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This research explores the extent of private law and the influence of private entities in healthcare in Europe. The three-part analysis reveals a complex interplay between different health system structures, laws, and influences. First, it highlights four distinctions between Europe and the United States (US) concerning universal health care, the role of government, private insurance, and the legal framework for disputes. Second, it considers the role of private law in resolving disputes in Europe. Ultimately, this research calls for further research to close those gaps in the literature concerning the number and scope of health disputes governed under contract law and the laws that health lobbies have influenced. Third, it emphasizes the influence of private healthcare lobbies in Europe and provides a case study of their influence on the United Kingdom’s (UK) health landscape.
Fiduciaries abound in health care. Employers pretend they can act in the best interests of employees when maintaining health plans – even though they pay (directly or indirectly) for claims against those plans. Physicians pretend they can act in the best interests of patients – even when hospitals and group practices pressure them to see more patients and spend less time with them, and even though physicians and their employers are incentivized to order expensive tests and procedures. But what if, instead of ignoring these conflicts of interest, the American healthcare system abandoned the fiduciary fallacy?
Building on recent scholarship showing that targeted legislation, regulation, and self-policing – rather than broad fiduciary duties – better manage these conflicts, I use game theory to analyze different scenarios relating to the financing and provision of health care involving two actors – a provider and a payor. For this analysis, I assume that the actors are rational and behave in their own self-interest until constrained by external rules and social and professional norms. My goal is to advance this scholarship by arguing that broad fiduciary duties are inadequate to address conflicts in our healthcare system, while also proposing paths forward.
In September 1857, extracts from letters written in Gwalior and Agra, India, by an elite British “lady,” Wilhelmina “Minnie” Murray (1834–1912), were published as part of the “correspondence” sections of The Times's coverage of the 1857–58 Indian Rebellion. Through the letters she documented her escape from Gwalior to Agra. She described encounters with the maharajah and “fanatic” “ghazis,” and her experience navigating inversions of racial and class hierarchies at the Agra and Gwalior forts, as a displaced fugitive. Someone (unknown) designated these letters as “publishable,” and they became part of early interpretations of the “mutiny” in the imperial news sphere. Comparing the original copies with their various printed copies, and with texts written by the rest of her Gwalior-Agra cohort, indicates how knowledge of the uprisings was disseminated through the ways in which letters were circulated, repurposed, edited, and sometimes censored. As this article maps, the letters shaped British understandings and public imagination of India, the East India Company's response to the “imperial crisis,” and the events of the Rebellion itself. It contends that reconstructing deeper genealogies of intertextual narratives about empire in this way renders personal correspondents, and often, imperializing women, formative to the early discursive terrain and meaning/memory-making surrounding mid-century colonial conflict.
The first Chapter is the Introduction. I start with a puzzle stemming from the fact that even though the Textbook View of moral theories conceives of the main traditions as both explanatorily and extensionally incompatible, many philosophers have recently argued that much more agreement is possible. I argue that this puzzle might be best explained by the fact that just as scientific theories can be underdetermined by the evidence, so can moral theories be underdetermined by their extension. This analogy to the philosophy of science has received little attention so far, and the book provides the first comprehensive analysis of it.I characterize the main idea in some more detail by distinguishing it from several others. The idea is neither that the moral is underdetermined by the non-moral, nor that moral theories leave our particular choices underdetermined, nor that theories are underdetermined because the evidence is somehow lacking. Finally, I give an outline of the structure of the book.
Turbulent flows over porous substrates are studied via a systematic exploration of the dependence of the flow properties on the substrate parameters, including permeability $K$, grain pitch $L$ and depth $h$. The study uses direct numerical simulations mainly for staggered-cube substrates with $L^+\approx 10$–$50$, $\sqrt {K}/L\approx 0.01$–$0.25$ and depths from $h=O(L)$ to $h\gg L$, ranging from typical impermeable rough surfaces to deep porous substrates. The results indicate that the permeability has significantly greater relevance than the grain size and microscale topology for the properties of the overlying flow, including the mean-flow slip and the shear across the interface, the drag increase relative to smooth-wall flow and the statistics and spectra of the overlying turbulence, whereas the direct effect of grain size is only noticeable near the interface as grain-coherent flow fluctuations. The substrate depth also has a significant effect, with shallower substrates suppressing the effective transpiration at the interface. Based on the direct-simulation results, we propose an empirical ‘equivalent permeability’ $K_{eq}^t$ that incorporates this effect and scales well the overlying turbulence for substrates with different depths, permeabilities, etc. This result suggests that wall normal transpiration driven by pressure fluctuations is the leading contributor to the changes in the drag and the overlying turbulence. Based on this, we propose a conceptual $h^+$–$\sqrt {K^+}$ regime diagram where, for any given substrate topology, turbulence transitions smoothly from that over impermeable rough surfaces with $h=O(L)$ to that over deep porous substrates with $h^+\gtrsim 50$, with the latter limit determined by the typical lengthscale of the overlying pressure fluctuations.
