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We chart and assess the scope and utilisation of state-supplied hospital infrastructure in British Africa, c. 1900–60. Using archival sources, we examine the heterogeneity in colonial administrations’ investment into curative healthcare provision across various regions of British Africa. Our research highlights significant disparities in healthcare provision during the colonial period. These disparities were shaped by a range of observable factors, including differences in colonial policies, budgets, investment priorities, and the availability of medical personnel. We test stylised facts about public goods provision derived from previous literature and highlight the importance of understanding the historical context in shaping healthcare systems in Africa today.
Though not among the most famous of the Baroque’s architects and builders, the Bregenzerwald Baroque Master Builders, who were heavily involved in the creation of a sacred landscape of churches and monasteries in the wider Lake Constance area, have attracted scholarly attention since the nineteenth century. This article attempts to recontextualize these builders by taking them out of the usual framework proposed by art historians who, not least due to a chance discovery of an important source in the mid-twentieth century, tended to interpret the remote alpine valley of the Bregenzerwald as some kind of “rustic Florence.” Instead, this article rereads these builders in the context of the more mundane social and political realities of the Bregenzerwald. It suggests that in order to better understand this fascinating group of builders and craftsmen, it may be helpful to avoid reconstructing their sociopolitical history from their artistic achievement (How were they able to accomplish this?), and instead to reverse this approach to uncover the sociopolitical structures in which they lived (Who were they before they accomplished this?).
In this article, we study the behavior of complete two-sided hypersurfaces immersed in the hyperbolic space $\mathbb H^{n+1}$. Initially, we introduce the concept of the linearized curvature function $\mathcal {F}_{r,s}$ of a two-sided hypersurface, its associated modified Newton transformation $\mathcal {P}_{r,s}$ and its naturally attached differential operator $\mathcal {L}_{r,s}$. Then, we obtain two formulas for differential operator $\mathcal {L}_{r,s}$ acting on the height function of a two-sided hypersurface and, for the case where their support functions are related by a negative constant, we derive two new formulas for the Newton transformation $P_{r}$ and the modified Newton transformation $\mathcal {P}_{r,s}$ acting on a gradient of the height function. Finally, these formulas, jointly with suitable maximum principles, enable us to establish our rigidity and nonexistence results concerning complete two-sided hypersurfaces in $\mathbb H^{n+1}$.
We consider the stability of Couette flow when travelling vibrations perturb one boundary. It is demonstrated that if the bounding surface profile takes the form of sinusoidal waves, then the otherwise stable shear flow becomes unstable for appropriately chosen values of vibration amplitude, phase speed and wavenumber. When instability arises, it is driven by centrifugal forces that are created by wave-imposed changes in the direction of fluid movement. Only subcritical waves, defined as vibrations with phase speed smaller than the maximum flow velocity, cause instability. As the fluid Reynolds number grows, the interval of vibration wavenumbers and phase speeds capable of flow destabilisation is enhanced. A range of parameters is identified for which the vibrations seem to play dual roles: they decrease the flow resistance while simultaneously generating streamwise vortices. This vibration class constitutes an energy-efficient control tool that may potentially intensify the mixing within a flow.
Searching for the Neolithic along the Vardar-Morava River corridor revealed several new sites in a previously underexplored region. Multidisciplinary investigations at Svinjarička Čuka identified Neolithic and Bronze Age occupation. Highlights presented here demonstrate the potential of this new key site for enriching our understanding of the prehistory of the Balkans.
This article uses the case of the economist John Malcolm Blair as a vehicle for examining the durability of the institutional tradition in US economic policy making. Over a multidecade federal government career, Blair played an important role in focusing policy debate on institutionalist concerns like economic structure and corporate power even through the heyday of the Keynesian Revolution. Indeed, Blair stood as representative of an overlooked postwar policy-intellectual current that strove to anchor the study of macroeconomic issues like inflation and unemployment upon solid microfoundations: what I call Institutional Keynesianism. A primary influence behind such policy developments as the Celler-Kefauver Anti-Merger Act of 1950 and the wage–price guideposts implemented by the Kennedy administration, Blair’s work sheds light on the meaningful yet often neglected links between different schools of economic thought and policy domains.
