consulted. Primary outcomes were depression symptoms (Beck Depression Inventory-II, BDI-II) in the depression trial and anxiety symptoms (Beck Anxiety Inventory, BAI) in the anxiety trial at 6-month follow-up.
Results
In total, 302 participants with anxiety disorders and 389 participants with depression were included. A significant difference in BDI-II score was found in the depression trial, with larger symptom reductions in the CC-group (CC: 12.7, 95% CI 11.4–14.0; CL: 17.5, 95% CI 16.2–18.9; Cohen's d = −0.50, P ≤ 0.001). There was a significant difference in BAI in the anxiety trial (CC: 14.9, 95% CI 13.5–16.3; CL: 17.9, 95% CI 16.5–19.3; Cohen's d = −0.34, P ≤ 0.001), with larger symptom reductions in the CC-group.
Conclusions
Collaborative care was an effective model to improve outcomes for persons with depression and anxiety disorders.
In 2003, the Botswanan Court of Appeal decided in Kanane v The State that discrimination on the basis of sexual orientation was not proscribed by the Botswanan Constitution because no evidence had been adduced showing that the society of Botswana was ready for gay individuals. After sixteen years, things changed: in 2019, in Letsweletse Motshidiemang and LEGABIBO (as amicus) v The Attorney General, the High Court held that the law criminalizing anal intercourse violated the fundamental rights of gay people. In 2021, the Court of Appeal upheld the High Court decision. This commentary briefly examines these three decisions. It argues that Kanane gave too much weight to public opinion to the detriment of constitutional interpretation. Through a robust approach to generous interpretation of fundamental rights, the Motshidiemang decisions partly remedied the flaw in Kanane. However, judicial clarification is still required on some aspects of the decision.
This article examines a long-standing association of Martin Luther's christology with that of Cyril of Alexandria. However, for all its heuristic promise, the designation ‘Cyrillian’, must in Luther's case be understood either as an overly generalised statement of a well-established grammar of christology – in which case it simply is Luther's foundation and, as such, explains nothing specific about Luther's christology and, moreover, fails to do justice to the reformer's crucial argumentative moves. Alternatively, when taken for a set of material similarities, the designation is simply inaccurate, for Luther is decidedly not a Cyrillian, despite some fundamental convergences with the thought of the Alexandrian patriarch. Luther's context, as we demonstrate, leads him not only to go beyond Cyril, but also to argue in a manner contrary to Cyril, in order to secure what for both theologians is a realist eucharistic backdrop of their commitment to the Word's incarnation.
The Neoplatonist scholarch Proclus defined three categories of poetry: inspired, ‘middle’ and mimetic. Traditionally it has been thought that he considered only Homer to have excelled in all three, while other poets could fulfil one or at most two functions. It will be shown that Proclus also conceived of Hesiod as excelling in all three types and thereby assimilated Hesiodic authority to Homeric. He also considered Orpheus but assigned his poetry to just one category, not all three. In doing this, he increased his own authority as a teacher-hierophant, contributing to the dialogue between pagan Platonism and Christianity over the inspiration of texts.
In this article, I analyze a rhythmic device in musical theater performance that is often used but rarely discussed: The sudden break into halftime. Breaking into halftime—a rhythmic shift that is performed and perceived as occurring at half the tempo (or speed) of the groove in preceding and subsequent sections—has the effect of abruptly stretching out and slowing down musical temporality. With a break into halftime, a song's groove is suddenly broader, more open, and expansive. When accompanied by lyrics, the move suggests deliberateness, calls attention to the lyrical address, and invites a considered response from the listener. It is a musical device akin to drastically slowing down a spoken cadence to ensure that the listener is fully grasping the significance of one's words. With or without lyrics, this temporal disruption has a powerful effect on listeners’ bodies as, suddenly, the established timing of one's musical experience is disrupted and immediately set to half the speed of the previous pace. By analyzing the use of halftime in three filmed musicals—Newsies, Rent, and the Rocky Horror Picture Show—I show how the rhythmic device carries with it social coding of solidarity and collective power among queer, marginalized, and/or otherwise outcast individuals and ultimately alters the broader narrative of the shows. Ultimately, I articulate how halftime serves to queer time and forge collective action, allowing us to reimagine what sort of politics, formations, collectives, and futures are possible.
Coronations in Great Britain previously offered an occasion for national civic and spiritual renewal. However, the recent crowning of Charles III threw a spotlight on some of the deepening dissonance, diversity and divisions within British society. This paper is an ‘in principle’ argument for change and development. As the clamour for constitutional reform in the United Kingdom continues, and the awkwardness of Church of England bishops sitting in the House of Lords becomes more apparent, the time is ripe to reconsider disestablishment. In particular, the power and privilege of one denomination over all others is interrogated in relation to a kenotic ecclesiology, and which may now require the intentional divesting of kingly power: not clinging to status any longer, but self-emptying and embracing equality.
