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Biotechnology, with its vast potential, is poised to revolutionize fields ranging from medicine and healthcare to environmental sensing. Central to this revolution are bio-interfaces, which include both electrical and non-electrical interventions using wearables and implants. These interfaces offer new avenues for monitoring and interacting with biological systems, thereby enhancing the capabilities of modern healthcare solutions. The adoption of innovative design strategies is crucial for fully harnessing this potential and overcoming current limitations. In the realm of medicine and healthcare, biotechnology design strategies can bring about significant breakthroughs in disease diagnosis, treatment and prevention. For instance, targeted drug delivery systems can improve treatment efficacy while minimizing side effects. Personalized medicine, made possible through advancements in genomics and proteomics, can tailor treatments to individual patients, leading to better outcomes and reduced healthcare costs.
To improve understanding of prototyping practice at the fuzzy front end of the design process, this article presents an analysis of a prototyping dataset captured during the IDEA challenge – a 4-day virtually hosted hackathon – using Pro2booth, a web-based prototype capture tool. The dataset comprised 203 prototypes created by four independent teams working in university labs across Europe supported by interviews carried out with each of the teams after the event. The results of the study provide nine key findings about prototyping at hackathons. These include elucidation of the purposes of prototypes in physical, digital and sketch domains and characterisation of teams’ prototyping practices and strategies. The most successful strategy focused on learning about the problem or solution space, often via physical prototypes rather than following more prescriptive ‘theoretical’ methodologies. Recommendations on prototyping strategies in hackathons or similar scenarios are provided, highlighting the importance of practical strategies that prioritise learning and adaptation. The results of this study raise the broader question to the wider research community of how design research and teaching should balance high-level strategic approaches with more hands-on ‘operational’ prototyping.
In a horizontally heated melting system, where a solid substance is subject to melting by a warmer liquid beneath, the presence of solute in the liquid introduces a complex interplay between temperature and concentration dynamics. Employing a recently developed sharp interface method (Xue et al., J. Comput. Phys., vol. 491, 2023), we conduct direct numerical simulations to investigate the transient behaviour of the system across a broad range of Rayleigh numbers and solute concentrations. Our observations reveal distinct flow regimes: at low concentrations, the system resembles a temperature-driven melting problem, characterized by vortex rolls beneath the melting interface. As the solute concentration increases, a stably stratified layer emerges beneath the interface, leading to the transition from thermal convection to penetrative convection, which resembles those flow characteristics observed in the double-diffusive convection. This shift results from the competition between the stabilizing effect induced by solute concentration gradient and the destabilizing effect caused by temperature gradient. Otherwise in the diffusion regime, characterized by very high solute concentrations, the flow becomes static due to the complete suppression of convection by the stably stratified layer. This regime further exhibits two distinct patterns: ‘melting’ and ‘dissolution’. Beyond characterizing diverse flow patterns, our study conducts a quantitative analysis, examining heat/mass transfer, melting rates, and the evolution of temperature and concentration at the interface. These insights contribute to a better understanding of the intricate interplay between temperature and solute concentration during phase change, with implications for accurately estimating melting rates in binary fluid systems.
Social isolation has been implicated in the development of cognitive impairment, but research on this association remains limited among racial-ethnic minoritized populations. Our study examined the interplay between social isolation, race–ethnicity and dementia.
Methods
We analyzed 11 years (2011–2021) of National Health and Aging Trends Study (NHATS) data, a prospective nationally representative cohort of U.S. Medicare beneficiaries aged 65 years and older. Dementia status was determined using a validated NHATS algorithm. We constructed a longitudinal score using a validated social isolation variable for our sample of 6,155 community-dwelling respondents. Cox regression determined how the interaction between social isolation and race–ethnicity was associated with incident dementia risk.
Results
Average longitudinal frequency of social isolation was higher among older Black (27.6%), Hispanic (26.6%) and Asian (21.0%) respondents than non-Hispanic White (19.1%) adults during the 11-year period (t = −7.35, p < .001). While a higher frequency of social isolation was significantly associated with an increased (approximately 47%) dementia risk after adjusting for sociodemographic covariates (adjusted hazard ratio [aHR] = 1.47, 95% CI [1.15, 1.88], p < .01), this association was not significant after adjusting for health covariates (aHR = 1.21, 95% CI [0.96, 1.54], p = .11). Race–ethnicity was not a significant moderator in the association between social isolation and dementia.
