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Many studies have shown that individuals who interact with government programs subsequently participate in politics at levels different from before, whether higher or lower. While most prior work examines the effect of policy recipiency, or program administration in one geographic location or at one snapshot in time, I study how the administration of Medicaid, a federal program administered by states, varies over time and by place, and how its variation in administration affects mass-level voter turnout. I argue that there are two highly salient sites of contact with the administrative state when considering effects on voter turnout: government programs and elections. I theorize that administrative burden from these sites creates interpretive effects on both those with direct public program experience and those whose experience is indirect, which shapes the likelihood of voting. Using a generalized differences-in-differences design and applying my separate, original measures of Medicaid and electoral burdens, I find that having a higher level of Medicaid burden resulted in a small but significant decrease in county-level turnout in recent national elections, net of Medicaid expansion status, burdens associated with registering to vote and voting, and other factors. These results imply that contact with the administrative state, via government program administration and elections, is a critical way in which policies shape mass-level political participation.
An improved understanding of the epidemiology of hospital-onset methicillin-resistant Staphylococcus aureus bloodstream infection (HO-MRSA BSI) could inform future prevention strategies for HO-MRSA BSI.
Methods:
We performed a retrospective cohort study of HO-MRSA BSI reported to NHSN from 2020–2023 at a system of 9 acute care hospitals located in New York City. The primary outcome was to describe the demographic and clinical characteristics of patients with HO-MRSA BSI. Secondary outcomes included comparisons of tertiary (TH) and community (CH) hospitals, standardized infection ratio (SIR) and rates per 10,000 patient-discharges, presumptive potential infectious sources, and mortality.
Results:
Between 2020 and 2023, 222 patients had HO-MRSA BSI. Their median age was 65 years, 139 (63%) were male, 92 (41%) had central lines, 89 (40%) were in ICUs, and 63 (28%) were on a ventilator. These characteristics were similar across the 176 (79%) patients in TH and the 46 (21%) patients in CH. SIRs were similar across each year of the study (with cumulative SIRs of 0.815 overall, 1.412 [CH] and 0.732 [TH]). Overall HO-MRSA BSI rates ranged from 2.58–3.53 per 10,000 patient-discharges. The most common sources of HO-MRSA BSI were pneumonia (41%), SSTIs (17%), CLABSIs (13%), and PIV catheter-related issues (9%). The all-cause mortality rate was 35%.
Discussion:
The unchanged HO-MRSA BSI SIRs in this study support the need for additional interventions that focus on prevention of the primary sources of MRSA infections. Ongoing systematic surveillance of the primary sources of HO-MRSA BSI should be implemented to inform and monitor best practices for prevention.
Previous research suggests the effects of negative campaigning are highly conditional on country context and the specific messages that are used. In this paper, we present an experiment on negative campaigning in an unexamined context in which existing studies could point to differing outcomes. We examine the effect of attacks placed in campaign leaflets on a candidate’s personal traits and policy positions in Great Britain. Unlike prior studies, our treatments are contrast ads and not purely negative ads. While the inclusion of positive messaging from the sponsor could increase voters’ parasocial relationship with the candidate, shielding them from backlash, the results from our experiment suggest that British voters view attacks on personal traits as too negative and lower their evaluation of the sponsor as a result.
Effectiveness of nirsevimab against respiratory syncytial virus (RSV) hospitalization during the 2024/2025 season in Spain was estimated using a test-negative design (TND) and hospital-based respiratory infections surveillance data. Children born between 1 April 2024 and 31 March 2025 and hospitalized with severe respiratory infection between the start of the 2024 immunization campaign (regionally variable, between 16 September and 1 October 2024) and 31 March 2025 were systematically RT-PCR RSV-tested within 10 days of symptom onset and classified as cases if positive or controls if negative. Nirsevimab effectiveness ((1 − odds ratio) × 100) was estimated using logistic regression, adjusted for admission week, age, sex, high-risk factors, and regional RSV hospitalization rate. We included 199 cases (68.8% immunized) and 360 controls (86.4% immunized). Overall effectiveness was 65.5% (95% confidence interval: 45.2 to 78.3). Effectiveness was similar among infants born before and after the campaign start (63.6% vs. 70.4%, respectively). We found an unexpected early decrease in effectiveness with increasing time since immunization and age, albeit with wide confidence intervals for some groups. Strong age–period–cohort effects and potential sources of bias were identified, highlighting the need to further explore methodological challenges of implementing the TND in the dynamic population of newborns.
