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To pilot a registry to evaluate the use and effectiveness of interventional cancer pain management.
Methods
Upon interventional pain procedure scheduling, patient demographics, cancer, and pain information were entered into the longitudinal clinical registry in 2 tertiary hospitals in Sydney, Australia (Royal Prince Alfred Hospital and Chris O’Brien Lifehouse). Details of the procedure (including proceduralist, nature of the intervention, and site of treatment), post-procedure patient-reported outcomes and quality of life surveys, adverse events, and mortality data (when known) were collected longitudinally.
Results
Between October 2021 and March 2023, 48 patients underwent 55 procedures. Procedures included treatment targeting autonomic plexuses, peripheral nerves, fascial planes, and neuraxial structures. Celiac plexus neurolysis was the most frequently reported procedure (33.3%). Post-procedure, there was a trend in reduction in pain intensity on the Patient-Reported Outcome Measurement Information System (p < 0.01), reduction in opioid consumption, and improvement in quality of life on the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core-15-Palliative Care.
Significance of results
This is a vital first step in creating a more widely applicable registry evaluating cancer pain intervention. It provided valuable information on the range of available pain intervention procedures and data on patient-reported outcome measures using validated instruments. This will facilitate a timely review of clinical practice to improve future patient care. An Australian-wide database of cancer pain will be a valuable next step in the improvement of cancer pain management.
What counts as a human and as a proper human life has been a lifelong preoccupation of our species. Today it is digitalism, technology, and AI triggering renewed nightmares and hopeful dreams around being human. Through an examination of Samantha Schweblin’s novel “Little Eyes” (Kentukis in the original), I show how humanities are crucial to (i) keep track of what is new and old in these shifts and (ii) maintain a vigorous public sphere that is qualitatively different from gamified individual and social relations. The result is the defense of an idea of public life that stands beyond our individual private desires, marking a stark contrast with a vision of society in which we relate to others and the public as we would to toys we play with.
In recent elections across major destination countries in the developed world, migration has become a major issue of political salience. Japan has traditionally been an outlier to the trend, but migration did become a major topic driving public opinion in the 2025 Upper House election. This article explores the overall political salience of migration in Japan, focusing primarily on how the ruling coalition managed public discourse as it pushed through major reforms over the past decade, why it lost control of the narrative in the recent election, and what this means for the politics of migration in Japan going forward.
Polychrony is a virtual or artificial tempor[e]ality that is constructed by the fine augmentation or tempering of a natural set of latencies that articulate a complex networked acoustic. The art is to optimise the alignment of these disjunct temporalities as they merge in a new chronotopic fusion. This fooling with Mother Nature, however, does not come without consequences: due to the significant latency effects intrinsic to a planetary-scale network, a phenomenon called topo-rhythmia emerges. Toporhythms are derived simply as a feature of communication over distance; they are the multiple versions of a rhythm that occur at each node of a networked piece due to the temporal offsets caused by delay. To work with this feature more intentionally, rather than as an accident of relativity, we must tune or temper the network latency. Tempering is a general tactic for ontological negotiation, bringing observers and complex systems into some kind of coherency. The purpose of this article is to explore the tempering of musical time-space on networks and how that underlies the notational practices (and the alien compositional assumptions) built upon this novel orientation.
Machine learning (ML)-driven reduced-order modelling is applied to accelerate steady-state convergence in three-dimensional, nonlinear, flux-driven two-fluid simulations of boundary plasma turbulence. A parametric scan of plasma resistivity, heating and density sources is performed to generate comprehensive datasets across various turbulent regimes for model training and validation. To efficiently manage and interpret these datasets, we apply the proper orthogonal decomposition technique to reduce the dimensionality of key plasma quantities such as plasma density, temperature, electric potential and vorticity. Data-driven models are trained to map physical parameters to low-dimensional representation, enabling the rapid generation of quasi-steady-state plasma profiles. The results demonstrate that density, temperature and electric potential are qualitatively well captured with a relatively low number of bases, whereas vorticity requires a larger number of bases due to its fine spatial structures. A comparison between ML-generated restarts and simulations from scratch demonstrates a significant computational advantage of the ML approach, reducing simulation time by up to a factor of three. This hybrid framework, combining data-driven reduced-order modelling with first-principles simulations, highlights the potential of ML to accelerate plasma turbulence modelling, making high-fidelity simulations more computationally feasible for large-scale fusion devices, such as ITER and DEMO.