Conclusions
Older adults from racial-ethnic minoritized populations experienced a higher longitudinal frequency of social isolation. However, race–ethnicity did not moderate the positive association observed between social isolation and dementia. Future research is needed to investigate the underlying mechanisms contributing to racial-ethnic disparities in social isolation and to develop targeted interventions to mitigate the associated dementia risk.
Improving the hospital environment and developing novel disinfection strategies are critical for infection control in healthcare settings. In this study, we explored the effects of electrochromic (EC) windows on indoor and patient microbiome in an inpatient hospital.
Patient and setting:
Hematology-Oncology patients at the University of Vermont Medical Center
Methods:
We conducted a prospective study in ten occupied patient rooms. Five of the patient rooms had active EC windows that tint dynamically to control for heat and glare, and the other five rooms had deactivated EC windows that simulated traditional windows and blinds. Samples were collected one day before patient admission as baseline and on the 1st, 3rd, and 5th day of the patient stay. Total bacterial abundance and bacterial community structure were determined through quantitative PCR and 16s rRNA Illumina MiSeq sequencing, respectively.
Results:
Patient rooms with active EC windows had significantly lower light intensity and temperature than traditional patient rooms with blinds. The absolute bacterial abundance and diversities on windows were significantly lower in rooms with EC windows and the bacterial composition changed after one day EC window activation. Compared to baseline, relative abundance of the Staphylococcus genus was significantly lower on EC window surface during the five-day experiment. In contrast, the air microbiome was more diverse in rooms with EC windows.
Conclusion:
Active electrochromic (EC) windows in patient rooms result in lower light intensity and temperature, reduced bacterial abundance and diversities on window surfaces, and a more diverse air microbiome, informing future healthcare design.
Logical arguments from evil against the existence of God are the strongest form of arguments from evil. They maintain that the all-good, all-powerful God of traditional theism is logically incompatible with the evil in the world. Given that the most well-known logical argument from evil remains the argument put forward by John Mackie over fifty years ago, I begin by setting out Mackie’s argument in detail as well as Alvin Plantinga’s well-regarded critique of it. I then discuss Mackie’s not well-known confusing response to Plantinga’s critique along with attempts by Hugh LaFollette and Quentin Smith to support Mackie’s argument, which fail to take into account Mackie’s own concession to Plantinga’s critique. I then discuss my own attempt in 2019 to provide a Mackie-style logical argument from evil and the reception it has received. I end by suggesting that further discussion might best be pursued by taking up the related question of whether an objective ethics can by adequately supported without appealing to the existence of the God of traditional theism.
While governments have long discussed the promise of delegating important decisions to machines, actual use often lags. Consequently, we know little about the variation in the deployment of such delegations in large numbers of similar governmental organizations. Using data from crime laboratories in the United States, we examine the uneven distribution over time of a specific, well-known expert system for ballistics imaging for a large sample of local and regional public agencies; an expert system is an inference engine joined with a knowledge base. Our statistical model is informed by the push-pull-capability theory of innovation in the public sector. We test hypotheses about the probability of deployment and provide evidence that the use of this expert system varies with the pull of agency task environments and the enabling support of organizational resources—and that the impacts of those factors have changed over time. Within this context, we also present evidence that general knowledge of the use of expert systems has supported the use of this specific expert system in many agencies. This empirical case and this theory of innovation provide broad evidence about the historical utilization of expert systems as algorithms in public sector applications.