Since the 1980s, the Nonesuch label, a longstanding subsidiary of the Warner Music Group (WMG), has become noteworthy for its steady market performance during a period of volatility for media multinationals. Nonesuch Records, having once been an adventurous boutique classical label under Teresa Sterne, has developed over the last three decades as a creatively idiosyncratic and commercially successful “adult” imprint under Robert Hurwitz, the erstwhile director of the Munich-based Edition of Contemporary Music jazz label.
Nonesuch has not historically been understood as a jazz label, though it has served as a home for a few jazz acts, including Bill Frisell, Fred Hersch, and the World Saxophone Quartet. By the early years of the new millennium, though, Nonesuch had become one of the few major label subsidiaries willing to maintain an active roster of jazz instrumentalists, harnessing its diversified roster as a source of strength.
This paper examines the Nonesuch label's cultivation of a distinctive jazz niche and situates this development against the backdrop of a period of structural turbulence for the WMG. The leveraged buyout of WMG in 2004, which precipitated the dissolution of the Warner Jazz subsidiary and the transfer of much of its jazz roster to Nonesuch, reflects a contemporary logic of financialization, where value extraction has become the overriding goal of corporate restructuring. Mergers and acquisitions enacted at the uppermost reaches of major label corporate hierarchies pass along significant costs to the label subsidiaries and their artist rosters, installing precarity at the core of the music industry's creative ecologies.
Guided self-help (GSH) for anxiety is widely implemented in primary care services because of service efficiency gains, but there is also evidence of poor acceptability, low effectiveness and relapse.
Aims
The aim was to compare preferences for, acceptability and efficacy of cognitive–behavioural guided self-help (CBT-GSH) versus cognitive–analytic guided self-help (CAT-GSH).
Method
This was a pragmatic, randomised, patient preference trial (Clinical trials identifier: NCT03730532). The Beck Anxiety Inventory (BAI) was the primary outcome at 8- and 24-week follow-up. Interventions were delivered competently on the telephone via structured workbooks over 6–8 (30–35 min) sessions by trained practitioners.
Results
A total of 271 eligible participants were included, of whom 19 (7%) accepted being randomised and 252 (93%) chose their treatment. In the preference cohort, 181 (72%) chose CAT-GSH and 71 (28%) preferred CBT-GSH. BAI outcomes in the preference and randomised cohorts did not differ at 8 weeks (−0.80, 95% confidence interval (CI) −4.52 to 2.92) or 24 weeks (0.85, 95% CI −2.87 to 4.57). After controlling for allocation method and baseline covariates, there were no differences between CAT-GSH and CBT-GSH at 8 weeks (F(1, 263) = 0.22, P = 0.639) or at 24 weeks (F(1, 263) = 0.22, P = 0.639). Mean BAI change from baseline was a reduction of 9.28 for CAT-GSH and 9.78 for CBT-GSH at 8 weeks and 12.90 for CAT-GSH and 12.43 for CBT-GSH at 24 weeks.
Conclusions
Patients accessing routine primary care talking treatments prefer to choose the intervention they receive. CAT-GSH expands the treatment offer in primary care for patients with anxiety seeking a brief but analytically informed GSH solution.
Near-wall flow simulation remains a central challenge in aerodynamics modelling: Reynolds-averaged Navier–Stokes predictions of separated flows are often inaccurate, and large-eddy simulation (LES) can require prohibitively small near-wall mesh sizes. A deep learning (DL) closure model for LES is developed by introducing untrained neural networks into the governing equations and training in situ for incompressible flows around rectangular prisms at moderate Reynolds numbers. The DL-LES models are trained using adjoint partial differential equation (PDE) optimization methods to match, as closely as possible, direct numerical simulation (DNS) data. They are then evaluated out-of-sample – for aspect ratios, Reynolds numbers and bluff-body geometries not included in the training data – and compared with standard LES models. The DL-LES models outperform these models and are able to achieve accurate LES predictions on a relatively coarse mesh (downsampled from the DNS mesh by factors of four or eight in each Cartesian direction). We study the accuracy of the DL-LES model for predicting the drag coefficient, near-wall and far-field mean flow, and resolved Reynolds stress. A crucial challenge is that the LES quantities of interest are the steady-state flow statistics; for example, a time-averaged velocity component $\langle {u}_i\rangle (x) = \lim _{t \rightarrow \infty } ({1}/{t}) \int _0^t u_i(s,x)\, {\rm d}s$. Calculating the steady-state flow statistics therefore requires simulating the DL-LES equations over a large number of flow times through the domain. It is a non-trivial question whether an unsteady PDE model with a functional form defined by a deep neural network can remain stable and accurate on $t \in [0, \infty )$, especially when trained over comparatively short time intervals. Our results demonstrate that the DL-LES models are accurate and stable over long time horizons, which enables the estimation of the steady-state mean velocity, fluctuations and drag coefficient of turbulent flows around bluff bodies relevant to aerodynamics applications.