Health systems have finite capacity. During crises, policymakers may explicitly reallocate health system resources, or capacity limitations may necessitate implicit resource reallocation. This study modelled timing and intensity of pre-vaccination health system resource reallocation policies to predict excess mortality during the COVID-19 pandemic.
Methods
This longitudinal panel analysis included 85 countries (752 country-months, January 2020-January 2021). The predictor was resource reallocation scope, scale (summarized as intensity, 0-100), and timing. The outcome was all-cause excess mortality (percentage deaths greater than historical average/month). Covariates included COVID-19 incidence and health system parameters.
Results
Simultaneous health system resource reallocation was associated with increased mortality in multivariate models (b = 0.80, 95%CI 0.42-1.18). However, preemptive (previous month’s) resource reallocation was protective against excess mortality (b = −0.58, 95%CI −0.93–0.23: e.g., 42,010 fewer deaths per unit increased resource reallocation, March 2020, all study countries). Effects were magnified in older populations. Health system capacity and preparedness were associated with lower mortality.
Conclusions
In the pre-vaccination COVID-19 pandemic, preemptive health system resource reallocation was associated with lower mortality, whereas simultaneous resource reallocation was associated with greater mortality. This longitudinal multinational study indicates that readiness, capacity building, and proactive resource reallocation improve crisis response.
The US major-party presidential nominating conventions are an essential platform for a political party’s branding and messaging for upcoming presidential and congressional elections. The conventions also can provide revenue and media attention to their host cities and, consequently, convention fundraising has grown substantially in recent decades. Convention fundraising rules were changed in 2014, tripling the limit for contributions to a party’s campaign funds and removing limits on contributions to host-city committees. Although we do not expect these changes to affect individual donors, we expect corporations, banks, and labor unions to have taken advantage of these new rules. Elections since 2014, however, have been unusual in many ways—for instance, in the relationship between the nominees and their parties and, in 2020, the public health precautions required to hold conventions. This study examines developments in political-party convention fundraising since 2014, focusing on the relationships among candidates, their parties, and the cities where conventions have been held. To make this determination, funding reports were collected for the 2000–2024 election cycles. The article explores changes in the characteristics of convention donors—their other contributions and their relationships to candidates, party committees, and host cities—and notes variations that might be attributable to the nominees or the host cities. It considers whether the new convention-funding rules have matured sufficiently that it is possible to make broad claims about the effects of the rules themselves.
Biochar, when used as soil amendment, could enhance soil health, plant growth, and farm profitability while offsetting adverse effects of environmental pollution. Yet the adoption rate of biochar among agricultural producers remains extremely low. Message framing has been shown to play an important role in forming positive attitudes and generating desirable outcomes. To understand the effect of message framing in promoting biochar, we conducted a randomized experiment through an online survey of crop producers located in Eastern South Dakota. The results showed that participants who read a message about the benefits of adopting biochar from an economic perspective expressed higher interest in learning about biochar; no such effect was observed among participants who read a message about the benefits of adopting biochar from a stewardship perspective. Compared with the control group, economic and stewardship frames increased farmers’ likelihood of adopting biochar in the next 5 years, by 10.6% and 10.8%, respectively. Our findings illustrate the importance of message framing in encouraging farmers to adopt conservation practices that are rarely used. To promote future adoption of conservation practices such as biochar, it is important to highlight both economic and stewardship benefits when conveying information to farmers.