Inflammation and infections such as malaria affect micronutrient biomarker concentrations and hence estimates of nutritional status. It is unknown whether correction for C-reactive protein (CRP) and α1-acid glycoprotein (AGP) fully captures the modification in ferritin concentrations during a malaria infection, or whether environmental and sociodemographic factors modify this association. Cross-sectional data from eight surveys in children aged 6–59 months (Cameroon, Cote d’Ivoire, Kenya, Liberia, Malawi, Nigeria and Zambia; n 6653) from the Biomarkers Reflecting Inflammation and Nutritional Determinants of Anaemia (BRINDA) project were pooled. Ferritin was adjusted using the BRINDA adjustment method, with values < 12 μg/l indicating iron deficiency. The association between current or recent malaria infection, detected by microscopy or rapid test kit, and inflammation-adjusted ferritin was estimated using pooled multivariable linear regression. Age, sex, malaria endemicity profile (defined by the Plasmodium falciparum infection prevalence) and malaria diagnostic methods were examined as effect modifiers. Unweighted pooled malaria prevalence was 26·0 % (95 % CI 25·0, 27·1) and unweighted pooled iron deficiency was 41·9 % (95 % CI 40·7, 43·1). Current or recent malaria infection was associated with a 44 % (95 % CI 39·0, 52·0; P < 0·001) increase in inflammation-adjusted ferritin after adjusting for age and study identifier. In children, ferritin increased less with malaria infection as age and malaria endemicity increased. Adjustment for malaria increased the prevalence of iron deficiency, but the effect was small. Additional information would help elucidate the underlying mechanisms of the role of endemicity and age in the association between malaria and ferritin.
Electron heating and acceleration in collisionless shocks is a long-standing problem. Rapid isotropization of heated electrons cannot be explained solely by the cross-shock potential. In addition, the macroscopic cross-shock potential prevents efficient reflection and injection into the diffusive acceleration regime. Recent observations have shown that small-scale electric fields are present in the shock front, together with the large-scale cross-shock potential. These small-scale fields have been found also in the upstream and downstream regions. Electron heating in shocks is produced by the combined action of the large- and small-scale fields. The large-scale potential determines the energy transferred to the electrons. The small-scale electrostatic fields scatter electrons. Here we study the scattering of electrons on the typical waveforms, namely solitary bipolar spikes and wavepackets. The main effect is the generation of backstreaming electrons with large pitch angles. It is found that wavepackets are more efficient in electron reflection in the interaction of electrons both with a single spike and with multiple spikes.
The purpose of this paper is to examine the contours of evolving jurisprudence on offensive expression and negative messages, and to suggest that it can best be understood by reference to the concept of stigma. At the European Court of Human Rights, there appears to have been an increasing willingness to recognise the harm of offensive expression through an interpretation of Article 8 of the European Convention on Human Rights, but the reach of this case law remains uncertain. In particular, while some cases associate negative expression with negative stereotyping, not all of these cases do, and there are potential conflicts with freedom of speech. In the domestic context, these issues recently arose in a significant case from the Court of Appeal, R (Crowter) v Secretary of State for Health and Social Care. In this case, the appellants argued that a legal provision sends a negative ‘message’, through the negative stereotyping of disabled people, but this ‘message’ is implicit, rather than explicitly articulated. While these developments raise important questions about the future evolution of case law, we propose that a focus on stigma can more clearly highlight the harms involved.
Although psychological interventions can be used to improve chronic pain management, underserved individuals (i.e., racially minoritized and socioeconomically disadvantaged) may be less likely to engage in such services. The purpose of this study was to examine whether offering a psychological intervention for chronic pain in a primary care clinic could be a method in which to successfully engage underserved patients.
Methods:
There were 220 patients with chronic pain in a primary care clinic located in a socioeconomically and racially diverse city who were approached to discuss enrolment in a pilot randomized controlled trial of a five-session psychological intervention for chronic pain. Patients were introduced to the study by their primary care provider using the warm handoff model. We compared whether there were sociodemographic differences between those who enrolled in the study and those who declined to enrol.
Results:
There were no differences between those who enrolled and those who declined enrolment with regard to race, age, insurance type, and household income. However, females were more likely to enrol in the study compared to males.
Conclusions:
Recruiting patients to participate in a trial of a psychological intervention for chronic pain in a primary care clinic appeared to be effective for engaging Black patients, patients with lower income, and those with government insurance. Thus, offering a psychological intervention for chronic pain in a primary care clinic may encourage engagement among racially minoritized individuals and those with lower socioeconomic status.
