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We conducted interviews with state epidemiologists involved in the state-level COVID-19 response to understand the challenges and opportunities that state epidemiologists and state health departments faced during COVID-19 and consider the implications for future pandemic responses.
Methods
As part of a broader study on policymaking during COVID-19, we analyzed 12 qualitative interviews with state-epidemiologists from 11 US states regarding the challenges and opportunities they experienced during the COVID-19 response.
Results
Interviewees described the unprecedented demands COVID-19 placed on them, including increased workloads as well as political and public scrutiny. Decades of under-funding and constraints posed particular challenges for meeting these demands and compromised state responses. Emergency funding contributed to ameliorating some challenges. However, state health departments were unable to absorb the funds quickly, which created added pressure for employees. The emergency funding also did not resolve longstanding resource deficits.
Conclusions
State health departments were not equipped to meet the demands of a comprehensive COVID-19 response, and increased funding failed to address shortfalls. Effective future pandemic responses will require sustained investment and adequate support to manage on-going and surge capacity needs. Increased public interest and skepticism complicated the COVID-19 response, and additional measures are needed to address these factors.
Droplet coalescence is an essential multiphase flow process in nature and industry. For the inviscid coalescence of two spherical droplets, our experiment shows that the classical 1/2 power-law scaling for equal-size droplets still holds for the unequal-size situation of small size ratios, but it diverges as the size ratio increases. Employing an energy balance analysis, we develop the first theory for asymmetric droplet coalescence, yielding a solution that collapses all experimental data of different size ratios. This confirms the physical relevance of the new set of length and time scales given by the theory. The functionality of the solution reveals an exponential dependence of the bridge’s radial growth on time, implying a scaling-free nature. Nevertheless, the small-time asymptote of the model is able to recover the classical power-law scaling, so that the actual bridge evolution still follows the scaling law asymptotically in a wide parameter space. Further analysis suggests that the scaling-free evolution behaviour emerges only at late coalescence time and large size ratios.
An experimental study is conducted to compare droplet generation in a deep-water plunging breaker in filtered tap water and in the presence of low and high bulk concentrations of the soluble surfactant Triton X-100. The breakers are generated by a programmable wave maker that is set with a single motion profile that produces a highly repeatable dispersively focused two-dimensional (2-D) wave packet with a central wavelength of $\lambda _0=1.18\,\rm m$. The droplets are measured with an in-line cinematic holographic system. It is found that the presence of surfactants significantly modifies the overall droplet number and the distributions of droplet diameter and velocity components produced by the four main droplet producing mechanisms of the breaker as identified by Erinin et al. ( J. Fluid Mech., vol. 967, 2023, p. A36). These modifications are due to both surfactant-induced changes in the flow structures that generate droplets and changes in the details of droplet production mechanisms in each flow structure.
The free-living, stalkless comatulids make up the bulk of living crinoid diversity and are the only crinoids remaining in shallow water, but compared to the stalked crinoids their fossil record is fragmentary and understudied, especially outside Europe. We present new Albian fossil comatulids from the Glen Rose Formation, central Texas, and study them using computed tomography, scanning electron microscopy, morphometry, and cladistic analysis of discrete and continuous characters. New material comprises the previously described Decameros wertheimi and Semiometra klari? and the new taxa Semiometra alveoradiata n. sp. and an extremely unusual new form Castaneametra hodgesi n. gen. n. sp. In addition to being exceptionally variable, this species is the largest known comatulid, has the most cirri of any known comatulid, and exhibits unique architectural features and voluminous, through-going coelomic cavities. We reconstruct its paleobiology, infer its phylogenetic affinities, argue for its origin from small Semiometra-like ancestors in a brief Albian North American radiation, and suggest new interpretations of early comatulid phylogeny based on our findings. Adaptive allometry related to respiratory demands, along with an origin by peramorphosis, may explain some features of this odd, short-lived giant.
Bronze Age–Early Iron Age tin ingots recovered from four Mediterranean shipwrecks off the coasts of Israel and southern France can now be provenanced to tin ores in south-west Britain. These exceptionally rich and accessible ores played a fundamental role in the transition from copper to full tin-bronze metallurgy across Europe and the Mediterranean during the second millennium BC. The authors’ application of a novel combination of three independent analyses (trace element, lead and tin isotopes) to tin ores and artefacts from Western and Central Europe also provides the foundation for future analyses of the pan-continental tin trade in later periods.