This article critically re-examines the long-standing dominance of constructivism in debates concerning the epistemic reliability of religious experience. It argues that the epistemic reliability of such experiences can be more supported not through a strictly cognitivistic framework, but rather through an embodied approach. By interpreting religious experience from the perspective of embodied cognition, this article offers a possible resolution to the prolonged impasse between religious-experience-based epistemology and constructivism. Moreover, it proposes not merely a compatibility between the two paradigms, but the potential for an integrative framework that moves beyond their traditional opposition.
This article proposes a mixed-method approach to examine historical censuses with regard to race. It does so by exploring various kinds of demographic records from nineteenth-century Buenos Aires in order to test the conventional hypothesis of a significant census underenumeration of the city’s population of African descent. Starting from the overall progression of census results, the article is divided into three parts. The first of these deals with potential under-coverage, the second with the possibility of classificatory changes, and the third with vital statistics, largely derived from parish books. With special attention to two censuses of the 1850s, it concludes that Buenos Aires’s Afro-descendant population likely did suffer serious demographic decline between 1840 and 1890.
Parasitoids play a key role in biological control, regulating pest populations in natural and agricultural ecosystems. Their efficiency depends on a thorough understanding of host–parasitoid interactions. Among these, the functional response, the relationship between parasitism rate and host density, plays a critical role. Despite a well-established background, challenges remain in experimental design, model selection, and parameter estimation for functional response analysis in parasitoids. This study aims to provide a practical guide to addressing these challenges. We outline key considerations in experimental design, including the selection of model organisms and initial host densities. For model selection, we present methods to differentiate between Type II and Type III functional responses, identifying the best-fitting models for parasitoids. In parameter estimation, we present an example demonstrating the application of functional response models for each type, including parameter estimation to guide model choice. Additionally, we provide equations and code based on published data to facilitate parameter comparisons. This guide provides a structured framework for experimental design, parameter estimation, and model selection in functional response studies, which is adaptable to various host–parasitoid interactions. By enhancing methodological rigour, we aim to support researchers in improving the precision and applicability of functional response analyses in parasitoid research.
Mizo (ISO 639-3 code: lus) is a Tibeto-Burman tone language spoken in Mizoram, India. This work provides an acoustic-phonetic description of Mizo tones spoken in Aizawl. The acoustic features of Mizo tones are modelled after the four tones in the language. The patterns of the f0 contours of the four Mizo tones in this study indicate that three have dynamic f0 contours. The analysis also shows that the f0 slope is crucial in distinguishing the four Mizo tones. Discrete Cosine Transform is used to obtain the average f0 and the f0 slope features of the Mizo tone contours represented by the first three Discrete Cosine Transform coefficients. The first three coefficients of the Discrete Cosine Transform, which are associated with the average f0 and the f0 slope of the four Mizo tone f0 contours, along with the tonal duration, can automatically classify the Mizo tones with an average accuracy of 87.12% using a quadratic discriminant analysis.