Between 1964 and 1985, a military dictatorship in Brazil combined an arsenal of political instruments—surveillance, violent repression, and propaganda, among others—to justify its illegal rule. How did the Brazilian military regime attempt to justify its claim to power for more than two decades? What discursive strategies did it use to win popular support, despite the violence it perpetrated? This paper investigates how discourse is used to legitimize power and create meaning in authoritarian regimes. Using ethnographic content analysis of archival materials, I pinpoint and analyze three key discursive frames employed in regime propaganda: “defenders of democracy,” “Great Brazil” and “model citizenship.” I argue that the Brazilian military regime used these frames to justify its authority, forge national values and social norms, and redefine the boundaries of the national community. These findings not only contribute to our understanding of authoritarian power that is wielded and legitimized through discourse, but also speak to the enduring consequences of authoritarianism in sociopolitical subjects.
This article examines how and why the Ptolemies, soon after they succeeded Alexander in Egypt, orchestrated the return of Egyptian statues supposedly stolen by the Persians, drawing on the cultural memory of different population groups: Egyptians and Graeco-Macedonians. First, it argues that the Ptolemies invested energy in searching for Egyptian objects and gods’ statues in the Levant, which they distributed among the temples, though some may have been newly fabricated statues. Second, the study aims to reconstruct what the Ptolemies knew about earlier Greek and Near Eastern traditions of seizing and returning statues, which mixed elements of truth with topoi. This reconstruction serves to explain how meaningful it was to Egyptians and Graeco-Macedonians to bring back statues after each campaign. Finally, comparing the tale of Bentresh, the account of Sarapis’ origin by Tacitus and the Ptolemaic stelae, the article suggests that these narratives highlighted Egypt as the centre of the world with the most powerful ruler, a claim appealing to all its inhabitants.
We sought to compare patient outcomes between carbapenem-resistant Enterobacterales (CRE) and carbapenem-susceptible Enterobacterales (CSE) infections at our academic medical center.
Design:
We conducted a retrospective cohort study of adult patients with a positive culture of E. coli, E. cloacae, K. aerogenes, K. oxytoca, and/or K. pneumoniae admitted at UK HealthCare (January 1, 2010–December 31, 2019). Based on the type of pathogen on the date of the first culture (index date), patients were included in the CRE (i.e., exposed) group, or the CSE (comparator) group. Exclusion criteria were age < 18 years old, pregnancy, endocarditis, osteomyelitis, necrotizing fasciitis, or cystic fibrosis. We evaluated the impact of CRE vs CSE on a composite outcome of 30-day of all-cause mortality or discharge to hospice using Kaplan–Meier survival curves and Cox proportional hazard regression with inverse probability of treatment weights (IPTW).
Results:
Of 17,839 hospitalized patients, 128 and 6,953 patients were included in the CRE and CSE groups, respectively. Baseline differences existed in sex-assigned-at-birth, admission source, time-to-index culture, and infection type/severity. Most CRE index cultures observed (76%) only exhibited resistance to ertapenem. IPTW-adjusted HR [95% CI] of composite outcome was 0.99 [0.65, 1.51] after 30 days. Follow-up analysis in patients with carbapenem-non-susceptible Enterobacteralesbloodstream infections on index yielded an HR of 1.38 [0.85, 2.24].
Conclusions:
Risk of composite outcome was not estimated to differ between patients with CRE and CSE in the overall analysis. Although follow-up analysis identified an increased risk, we cannot statistically distinguish this from a null effect.
We investigate how hardships affect rural politics, considering the case of hospital closures. In the last two decades, more than two hundred rural hospitals have closed their doors or drastically reduced their services. Drawing from resource models of voting, our hypothesis is that personal- and community-level deprivations brought about by hospital closures should reduce election turnout. Empirical tests pair geographic information on the location of open and closed hospitals with data from state voter files to create a panel of over 10 million rural residents for the 2016, 2018, and 2020 national elections. Results show that individuals whose nearest hospital closed prior to the proximate election were less likely to vote than their unaffected counterparts. These effects are strongest for older and lower-income residents, but they decay over time so that voting likelihood resembles a pre-closure baseline within 12 months.