Space is an increasingly militarized domain, with the potential to be a source and place of armed conflict. Tests of anti-satellite (ASAT) weapons capable of neutralizing civilian and military satellites have fuelled fears of warfare in that domain. Resulting space debris from ASAT weapon use is of particular concern, as it threatens other satellites in orbit, many of which underpin the operation of human societies and the functioning of global economies. Although states recognize this threat, attempts at weapons control have failed. Instead, we must look to existing international law that governs military activities in space. Yet, how the jus ad bellum, which regulates when states may use force, applies to ASAT weapons has received little attention. This is despite state assertions of their right to act in self-defence in space. This article argues that jus ad bellum regulation of ASAT technologies directly addresses state concerns regarding protecting their space assets and avoiding conflict in space. This author contends that states acting defensively in space are restricted by the requirements of jus ad bellum necessity and proportionality in their choice of targets, thereby protecting civilians and the interests of other states. A clearer understanding of how these jus ad bellum requirements apply in space helps decision makers avoid putative defensive acts being characterized as unlawful uses of force. Adherence to these requirements ultimately helps to secure international peace and security on Earth and in space.
Who is deemed deathworthy, and how is this status produced? What discourses, affects, and histories enable the industrialization of premature Black death while rendering it largely invisible? Rooted in a decolonial queer feminist epistemological framework, this article examines how discursive and affective strategies in U.K. print media and immigration policies during the European “refugee crisis” (2013–2016) justified routine death-making at sea. Conceptualizing Blackness as a relational political and epistemological tool, the article reveals how media and state actors—drawing on racialized mythologies of young single Black men and appeals to imperial nostalgia—constructed these men as objects of panic, disgust, resentment, and fear. Applying collocation analysis and visualization techniques, the article theorizes “affective-racialized networks”—discursive formations that circulate and accumulate affective meanings across space and time, shaping public perception and legitimizing policies of deterrence, externalization, and active abandonment. These networks sustained the routinized deaths of Black migrant men at sea, reinforcing Europe’s imperial border regimes. By foregrounding the mutual constitution of race, affect, and temporality, this study expands migration scholarship’s engagement with race, demonstrating how racial logics operate beyond geopolitical and temporal boundaries through transnational circuits of meaning, power, and governance. The article argues that centering Blackness and affect is essential to understanding how racialization functions and how Black deaths are rendered normative within global bordering practices.
There have been unsafe levels of unpaired fructose in the high fructose corn syrup (HFCS) in US beverages, and research/case study evidence shows that their intake is associated with greater asthma prevalence/risk/incidence, a debilitating disease, likely due to fructose malabsorption, gut fructosylation and gut dysbiosis mechanisms. The ‘unexplained’ asthma epidemic has disproportionately affected children and Black individuals, groups with higher fructose malabsorption prevalence than others, and research to assess disproportionately higher asthma risk/incidence among Black individuals in association with HFCS-sweetened beverage intake is lacking.
Design:
Demographic, lifestyle and dietary data collected at enrollment (1985–86), and incident asthma through exam 5 (1995–96), were used in Cox proportional hazards models to assess HFCS intake associations (hazard ratios) with asthma risk/incidence.
Setting:
CARDIA study participants from Birmingham, AL, Chicago, IL, Minneapolis, MN and Oakland, CA.
Participants:
1998 Black and 2104 White young adults.
Results:
HFCS-sweetened beverage intake > once/week was significantly associated with higher asthma risk relative to ≤ once/week (P-trend = 0·04), among Black participants only; risk was 2·8 times higher among 2–4 times/week consumers (HR = 2·8, 95 % CI 1·1, 7·3, P = 0·04) and 3·5 times higher when consumed multiple times/d, independent of sucrose intake/obesity/dietary quality/smoking/in-home smoke-exposure (HR = 3·5, 95 % CI 1·3, 9·9, P = 0·02). Intake of orange juice, with nominal unpaired fructose, was not associated with asthma in either group, nor was intake of sucrose, a disaccharide (paired) of fructose/glucose.
Conclusions:
Ubiquitous HFCS in the US food supply, with HFCS that contains high/unsafe unpaired fructose, also known as excess-free-fructose, and the fructose/gut/lung/axis are overlooked risk factors in the ‘unexplained’ US asthma epidemic that disproportionately affects Black individuals.