This article is an environmental history of Anaconda Copper Company’s disposal of hundreds of thousands of tons of toxic waste from its Potrerillos and El Salvador mines into Chile’s Río Salado and Bahía de Chañaral. First, it uncovers a long history of disputes between copper companies and workers who panned the river for tailings. This early water war in Chile was shaped by competing understandings of water’s legal status. While workers claimed rights under the water law’s definition of water as a bien nacional de uso común, mining companies invoked the mining code and contended that the river’s water and waste were private property under civil law. Mining companies claimed rivers’ water by treating rivers in legal terms as mines and property of the state, bienes fiscales, that could be conceded as private property. They argued that human engineering of rivers in dams and canals, and through pollution, made rivers into a commodity and a form of property akin to subsoil minerals. Second, the article describes how, during the social reformist government of Eduardo Frei (1964–1970) and the revolutionary government of Salvador Allende (1970–1973), the state asserted control over Chile’s waterways while balancing centralized state management of water in the name of development with local users’ claims of long-standing riparian use rights. Third, the article traces the long history of the state and mining companies treating water as an economic commodity, often superseding local use rights, and argues that this history built the foundation for the later privatization of water during the Pinochet dictatorship. The article demonstrates that the privatization of water in Chile under Pinochet had its origins in the resolution of the tension between water and civil law in favor of extending property rights to water and building as a subsidy to transnational mining companies. This meant rolling back state management of rivers and often eroding local users’ water rights. Finally, the article concludes by examining the town of Chañaral’s successful 1987 lawsuit against the El Salvador mine to win an injunction against further pollution of the Salado as part of a moment of broader Latin American “environmental constitutionalism” during the 1980s. While this legal victory reflected a significant change in environmental law and an emergent environmentalist movement in Chile and across Latin America, it struck a blow to hundreds of workers who depended on extracting tailings from the river for their livelihood and who responded with unsuccessful protests.
Deficits in working memory (WM) and attention have a considerable functional impact on people with bipolar disorder (PBD). Understanding the neurocognitive underpinnings of these cognitive constructs might facilitate the discovery of more effective pro-cognitive interventions. Therefore, we employed a paradigm designed for jointly studying attentional control and WM encoding.
Methods
We used a visuospatial change-detection task using four Gabor Patches with differing orientations in 63 euthymic PBD and 76 healthy controls (HCS), which investigated attentional competition during WM encoding. To manipulate bottom-up attention using stimulus salience, two Gabor patches flickered, which were designated as either targets or distractors. To manipulate top-down attention, the Gabor patches were preceded by either a predictive or a non-predictive cue for the target locations.
Results
Across all task conditions, PBD stored significantly less information in visual WM than HCS (significant effect of group). However, we observed no significant group-by-salience or group-by-cue interactions. This indicates that impaired WM was not caused by deficits in attentional control.
Conclusions
While WM was disturbed in PBD, attentional prioritization of salient targets and distractors, as well as the utilization of external top-down cues, were not compromised. Thus, the control of attentional selection appears to be intact at least for our specific manipulation of this cognitive construct. These findings provide valuable clues for models of WM dysfunction in PBD by suggesting that later stages of WM encoding, such as WM consolidation, are likely primarily impaired, while selective attention is not a main source of impairment.
Trust in biomedical research is essential, multidimensional, and shaped by individual experiences, culture, and communication. Participants’ trust relies on researchers’ commitment to ethical practices. As public trust in science declines due to misinformation and disinformation campaigns, biomedical researchers (BmRs) must ensure trust and cultivate trustworthiness. This study explores BmR’s perspectives on trust and trustworthiness.
Methods:
We employed a qualitative, phenomenological approach to explore the experiences of BmRs. Through purposive sampling via the Indiana Clinical and Translational Sciences Institute, we invited BmRs to participate in semi-structured interviews. We employed rapid qualitative analysis (RQA) to identify key themes from interviews with BmRs. This action-oriented approach enables a research team to efficiently summarize experiences and perspectives, using structured templates and matrixes for systematic analysis and interpretation.
Results:
Fourteen BmRs were interviewed. Volunteer demographics were collected for race/ethnicity, gender, faculty rank, and investigator experience level. The following domains were identified: individual trust and trustworthiness, institutional trustworthiness, and trust and equity as a crucial part of structural and social drivers of health.
Conclusion:
We recognize that BmRs are dedicated to health equity and addressing disparities. However, in addition to committing to “best practices,” BmRs should prioritize actions that foster genuine trust from the communities they serve. More development opportunities are needed for reflection of what it means to be trusted by research volunteers and communities. Furthermore, intentions alone aren’t sufficient; earned trust and trustworthiness are vital.