Cereal products provide 50 % of iron and 30 % of zinc in the UK diet. However, despite having high content, the bioavailability of minerals from cereals is low. This review discusses strategies to increase mineral bioavailability from cereal-based foods. Iron and zinc are localised to specific tissue structures within cereals; however, the cell walls of these structures are resistant to digestion in the human gastrointestinal tract and therefore the bioaccessibility of these essential minerals from foods for absorption in the intestine is limited. In addition, minerals are stored in cereals bound to phytate, which is the main dietary inhibitor of mineral absorption. Recent research has focused on ways to enhance mineral bioavailability from cereals. Current strategies include disruption of plant cell walls to increase mineral release (bioaccessibility) during digestion; increasing the mineral:phytate ratio either by increasing the mineral content through conventional breeding and/or agronomic biofortification, or by reducing phytate levels; and genetic biofortification to increase the mineral content in the starchy endosperm, which is used to produce white wheat flour. While much of this work is at an early stage, there is potential for these strategies to lead to the development of cereal-based foods with enhanced nutritional qualities that could address the low mineral status in the UK and globally.
Several authors have shown that Kusuoka’s measure κ on fractals is a scalar Gibbs measure; in particular, it maximizes a pressure. There is also a different approach, in which one defines a matrix-valued Gibbs measure µ, which induces both Kusuoka’s measure κ and Kusuoka’s bilinear form. In the first part of the paper, we show that one can define a ‘pressure’ for matrix-valued measures; this pressure is maximized by µ. In the second part, we use the matrix-valued Gibbs measure µ to count periodic orbits on fractals, weighted by their Lyapounov exponents.
An archaeological field project designed to investigate Palaeolithic occupation is being undertaken in Mardin Province, south-east Turkey. New sites have been identified and recorded systematically, including Şıkefta Elobrahimo Cave. Together, these provide ample evidence for hominin presence in this area since the Middle Palaeolithic.
Let k be a field of characteristic zero and $k^{[n]}$ the polynomial algebra in n variables over k. The LND conjecture concerning the images of locally nilpotent derivations arose from the Jacobian conjecture. We give a positive answer to the LND conjecture in several cases. More precisely, we prove that the images of rank-one locally nilpotent derivations of $k^{[n]}$ acting on principal ideals are MZ-subspaces for any $n\geq 2$, and that the images of a large class of locally nilpotent derivations of $k^{[3]}$ (including all rank-two and homogeneous rank-three locally nilpotent derivations) acting on principal ideals are MZ-subspaces.
Childhood and lifetime adversity may reduce brain serotonergic (5-HT) neurotransmission by epigenetic mechanisms.
Aims
We tested the relationships of childhood adversity and recent stress to serotonin 1A (5-HT1A) receptor genotype, DNA methylation of this gene in peripheral blood monocytes and in vivo 5-HT1A receptor binding potential (BPF) determined by positron emission tomography (PET) in 13 a priori brain regions, in participants with major depressive disorder (MDD) and healthy volunteers (controls).
Method
Medication-free participants with MDD (n = 192: 110 female, 81 male, 1 other) and controls (n = 88: 48 female, 40 male) were interviewed about childhood adversity and recent stressors and genotyped for rs6295. DNA methylation was assayed at three upstream promoter sites (−1019, −1007, −681) of the 5-HT1A receptor gene. A subgroup (n = 119) had regional brain 5-HT1A receptor BPF quantified by PET. Multi-predictor models were used to test associations between diagnosis, recent stress, childhood adversity, genotype, methylation and BPF.
Results
Recent stress correlated positively with blood monocyte methylation at the −681 CpG site, adjusted for diagnosis, and had positive and region-specific correlations with 5-HT1A BPF in participants with MDD, but not in controls. In participants with MDD, but not in controls, methylation at the −1007 CpG site had positive and region-specific correlations with binding potential. Childhood adversity was not associated with methylation or BPF in participants with MDD.
Conclusions
These findings support a model in which recent stress increases 5-HT1A receptor binding, via methylation of promoter sites, thus affecting MDD psychopathology.