Rogue waves (RWs) can form on the ocean surface due to the well-known quasi-four-wave resonant interaction or superposition principle. The first is known as the nonlinear focusing mechanism and leads to an increased probability of RWs when unidirectionality and narrowband energy of the wave field are satisfied. This work delves into the dynamics of extreme wave focusing in crossing seas, revealing a distinct type of nonlinear RWs, characterised by a decisive longevity compared with those generated by the dispersive focusing (superposition) mechanism. In fact, through fully nonlinear hydrodynamic numerical simulations, we show that the interactions between two crossing unidirectional wave beams can trigger fully localised and robust development of RWs. These coherent structures, characterised by a typical spectral broadening then spreading in the form of dual bimodality and recurrent wave group focusing, not only defy the weakening expectation of quasi-four-wave resonant interaction in directionally spreading wave fields, but also differ from classical focusing mechanisms already mentioned. This has been determined following a rigorous lifespan-based statistical analysis of extreme wave events in our fully nonlinear simulations. Utilising the coupled nonlinear Schrödinger framework, we also show that such intrinsic focusing dynamics can be captured by weakly nonlinear wave evolution equations. This opens new research avenues for further explorations of these complex and intriguing wave phenomena in hydrodynamics as well as other nonlinear and dispersive multi-wave systems.
Since 2021, 18 states in the USA have restricted education on race and structural inequality. Conservative coalitions frame these restrictions as a war on “woke” ideologies. Through interviews with youth and educators in locales (Florida; Georgia; and York, Pennsylvania) that restrict education on race and structural inequality, I investigate the following: What discourses do students and educators use to describe bills that restrict race-related studies? What, if anything, do their discourses suggest about the perceived political implications of these restrictions?
In this study, I argue that gleaning students’ and educators’ views on “anti-woke” legislation sheds light on the perceived political consequences of these bills for American democracy. I find that students and educators perceive restrictions on race-related studies as epistemic injustices that divest society of the knowledge to identify, problematize, and redress the structural conditions that (re)produce racial subordination. For participants, the health of democracy is contingent on addressing racial disempowerment. Hence, they suggest that restrictions on race-related studies encumber democracy precisely because these policies impose epistemologies of racial ignorance that impede racial redress and allow systems of racial inequality to fester.
We introduce a double framing construction for moduli spaces of quiver representations. This allows us to reduce certain sheaf cohomology computations involving the universal representation, to computations involving line bundles, making them amenable to methods from geometric invariant theory. We will use this to show that in many good situations the vector fields on the moduli space are isomorphic as vector spaces to the first Hochschild cohomology of the path algebra. We also show that considering the universal representation as a Fourier–Mukai kernel in the appropriate sense gives an admissible embedding of derived categories.
We provide an assessment of the Infinity Two fusion pilot plant (FPP) baseline plasma physics design. Infinity Two is a four-field period, aspect ratio $A = 10$, quasi-isodynamic stellarator with improved confinement appealing to a max-$J$ approach, elevated plasma density and high magnetic fields ($ \langle B\rangle = 9$ T). Here $J$ denotes the second adiabatic invariant. At the envisioned operating point ($800$ MW deuterium-tritium (DT) fusion), the configuration has robust magnetic surfaces based on magnetohydrodynamic (MHD) equilibrium calculations and is stable to both local and global MHD instabilities. The configuration has excellent confinement properties with small neoclassical transport and low bootstrap current ($|I_{bootstrap}| \sim 2$ kA). Calculations of collisional alpha-particle confinement in a DT FPP scenario show small energy losses to the first wall (${\lt}1.5 \,\%$) and stable energetic particle/Alfvén eigenmodes at high ion density. Low turbulent transport is produced using a combination of density profile control consistent with pellet fueling and reduced stiffness to turbulent transport via three-dimensional shaping. Transport simulations with the T3D-GX-SFINCS code suite with self-consistent turbulent and neoclassical transport predict that the DT fusion power$P_{{fus}}=800$ MW operating point is attainable with high fusion gain ($Q=40$) at volume-averaged electron densities $n_e\approx 2 \times 10^{20}$ m$^{-3}$, below the Sudo density limit. Additional transport calculations show that an ignited ($Q=\infty$) solution is available at slightly higher density ($2.2 \times 10^{20}$ m$^{-3}$) with $P_{{fus}}=1.5$ GW. The magnetic configuration is defined by a magnetic coil set with sufficient room for an island divertor, shielding and blanket solutions with tritium breeding ratios (TBR) above unity. An optimistic estimate for the gas-cooled solid breeder designed helium-cooled pebble bed is TBR $\sim 1.3$. Infinity Two satisfies the physics requirements of a stellarator fusion pilot plant.