This study examined whether mothers with schizophrenia spectrum disorder (SZSD) or mothers with bipolar disorder express less warmth, and more criticism compared to controls and whether mothers’ expressed warmth and criticism are associated with child self-esteem and mental health outcomes. Sixty mothers with SZSD, 60 mothers with bipolar disorder, and 60 control mothers, and their 7-year-old children were included from The Danish High Risk and Resilience Study VIA 7. Expressed warmth and criticism were evaluated by coding Five Minute Speech Samples using the Family Affective Attitudes Rating Scale. Child self-esteem was assessed with the “I Think I Am.” Child global functioning was assessed with the Children’s Global Assessment Scale, mental health with the Child Behavior Checklist School-age version, and KIDSCREEN-10 captured quality of life. Results showed that mothers with SZSD and mothers with bipolar disorder did not differ from controls on expressed warmth or criticism. Across groups, expressed criticism showed robust associations with poorer child mental health outcomes also when controlling for child sex and maternal functioning. Diagnostic status did not affect maternal expressed warmth or criticism toward their child. However, because more expressed criticism can be associated with adverse child outcomes, interventions promoting more positive interpretations may aid child mental health.
This paper responds to Rosolini’s suggestion to use the ultracompletion of a category as a way to understand versions of conceptual completeness. Over 50 years ago, Kock and Mikkelsen observed in effect that one obtains ultracompletions of the category of sets by factorising ultrapower functors. They gave a concrete description of the factorisation under what they recognised were special conditions. In parallel work, Volger obtained a different description using categorical logic. Here, I revisit these ideas using Tripos Theory and show in particular that any left exact functor of toposes admits a Kock–Mikkelsen factorisation. In this reading, the ultracompletion appears amongst the various regular and exact completions which have been studied in particular by members of the Italian Category Theory School.
Community-acquired pneumonia (CAP) is a leading cause of hospitalization and mortality in the US. Studies report racial disparities in various infectious syndromes. Our objective was to assess the relationship between patient race and antibiotic prescribing in inpatient CAP management.
Design:
Retrospective cohort study.
Setting:
11 Cleveland Clinic community hospitals.
Patients:
Patients aged ≥18 years hospitalized with CAP between November 1, 2022, and January 31, 2025.
Methods:
Parametric and non-parametric methods were used to describe demographic and clinical differences by race. The association between race and extended spectrum antibiotic (ESA) guideline concordance was assessed using multivariable logistic regression models adjusting for age, gender, admission source, area deprivation index (ADI), hospital, diabetes, cardiovascular disease, chronic respiratory disease, renal failure, liver disease, immunocompromising condition, alcohol and substance use disorder, dialysis, and clinical instability and severity on day 1.
Results:
In bivariate analyses, Non-Hispanic Black (NHB) patients were less likely than NHW patients to receive ESA guideline-concordant CAP therapy (63.2% vs 64.4%; OR = 0.91, P = .2). After adjusting for patient characteristics, there were no differences between NHB and NHW patients in receipt of ESA therapy (adjusted OR = 0.93; 95% CI = 0.83, 1.00). After adjusting for hospital, NHB patients were more likely to receive ESA guideline-concordant CAP therapy (adjusted OR = 1.17; 95% CI = 1.06, 1.30).
Conclusion:
NHB patients were more likely to receive ESA-guideline concordant therapy, but this was influenced by where they sought care. Further studies are needed to understand why prescribing varies across hospitals.
The UK Department for Education stipulates that lesbian, gay, bisexual, trans, and queer+ (LGBTQ+) topics should be integrated throughout the secondary curriculum; however, for various reasons, it can be hard to follow these stipulations in the Classical studies classroom (broadly conceived). This article outlines the context for LGBTQ+ education in the UK, establishing the need for some kind of intervention. It focuses specifically on how sector-wide difficulties in this area manifest acutely in the Classical studies classroom because of several, discipline-specific challenges. It then demonstrates how the materials produced by ‘Queering the Past(s)’, a recently formed collective of academics and teachers, can be used to several pedagogical ends. The Queering the Past(s) resources are shown to fulfil government mandates about LGBTQ+ education whilst also providing important correctives to previous teaching materials. Most crucially, the article outlines how resources from Queering the Past(s) may be used to develop secondary students’ knowledge about LGBTQ+ topics and core KS4 and KS5 skills such as critical thinking and source analysis. This is demonstrated by means of a case study of Elagabalus, emperor of Rome from 218 to 222 CE, and the focus of one of the resources from Queering the Past(s).