The objective of this study was to develop and validate an educational comic book designed to promote healthy eating among caregivers of young children. The study was conducted in four phases: (1) literature review and script development; (2) creation of the initial version of the comic book, including illustrations, layout and design, and calculation of the Flesch Readability Index (FI); (3) expert validation of the initial version and calculation of the Content Validity Index (CVI); and (4) adaptation of the comic book based on expert suggestions, recalculation of the FI, and pilot testing (CVI) with a lay population. A total of 64 volunteers participated in the validation process, including 14 expert judges and 50 caregivers responsible for feeding children aged 0 to 5 years. Statistical analysis included descriptive measures and inferential testing using the Wilcoxon signed-rank test. The FI score for the initial version was 85.0%, indicating a reading level classified as “easy to understand.” After expert evaluation, the CVI reached 94%, reflecting high agreement among participants. In the revised version, the FI remained high at 84.7%, reinforcing the “easy to understand” reading level, while the CVI increased to 98% following the pilot test, demonstrating strong consensus among participants. A significant improvement in knowledge regarding healthy eating was observed after reading the comic book (p < 0.05). The comic book was validated for appearance, content and readability, showing a positive impact on caregivers’ knowledge about healthy eating practices. It represents an accessible and effective resource that can be integrated into community-based nutrition education programmes.
People living with dementia (PLWD) want – and have the right – to participate in research that impacts them. However, barriers in legislation, institutional practices, and/or biases may jeopardize inclusion.
Objective and Methods
Interviews with 33 Canadian dementia researchers were conducted to explore understandings of research consent with regard to dementia, research practices, and approaches in everyday research contexts.
Findings
Analysis of these interviews revealed challenges in negotiating the space between best practices and institutional requirements; gaps in knowledge, procedures, and guidelines on inclusion and consent; tensions regarding who should be involved in decision making; and how assumptions of presumed incapacity and/or the ‘protection’ of vulnerable groups create and/or sustain the exclusion of PLWD from research.
Discussion
Moving forward, findings suggest that advancing the meaningful inclusion of PLWD in Canadian dementia research will require clear, consistent standardized guidelines, flexible and ongoing consent processes, accessibility accommodations, and a stronger focus on rights-based practices.
In 2018, the UK government commissioned National Health Service Talking Therapies (NHS TT) services to provide integrated mental and physical health care for individuals with a long-term condition (LTC) and coexisting depression and/or anxiety. Nevertheless, evidence on the effectiveness of NHS TT in physical LTCs remains inconsistent.
Aims
This review aims to evaluate the impact of NHS TT on mental health outcomes among adults with physical LTCs.
Method
We conducted a systematic review and meta-analysis of quantitative studies published between 2008 and 2024. We used several databases for the search, including Embase, MEDLINE, Cochrane Library, NHS Evidence, PsycINFO, Bielefeld Academic Search Engine and ProQuest. We combined terms related to NHS TT, LTCs and mental health outcomes to identify eligible studies. The Population, Intervention, Comparison, Outcomes and Study framework guided the development of the inclusion criteria. We employed the random-effects model for meta-analysis and assessed heterogeneity bias using the I2 statistic, and the Newcastle–Ottawa scale to evaluate the overall quality of the evidence.
Results
Twenty-four studies met the inclusion criteria. The meta-analysis revealed a significant pre–post NHS TT intervention effect on reliable improvement (odds ratio 0.77, 95% CI: 0.60–0.98) and reliable recovery (odds ratio 0.80, CI: 0.68–0.95). There were no significant differences in NHS TT accessibility (e.g. treatment engagement) between participants with and without LTCs (odds ratio 0.97, 95% CI: 0.82–1.14). However, heterogeneity between the studies was high (>90%).
Conclusions
The observed evidence provides reassurance for individuals with LTCs engaging with treatment; however, the association with post-treatment distress is still of concern. Furthermore, extensive and rigorous research is needed to strengthen and guide service development for individuals with LTCs, thereby improving effectiveness.
To describe the prevalence, patterns, and quality indicators of antimicrobial use (AMU) in Burkinabe hospitals and identify priorities for stewardship.
Design:
Multicentre, cross-sectional point prevalence survey (PPS) following the Global Point Prevalence Survey protocol.
Setting:
Eight public hospitals across six cities in Burkina Faso (3 primary, 3 secondary, and 2 tertiary), February–June 2019.
Participants:
All inpatients present on the survey day at 8:00. Medical records were reviewed for those receiving systemic antimicrobial agents.
Methods:
Standardized ward- and patient-level data were collected on indications, agents, routes, and WHO AWaRe categories, alongside quality indicators (documented indication, stop/review date, guideline compliance, and targeted vs empirical therapy). Descriptive analyses compared hospital tiers.