This study examined the association between willingness-to-respond (WTR) and behavioral factors among emergency department health care workers (HCWs) during a pandemic situation in Pakistan.
Methods
A cross-sectional survey was conducted between August and September 2022, involving health care workers from 2 hospitals located in Karachi, Pakistan. Participants were recruited using a non-probability purposive sampling method. The survey instrument was designed based on Witte’s Extended Parallel Process Model (EPPM). Multivariate logistic regression analyses were used to investigate the relationship between WTR and HCWs’ attitudes, beliefs, and EPPM profiles.
Results
Health workers’ overall willingness to respond was 52.57% if required and 52.26% if asked. Female health workers showed 1.78 greater odds of WTR if required, compared to male health workers. Health workers who reported high efficacy were 21 times more likely to report to work during pandemics when required and 6 times more likely to report if asked compared to those with low efficacy.
Conclusion
This study explored health care workers’ willingness to respond during a pandemic. Female health care workers and those in clinical roles were more likely to be willing to respond during an influenza pandemic. Enhancing self-efficacy, knowledge, and addressing perceived risks can significantly improve workforce preparedness for future pandemics.
In sharp contrast to the Hardy space case, the algebraic properties of Toeplitz operators on the Bergman space are quite different and abnormally complicated. In this paper, we study the finite-rank problem for a class of operators consisting of all finite linear combinations of Toeplitz products with monomial symbols on the Bergman space of the unit disk. It turns out that such a problem is equivalent to the problem of when the corresponding finite linear combination of rational functions is zero. As an application, we consider the finite-rank problem for the commutator and semi-commutator of Toeplitz operators whose symbols are finite linear combinations of monomials. In particular, we construct many motivating examples in the theory of algebraic properties of Toeplitz operators.
Prior to the Civil War, the US and state governments required the modern licensing of only three occupations, doctors, lawyers, and ship pilots. Most other references to licensing in the 15,000 surveyed antebellum statutes referred to licensing in general terms. Those that referred to the “licensing” of occupations clearly referenced a type of tax or regulation of occupations thought sinful or diplomatically sensitive, like Indian trading and privateering. In other words, the presumption of occupational freedom that developed in medieval and early modern Britain transferred to the colonies and the United States. Only with the rise of Progressivism did modern occupational licensing become common, thus adding weight to economic critiques of the current system.
There is a growing focus on understanding the complexity of dietary patterns and how they relate to health and other factors. Approaches that have not traditionally been applied to characterise dietary patterns, such as latent class analysis and machine learning algorithms, may offer opportunities to characterise dietary patterns in greater depth than previously considered. However, there has not been a formal examination of how this wide range of approaches has been applied to characterise dietary patterns. This scoping review synthesised literature from 2005 to 2022 applying methods not traditionally used to characterise dietary patterns, referred to as novel methods. MEDLINE, CINAHL and Scopus were searched using keywords including latent class analysis, machine learning and least absolute shrinkage and selection operator. Of 5274 records identified, 24 met the inclusion criteria. Twelve of twenty-four articles were published since 2020. Studies were conducted across seventeen countries. Nine studies used approaches with applications in machine learning, such as classification models, neural networks and probabilistic graphical models, to identify dietary patterns. The remaining studies applied methods such as latent class analysis, mutual information and treelet transform. Fourteen studies assessed associations between dietary patterns characterised using novel methods and health outcomes, including cancer, cardiovascular disease and asthma. There was wide variation in the methods applied to characterise dietary patterns and in how these methods were described. The extension of reporting guidelines and quality appraisal tools relevant to nutrition research to consider specific features of novel methods may facilitate consistent reporting and enable synthesis to inform policies and programs.