In this article, I study the effect of endogenous challenger entry on electoral accountability in the presence of adverse selection. To this end, I analyze a two-period electoral agency model wherein a potential challenger freely chooses whether to run for office. The effect of endogenous challenger entry on policy decisions in this model is ambiguous: depending on model parameters, it can worsen or ease policy distortions. Analogously, marginally increasing the cost of running for office can deepen or reduce these distortions. This uncertainty regarding the effect of endogenous challenger entry on policymaking leads to equally ambiguous welfare implications. Nonetheless, I identify conditions under which endogenous challenger entry improves policymaking and voter welfare. This suggests that, in some circumstances, imposing higher barriers to entry in elections can improve policymaking and voter welfare.
AstroSat observed transient neutron star low-mass X-ray binary XTE J1701-462 for a total duration of $\sim$ 135 ks during its 2022 outburst. We report the results of a detailed spectral and timing analysis carried out using this data. The source traced a complete ‘Z’ shaped structure in the hardness intensity diagram (HID). The source exhibited an extended horizontal branch and a short-dipping flaring branch in the HID. The spectra of the source were fitted with different approaches. We find that most suitable spectral model comprises emission from a standard multi-color accretion disk (diskbb in XSPEC) and Comptonised radiation from a hot central corona, described by Comptb model of XSPEC. The observed disk component is cool, having a temperature in the range of $\sim 0.28-0.42$ keV and truncated far ($\sim$ 250 - 1600 km) from the compact object. The Compton corona has an optical depth in the range of $\sim 3.4- 5.1 $ and a temperature in the range of $3.3-4.5$ keV. The disk and corona flux as well as truncation radius vary significantly along the HID. The temperature $kT_{in}$ depends on both luminosity and inner disk radius and hence shows marginal variation as compared to the truncation radius. We discuss possible scenarios to explain the relationship between the spectral evolution and motion of the source along the HID. The timing analysis revealed horizontal branch oscillations (HBOs) in the frequency range $\sim 34-40$ Hz. The frequency and rms strength of HBO vary systematically as the source moves along the horizontal branch (HB). The observed correlation of the HBO properties with the position on the HB is similar to that previously reported in this source using RXTE data during the 2006 outburst of the source. The source also showed normal branch oscillations (NBOs) with frequency $\sim$ 6.7 Hz in the middle and the lower normal branch. The energy-dependent study of the HBO properties suggests that the HBO is stronger in the higher energy band. We also observed very-low frequency noise and band-limited noise (BLN) components in the power density spectra. The break frequency of BLN component was found to be tightly correlated with the HBO frequency. We discuss possible models to explain the origin and nature of the observed features in the PDS.
During the coronavirus pandemic in the United Kingdom, media outlets shifted their focus from divisive political issues to more neutral topics like lifestyle, sports, and entertainment. This study explores how this change in media content relates to partisan divides in satisfaction with democracy. Using data from a representative survey of 201,144 individuals, we linked respondents’ perceptions of democratic performance to their daily media exposure. We did so by analysing 1.5 million tweets from British newspapers using a topic modelling algorithm to identify shifts in topic salience and sentiment using sentiment analysis. Our findings reveal a decline in partisan media exposure during the pandemic, associated with increased satisfaction with democracy at both individual and collective levels, and a narrowing of cross-party divides. These results contribute to discussions on affective polarization, the winner-loser gap in democratic evaluation, and media framing effects, highlighting the potential influence of depoliticized news coverage on democratic attitudes.
In legal proceedings, a fact-finder needs to decide whether a defendant is guilty, or not, based on probabilistic evidence. We defend the thesis that the defendant should be found guilty just in case it is rational for the fact-finder to believe that the defendant is guilty. We draw on Leitgeb’s stability theory for an appropriate notion of rational belief and show how our thesis solves the problem of statistical evidence. Finally, we defend our account of legal proof against challenges from Staffel and compare it to a recent competitor put forth by Moss.
In this article I begin by presenting some examples from Early-Modern French of how, using a large multi-genre database (Frantext), it is possible to track the spread of change and how it embeds across different genres (the genres in Frantext ranging from correspondence and first-person travel narratives to essays and poetry). These case studies allow us to explore a number of questions, including which changes seem to diffuse “from above” and which rather come “from below”; and which textual sources best reflect “authentic” usage or indeed are closest to reflecting spoken usage. They also raise questions as to whether it is possible to create a continuum of genres with those that are more “progressive” or are early adopters of change at one end, and those which are more resistant to change at the other. I then discuss some of the challenges surrounding this work, including the theorization (or lack of theorization) of text types and genres in various corpora and the privileging of other factors when they are elaborated. Consequently, there is currently a lack of comparability between different corpora in the way they categorize and calibrate different text types and genres.