This study investigates the impact of communication delays and recruitment selection stages on candidates’ perceptions of fairness and recruitment selection outcomes and explores the moderating role of employability. Employing a mixed-method approach across two independent studies involving 264 and 259 mid-level position candidates, two variables – communication timeliness and recruitment stages – are manipulated, while employability is investigated as a moderating variable. Our results indicate that timely communication of rejection, especially during the initial selection stages, significantly enhances candidates’ satisfaction, fairness perceptions, intentions to reapply, and intentions to recommend the organisation to others. Employability moderates the relationship between perceived fairness and recruitment outcomes, strongly influencing the likelihood of peer referrals and reapplication intentions. These findings underscore the importance of strategic communication management in recruitment selection processes to enhance employer branding and the job candidate experience.
Cognitive–behavioural therapy (CBT) is a first-line treatment for depressive disorders, but research on its neurobiological mechanisms is limited. Given the heterogeneity in CBT response, investigating the neurobiological effects of CBT may improve response prediction and outcomes.
Aims
To examine brain functional changes during negative emotion processing following naturalistic CBT.
Method
In this case-control study, 59 patients with depressive disorders were investigated before and after 20 CBT sessions using a negative-emotion-processing paradigm during functional magnetic resonance imaging, clinical interviews and depressive symptom questionnaires. Healthy controls (n = 60) were also assessed twice within an equivalent time interval. Patients were classified into subgroups based on changes in diagnosis according to DSM-IV criteria (n = 40 responders, n = 19 non-responders). Brain activity changes were examined using group × time analysis of variance for limbic areas, and at the whole-brain level.
Results
Analyses yielded a significant group × time interaction in the hippocampus (P family-wise error [PFWE] = 0.022, ηP2 = 0.101), and a significant main effect of time in the dorsal anterior cingulate cortex (PFWE = 0.043, ηP² = 0.098), resulting from activity decreases following CBT (PFWE ≤ 0.024, ηP² ≤ 0.233), with no changes in healthy controls. Hippocampal activity decreases were driven by responders (PFWE ≤ 0.020, ηP² ≤ 0.260) and correlated with symptom improvement (r = 0.293, P = 0.024). Responders exhibited higher pre-treatment hippocampal activity (PFWE = 0.017, ηP² = 0.189).
Conclusions
Following CBT, reduced activity in emotion-processing regions was observed in patients with depressive disorders, with hippocampal activity decreases linked to treatment response. This suggests successful CBT could correct biased emotion processing, potentially by altering activity in key areas of emotion processing.Hippocampal activity may function as a predictive marker of CBT response.
Longevity risk is threatening the sustainability of traditional pension systems. To deal with this issue, decumulation strategies alternative to annuities have been proposed in the literature. However, heterogeneity in mortality experiences in the pool of policyholders due to socio-economic classes generates inequity, because of implicit wealth transfers from the more disadvantaged to the wealthier classes. We address this issue in a Group Self-Annuitization (GSA) scheme in the presence of stochastic mortality by proposing a redistributive GSA scheme where benefits are optimally shared across classes. The expected present values of the benefits in a standard GSA scheme show relevant gaps across socio-economic groups, which are reduced in the redistributive GSA scheme. We explore sensitivity to pool size, interest rates and mortality assumptions.
This article uses online genealogy data from the United States over the nineteenth century to estimate period and cohort-based sex differences in longevity. Following previous work, we find a longevity reversal in the mid-nineteenth century that expanded rapidly for at least a half-century. For measures of conditional survival past childbearing age, females enjoyed a longevity advantage for the whole century. Unlike most mortality databases of this period, genealogical data allow analysis of spatial patterns and the impacts of fertility on longevity. Our results suggest very limited evidence of spatial (state) variation in these patterns. We do, however, find evidence that the associations between fertility and longevity partially explain the trends.