Results:
Of 994 inpatients, 729 (73.3%) received ≥1 antimicrobial (range by tier: tertiary 69.7%, secondary 79.2%, primary 79.2%). Community-acquired infections accounted for 96.0% of therapeutic indications. Leading reasons were skin/soft tissue infections (12.2%), gastrointestinal infections (10.7%), and pneumonia (10.4%). Parenteral administration predominated. The most used agents were ceftriaxone (27.8%), metronidazole (15.7%), and gentamicin (9.4%). By AWaRe, Access agents comprised ∼ 50%, Watch agents ∼ 50% overall, with higher Watch use in tertiary hospitals; no Reserve antibiotics were recorded. Quality indicators were suboptimal: the indication was documented in 15.6%, the stop/review date was absent in 93.0%, and 41.1% of prescriptions were guideline-compliant. Therapy was largely empirical (98.5%). Prolonged surgical prophylaxis (>1 day) represented 86.8% of prophylaxis courses.
Conclusions:
Antimicrobial use (AMU) prevalence in Burkinabe hospitals is high, dominated by empirical therapy and Watch-class ceftriaxone. Deficits in prescribing quality and limited diagnostic use highlight urgent needs for context-adapted antimicrobial stewardship: enforce guideline-concordant care, curb prolonged prophylaxis and unnecessary Watch-class use, and expand affordable microbiology capacity to enable targeted therapy.
There is limited data describing statewide pediatric surge response during times of capacity strain.
Objective
Characterize the burden and response to a surge in pediatric respiratory admissions in Oregon in 2022.
Design, Setting, and Participants
This analysis utilized data from the Oregon Capacity System (OCS) and the state discharge database to describe patient characteristics, census changes, and admission pattern shifts during an RSV epidemic in 2022.
Main Outcome and Measure
Statewide pediatric census, weekly pediatric admissions, weekly admissions from non-children’s hospital emergency departments (EDs) to non-children’s hospitals.
Results
The median census in Oregon’s pediatric inpatient hospitals increased by 19% during the surge period (306 vs 364, P < 0.001), while the median pediatric intensive care unit census increased by 50% (24 vs 36, P < 0.001). Weekly elective pediatric admissions to children’s hospitals decreased by 33% (30 vs 20, P = 0.03). ED admissions to non-children’s hospitals increased by 160% (15 vs 39 per week, P = 0.02).
Conclusion and Relevance
As the statewide pediatric inpatient census increased, targeted reductions in elective admissions and increased utilization of non-children’s hospitals increased capacity during a respiratory surge. This analysis underscores the importance of real-time situational awareness and coordinated surge response between hospitals.
We tested whether people engage in proportional thinking when comparing the value of the lives of people in different countries, specifically, whether people consider a certain number of lost lives in a smaller country to be equivalent to the loss of a larger number of lives in a country with a larger population. We found evidence for this form of proportional thinking in Study 1, and in Studies 2–3 we further observed that it is modulated by motivated reasoning: In Study 2, there was more proportional thinking when it benefited the ingroup (1 ingroup life equals 4 outgroup lives) than when it benefited the outgroup (1 outgroup life equals 4 ingroup lives). In Study 3, there was more proportional thinking when it benefited the victim in a war (1 victim life equals 4 aggressor lives) than when both countries were victims. Study 3 also showed that this form of proportional thinking is more prevalent when thinking about collectives (1,000 lives in the smaller country are equivalent to 4,000 lives in the larger country) versus individuals (1 life in the smaller country is equivalent to 4 lives in the larger country).
The creation of the Administrative Review Tribunal represents a critical redesign of Australia’s federal administrative review system. In this article, we draw on a novel dataset from the Kaldor Centre Data Lab to question the government’s justifications for retaining separate codified procedures and other restrictive rules for the new tribunal’s migration and protection jurisdictions. Our data analysis reveals that historically, there is no evidence that the codification of procedures increases the efficiency or certainty of decision-making. This approach may in fact have the opposite effect, contributing to both inefficiencies and unfairness for applicants. The government’s decision to retain separate procedures for migration and protection applicants represents a missed opportunity and may undermine the new tribunal’s objectives.