Central line-associated bloodstream infections (CLABSIs) result in morbidity and mortality among hospitalized patients. Hospital interventions to reduce the incidence of CLABSI are often broadly applied to all patients with central venous access. Identifying central lines at high risk for CLABSI at time of insertion will allow for a more focused delivery of preventative interventions.
Design:
This was an observational cohort study conducted at three hospitals including all patients who received central venous access. CLABSIs were identified using an institutional CLABSI database maintained by the hospital epidemiology team. Logistic regression (LASSO) and machine learning (random forest, XGboost) techniques were applied for the prediction of CLABSI occurrence, adjusting for selected patent and insertion-level characteristics.
Results:
A total of 40,008 central venous catheters were included, of which 409 (1.02%) were associated with CLABSI. The random forest and the XGBoost models had the highest discrimination (Area Under the Received Operating Curve [AUC] 0.79) followed by LASSO (0.73). High illness severity, receipt of total parenteral nutrition, receipt of hemodialysis, pre-insertion hospital length-of-stay, and low albumin levels were all predictive of CLABSI occurrence. Precision for all models was poor owing to a high false-positive rate.
Discussion:
CLABSI can be predicted based upon patient and insertion level factors in the electronic health record. In this study, random forest and gradient-boosted models had the highest AUC. Prediction cut-offs for the identification of CLABSI can be adjusted based upon the acceptable rate of false-positives for a given CLABSI preventative intervention.
We obtain asymptotics for the average value taken by a Vassiliev invariant on knots appearing as periodic orbits of an Axiom A flow on $S^3.$ The methods used also give asymptotics for the writhe of periodic orbits. Our results are analogous to those of G. Contreras [Average linking numbers of closed orbits of hyperbolic flows. J. Lond. Math. Soc. (2)51 (1995), 614–624] for average linking numbers.
We give a complete description of Rees quotients of free inverse semigroups given by positive relators that satisfy nontrivial identities, including identities in signature with involution. They are finitely presented in the class of all inverse semigroups. Those that satisfy a nontrivial semigroup identity have polynomial growth and can be given by an irredundant presentation with at most four relators. Those that satisfy a nontrivial identity in signature with involution, but which do not satisfy a nontrivial semigroup identity, have exponential growth and fall within two infinite families of finite presentations with two generators. The first family involves an unbounded number of relators and the other involves presentations with at most four relators of unbounded length. We give a new sufficient condition for which a finite set X of reduced words over an alphabet $A\cup A^{-1}$ freely generates a free inverse subsemigroup of $FI_A$ and use it in our proofs.
This study aimed to assess the concordance between different anthropometric indexes in the Global Leaders Initiated Malnutrition Standards (GLIM) and the geriatric risk index (GNRI) for evaluating muscle mass, while also exploring performance-based criteria for GLIM muscle content suitable for elderly patients with intermediate and advanced tumours. A total of 312 patients admitted to Shanghai Tenth People’s Hospital between September 2022 and June 2023 were retrospectively included. Nutritional assessments were conducted using the GLIM framework, employing grip strength, upper arm circumference and calf circumference as criteria for muscle content evaluation. The diagnostic value of these tools was compared against the GNRI as a reference standard. Among the participants, 127 (40·71 %) were diagnosed as malnourished by GNRI, while the GLIM assessments yielded 138 (44·23 %), 128 (41·03 %) and 162 (51·92 %) malnutrition diagnoses based on grip strength, calf circumference and upper arm circumference, respectively. Both GNRI and GLIM-grip strength were significantly associated with complications and length of hospital stays. Notably, using GNRI as a reference, GLIM-grip strength demonstrated good consistency in diagnosing malnutrition (K value = 0·692, P< 0·001), with calf circumference having the highest diagnostic value. In conclusion, grip strength is a practical and effective performance-based criterion within the GLIM standards and has the potential to enhance malnutrition diagnosis in elderly patients with advanced malignancies, highlighting its relevance in nutritional science.