A late Eocene (Priabonian) decapod crustacean (Arthropoda: Malacostraca: Decapoda) faunule from the sandstones and siltstones of the Tomášovce Member (Borové Formation) of northern Slovakia (Western Carpathians) is presented. Several decades of collecting at the Ďurkovec quarry in the Spišská Nová Ves district, the stratotype locality of the Tomášovce Member, yielded four decapod species, including an axiidean shrimp Ctenocheles sp. indet. (Ctenochelidae), and three brachyuran crabs Amphoranina hazslinszkyi (Reuss, 1859) new combination (Raninidae), Calappilia tridentata (Beurlen, 1939) (Calappidae), and Coeloma vigil A. Milne-Edwards, 1865 (Polybiidae). The faunule is dominated by A. hazslinszkyi and Coeloma vigil. The specimens often represent more-or-less intact individuals with preserved claws and walking legs, suggesting rapid burial and minimal to no postmortem transport. Additionally, specimens of A. hazslinszkyi are in some cases preserved perpendicularly to the bedding planes and interpreted as being covered by large amount of sediment while being buried in the substrate, causing death of the animals. The presence of trace fossils assigned to Thalassinoides Ehrenberg, 1944 are indirectly linked with the burrowing shrimp Ctenocheles sp. indet. The decapod faunule inhabited a shallow marine environment with the depth likely not exceeding 100 m.
Thermo-responsive hydrogels are smart materials that rapidly switch between hydrophilic (swollen) and hydrophobic (shrunken) states when heated past a threshold temperature, resulting in order-of-magnitude changes in gel volume. Modelling the dynamics of this switch is notoriously difficult and typically involves fitting a large number of microscopic material parameters to experimental data. In this paper, we present and validate an intuitive, macroscopic description of responsive gel dynamics and use it to explore the shrinking, swelling and pumping of responsive hydrogel displacement pumps for microfluidic devices. We finish with a discussion on how such tubular structures may be used to speed up the response times of larger hydrogel smart actuators and unlock new possibilities for dynamic shape change.
In 2018, David Laitin and Pål Kolstø engaged in a discussion at the Annual Meeting of the Association for the Study of Nationalities held at Columbia University, New York. The panel was a 20-year retrospective on Identity in Formation: the Russian-speaking populations in the Near Abroad (Laitin 1998).
The Parthenon’s structure suggests a thought-out design particularly attentive to light. This includes the orientation of the building towards the rising sun, the placement of windows, the use of barriers and grilles, the translucent marble ceilings, the skylights, and even ‘reflective’ pools of various liquid. These are all devices that, alongside bright materials, may have been used to enhance the experience of visitors to the temple and their encounter with the colossal gold and ivory statue of the goddess Athena. To test the validity and the effect that each of these purported design strategies produced, this article proposes an experiment using advanced 3D digital technologies, along with physically based lighting simulations, to recreate the ambient and architectural conditions that existed in the original temple design. The results suggest that this temple, contrary to long-standing beliefs that imagined the interior as a ‘bright marble space’, was generally quite dark and dim. The subsequent discussion and concluding remarks suggest that the illumination of the chryselephantine statue’s materials through the glow of a lamp, and on rare occasions from the sun, probably represented the pinnacle of the viewing encounters.
Bubble bursting and subsequent collapse of the open cavity at free surfaces of contaminated liquids can generate aerosol droplets, facilitating pathogen transport. After film rupture, capillary waves focus at the cavity base, potentially generating fast Worthington jets that are responsible for ejecting the droplets away from the source. While extensively studied for Newtonian fluids, the influence of non-Newtonian rheology on this process remains poorly understood. Here, we employ direct numerical simulations to investigate the bubble cavity collapse in viscoelastic media, such as polymeric liquids. We find that the jet and drop formations are dictated by two dimensionless parameters: the elastocapillary number $Ec$ (the ratio of the elastic modulus and the Laplace pressure) and the Deborah number $De$ (the ratio of the relaxation time and the inertio-capillary time scale). We show that, for low values of $Ec$ and $De$, the viscoelastic liquid adopts a Newtonian-like behaviour, where the dynamics is governed by the solvent Ohnesorge number $Oh_s$ (the ratio of visco-capillary and inertio-capillary time scales). In contrast, for large values $Ec$ and $De$, the enhanced elastic stresses completely suppress the formation of the jet. For some cases with intermediate values of $Ec$ and $De$, smaller droplets are produced compared with Newtonian fluids, potentially enhancing aerosol dispersal. By mapping the phase space spanned by $Ec$, $De$ and $Oh_s$, we reveal three distinct flow regimes: (i) jets forming droplets, (ii) jets without droplet formation and (iii) absence of jet formation. Our results elucidate the mechanisms underlying aerosol suppression versus fine spray formation in polymeric liquids, with implications for pathogen transmission and industrial processes involving viscoelastic fluids.