Botanical supplements occupy a regulatory grey area between food and medicine within the European Union, a situation that has given rise to a series of interrelated challenges. This paper highlights regulatory dysfunctions across several dimensions: definitional voids in EU food law, unclear food–medicine classification boundaries, fragmented market access rules, and inadequate safety monitoring systems. These regulatory gaps impose costs on business operators, restrict consumer access, and result in uneven protection across Member States. The article also focuses on safety concerns, which are, however only one element of this broader puzzle. To address such systemic difficulties, the paper proposes the introduction of harmonised pre-market notification and post-market surveillance mechanisms, with a specific focus on botanical supplements. These measures could help reconcile market accessibility with stronger consumer protection while supporting innovation. Admittedly, they may not resolve all regulatory challenges, particularly the thousands of health claims that remain on hold. Nevertheless, they might offer a practical foundation for addressing long-term, often overlooked safety concerns related to botanicals. It remains to be seen whether they could also contribute to resolving the interconnected regulatory issues in this sector, potentially paving the way for broader reform.
Since the 1970s, the concepts of ‘systemic context’ and ‘archaeological context’, developed within the framework of behavioural archaeology by Michael Schiffer, have significantly influenced archaeological reasoning and language. However, these fundamental theoretical foundations have undergone few substantial changes over the years, and a re-evaluation of the notion of systemic context could prove beneficial, especially for archaeologists working on deeply stratified sites that have hosted human occupation for centuries, such as urban sites. This paper proposes a shift from the current understanding of systemic context to a palimpsestic perspective, wherein multiple systemic contexts are viewed as sequential time-slices. Each slice represents a living system within a specific time frame, varying in width depending on the accuracy of our chronological phasing. By replacing a single, non-temporally defined systemic context with a sequence of chronologically framed systemic contexts, each characterized by distinct cultural and ecological attributes, we can better address issues that are typical of studying urban sites from both archaeological (residuality, false residuality, phasing, etc.) and historical perspectives (rhythms of change, urban development or contraction, etc.).
For each integer $d\geq 2$, let $\mathrm {M}_d$ denote the moduli space of maps $f: \mathbb {P}^1\to \mathbb {P}^1$ of degree d. We study the geometric configurations of subsets of postcritically finite (or PCF) maps in $\mathrm {M}_d$. A complex-algebraic subvariety $Y \subset \mathrm {M}_d$ is said to be PCF-special if it contains a Zariski-dense set of PCF maps. Here we prove that there are only finitely many positive-dimensional irreducible PCF-special subvarieties in $\mathrm {M}_d$ with degree $\leq D$. In addition, there exist constants $N = N(D,d)$ and $B = B(D,d)$ so that for any complex algebraic subvariety $X \subset \mathrm {M}_d$ of degree $\leq D$, the Zariski closure $\overline {X \cap \mathrm {PCF}_d}$ has at most N irreducible components, each with degree $\leq B$. We also prove generalizations of these results for points with small critical height in $\mathrm {M}_d(\overline {\mathbb {Q}})$.
This study investigates consumer preferences for two emerging food waste reduction technologies – gene editing and all-natural spray coating – applied to apples. Using a discrete choice experiment with a nationally representative sample of U.S. consumers (n = 413), we estimate willingness to pay for gene-edited apples, spray-coated apples, and untreated apples. A generalized mixed logit model in willingness to pay space reveals that consumers exhibit the highest WTP for gene-edited apples ($2.45/lb), followed by spray-coated apples ($2.37/lb), with untreated apples valued least ($1.79/lb). Latent Class Analysis identifies three consumer segments: Price-Sensitive Skeptics, Sustainability-Oriented Consumers, and Selective Technology Adopters. Sustainability-Oriented Consumers showed the strongest support for both technologies, while Selective Technology Adopters displayed a clear preference for gene editing. Behavioral attitudes, rather than demographic variables, were the main drivers of segmentation. These findings suggest that tailored marketing strategies and policy interventions, including sustainability messaging, pricing incentives, and educational outreach, can support the adoption of food waste-reducing technologies. Overall, consumers are receptive to both gene-edited and spray-coated apples, though concerns about biotechnology and price sensitivity remain. Results offer insights for producers, retailers, and regulators aiming to enhance fresh produce sustainability and reduce food waste along the supply chain.