In a scene of father-son conflict in Aristophanes’ Clouds, father Strepsiades supports his right to be treated well by his son Pheidippides by reminding the boy of how well he was taken care of as a baby. Even before Pheidippides could talk properly, his father catered to his every wish. If he said ‘brū’, his father would get him something to drink, ‘mammā’ would make him get food, and ‘kakkā’ would lead to his being taken outside to relieve himself. These baby-words have always been taken for what Strepsiades claims they were: meaningful and intentional baby requests.
Starting with brū, we discuss ancient and modern interpretations of the passage and contextualize it within the history of ancient and later Western thought about child language. We then propose a new interpretation of brū as the conventional rendition of a universal baby vocalization, what is known as a ‘raspberry’. In performance, this would lead to a mimetic ‘depiction’ in the middle of Strepsiades’ sentence. Finally, we return to the utterances mammā and kakkā to show that there, too, Strepsiades may be demonstrating parental devotion by interpreting the virtually unintelligible and by acting out baby activities that lend plausibility to his mantic performance.
Photosynthetically active radiation (PAR) at the ice-ocean interface is critical for primary production. The value of PAR is affected by the thickness of snow and sea ice, with additional absorbers (e.g. algae) further attenuating PAR. Sea-ice algae exhibit a substantial geo-temporal variance in column-integrated concentration (0–500 mg chl-a m−2) and are typically present within the bottom 0.01–0.2 m of sea ice. PAR transmittance is affected by algae concentrations and vertical thicknesses of ice algal layers. Small column-integrated concentrations of chl-a (~<10 mg chl-a m−2) have a negligible effect on the value of PAR transmittance, and large column-integrated concentrations of chl-a (~>10 mg chl-a m−2) can significantly reduce the value of PAR transmittance. Large column-integrated concentrations of chl-a need consideration when calculating PAR transmittance in areas of high sea-ice algae biomass (e.g. the ‘interior’ shelves of the Arctic Ocean, the Canadian Arctic and Antarctica).
This paper considers a new corpus of 490,154 Roman coins (site finds) which have been recorded from England and Wales. The corpus provides British and regional means to aid in the preparation of coin reports in line with Historic England guidelines, along with spatial data providing new opportunities for research. The methods of data collection will be detailed and some of the possibilities this dataset can provide presented through a number of case studies. Through the consideration of applied numismatic analyses, the social distribution of the material and, crucially, the spatial distribution of Roman coinage, we can identify new trends and patterns. Case studies evaluating the fourth century will emphasise the changing importance of settlements in Roman Britain and identify those linked with the late Roman state. Furthermore, the retraction of coinage distributions in the second half of the fourth century will be explored. Building on the national and site type means explored within the paper, the full dataset has been made available in a range of forms on the Archaeology Data Service and in an interactive map developed by Maploom.
The ability to manipulate brain function through the communication between the microorganisms in the gastrointestinal tract and the brain along the gut-brain axis has emerged as a potential option to improve cognitive and emotional health. Dietary composition and patterns have demonstrated a robust capacity to modulate the microbiota-gut-brain axis. With their potential to possess pre-, pro-, post-, and synbiotic properties, dietary fibre and fermented foods stand out as potent shapers of the gut microbiota and subsequent signalling to the brain. Despite this potential, few studies have directly examined the mechanisms that might explain the beneficial action of dietary fibre and fermented foods on the microbiota-gut-brain axis, thus limiting insight and treatments for brain dysfunction. Herein, we evaluate the differential effects of dietary fibre and fermented foods from whole food sources on cognitive and emotional functioning. Potential mediating effects of dietary fibre and fermented foods on brain health via the microbiota-gut-brain axis are described. Although more multimodal research that combines psychological assessments and biological sampling to compare each food type is needed, the evidence accumulated to date suggests that dietary fibre, fermented foods, and/or their combination within a psychobiotic diet can be a cost-effective and convenient approach to improve cognitive and emotional functioning across the lifespan.