The article examines efforts to improve socioeconomic conditions in the Soviet Union during the late twentieth century. It does so to understand Soviet socialism’s capacity to evolve. Drawing on national and regional archival documents and newspapers, it contests the argument that the Soviet system was too rigid to survive in the world of computerised, post-Fordist ‘flexible’ production. Focusing on the enterprise level, this article demonstrates that the Communist Party inaugurated its own variation of flexible production; in doing so, it inadvertently created the conditions of possibility for the transition from state socialism to capitalism on the factory floor.
Cannabis use is linked to treatment non-adherence and relapses in psychotic disorders. Antipsychotic medication is effective for relapse prevention in primary psychoses, but its effectiveness after cannabis-induced psychosis (CIP) remains unclear.
Aims
To examine the effectiveness of antipsychotic medication for relapse prevention following the first clinically diagnosed CIP.
Method
A cohort of 1772 patients (84.1% men) with incident CIP was identified from the Swedish National Patient and Micro Data for Analyses of Social Insurance registers. The primary outcome was hospitalisation due to any psychotic episode. Drug use data were collected from the Prescribed Drug Register and modelled into drug use periods using the PRE2DUP method. A within-individual Cox regression model was used to study the risk of outcomes during the use of different oral or long-acting injectable (LAI) antipsychotics compared with non-use.
Results
The mean age at first diagnosis was 26.6 years (s.d. = 8.3). Of the cohort, 1343 (75.8%) used antipsychotics and 914 (51.3%) experienced psychosis hospitalisation during the follow-up. Any antipsychotic use was associated with a decreased risk of psychosis hospitalisation (adjusted hazard ratio (aHR) 0.75; 95% CI 0.67–0.84). Specific antipsychotics associated with decreased risk included aripiprazole LAI (aHR 0.27; 95% CI 0.14–0.51), olanzapine LAI (aHR 0.28; 95% CI 0.15–0.53), clozapine (aHR 0.55; 95% CI 0.34–0.90), oral aripiprazole (aHR 0.64; 95% CI 0.45–0.91), antipsychotic polytherapy (aHR 0.74; 95% CI 0.63–0.87) and oral olanzapine (aHR 0.81; 95% CI 0.69–0.94).
Conclusions
In particular, LAIs, clozapine and oral aripiprazole were associated with a decreased risk of psychosis relapse following CIP. Prescribers should consider using more LAIs for better treatment outcomes after CIP.
This article argues that the 1918 flu appeared so suddenly, spread so rapidly, killed so quickly and disappeared so swiftly that Europeans’ focus on their immediate circumstances led them to experience and interpret it as a local health crisis rather than as a global or continental pandemic. It also demonstrates that Europeans were so inured to privation and death; so isolated by anaemic and dysfunctional media and medical regimes; and so distracted by economic, political and social chaos that they were either unaware of or unconcerned with the flu’s origin. It takes as its source base nearly 1,000 memories of the 1918 flu collected from individuals across ten European countries and archival materials from federal, municipal, religious and diary archives in France (an Allied power in the First World War), Germany (a Central power in the First World War) and Switzerland (a neutral power in the First World War).
The evaluation of services has become a common strategy in service management, and there is a wide variety of tools available. The objective was to evaluate user satisfaction at a sports center using the Net Promoter Score (NPS) and Importance-Performance Analysis (IPA) techniques, comparing the information provided by each. To this end, this study involved 1,433 users of a sports center, analyzing the responses to the NPS® tool and subsequently to the IPA tool developed ad hoc with 11 attributes. The NPS® tool revealed 29.58% detractors, 30.36% passives, and 40.06% promoters, highlighting a negative impact on the overall score. The IPA tool offered detailed insights into attributes varying across the three NPS groups, identifying four critical attributes requiring strategic attention, enabling segmented marketing strategies. This research demonstrates the complementary value of combining NPS and IPA tools for strategic service management, providing actionable insights to enhance customer satisfaction and competitive positioning.