Elections in many contemporary Latin American democracies unfold in a setting that complicates traditional political communication strategies. Indeed, many countries in the region are characterized by weak political parties, high levels of institutional distrust, and growing disdain for political elites. While a large body of literature has sought to explain which factors weaken parties and increase institutional distrust, less attention has been paid to the question of how these characteristics shape political communication. Drawing on the content of television advertisements created for Chile’s constitutional plebiscite campaigns, and original interviews with the creative and political teams that designed the ads, we explore how each side communicated with voters; the issues they focused on; and to what extent they relied on partisan, policy, generic, or emotional appeals. The analysis identifies important changes in messaging across the three electoral contests and probes an explanation for this variation. We find that in the absence of partisan messages, the constitutional campaigns relied first on policy-based appeals but then transitioned to generic appeals, ultimately opting for “antipolitics” messaging. These changes resulted from the expansion of the electorate and growing distrust in the constitutional convention. The analysis also underscores that pro–status quo plebiscite campaigns are more likely to deploy negative emotional language than campaigns centered on change.
We present a back-in-time analysis for the origin of vorticity in viscous separated flows over immersed bodies, using the adjoint-vorticity framework recently introduced by Xiang et al. (2025 J. Fluid Mech. vol. 1011, A33. The solution of the adjoint-vorticity equations yields the volume density of mean deformation, which captures the stretching and tilting of the earlier vorticity that leads to the terminal value. The analysis also takes into account the boundary contributions of vorticity and its flux. Three examples are considered. Steady, axisymmetric separation in the flow over a sphere at Reynolds number $Re=200$ is shown to be established due to wall flux from both upstream and downstream of separation, the latter contribution being absent from the classical description by Lighthill. For unsteady separation at higher $Re=300$, the streamwise vorticity within the wake hairpin vortex is traced back, quantitatively, to the azimuthal vorticity on the sphere. The third configuration is the flow over a prolate spheroid at $Re=3000$. The null vorticity at three-dimensional separation originates from the cancellation of opposite interior contributions adjacent to the separation surface. The contribution from the downstream side migrates across the separation surface into the upstream region due to a tilting effect – a fundamental distinction between two- and three-dimensional separation. We also examine the detached vortical structures. The streamwise vorticity in the primary vortex originates from tilting of near-wall azimuthal vorticity, differing from Lighthill’s conjecture that the origin is streamwise near-wall vorticity that arises due to the reduced Coriolis force. Finally, a necklace vortex in the turbulent wake is traced back in time, and is shown to have contributions from the spheroid trailing-edge shed shear layer and the large-scale counter-rotating primary vortices.
Cancer-related fatigue is a common problem among colorectal cancer (CRC) survivors even after completion of treatment. In a randomised trial, we assessed the effect of a person-centred lifestyle programme on cancer-related fatigue among CRC survivors who completed treatment. Survivors who completed treatment at least 6 months but no longer than 5 years ago and who were experiencing cancer-related fatigue were randomised to intervention or control group. The intervention group worked with a lifestyle coach for 6 months during twelve sessions to stepwise increase adherence to the World Cancer Research Fund/American Institute of Cancer Research cancer prevention guidelines on healthy diet and physical activity. The control group did not receive lifestyle coaching. Changes in cancer-related fatigue from baseline to 6 months were assessed with the FACIT (Functional Assessment of Chronic Illness Therapy) – Fatigue Scale. As a secondary outcome, we assessed changes in health-related quality of life (HRQoL). Higher scores indicate less fatigue and better HRQoL. Eighty participants were randomised to the intervention group; eighty-one to the control group. Baseline characteristics were similar: mean age 64·1 (sd 10·9) years; 55·3 % were women; and 72 % had colon cancer. There were favourable changes in dietary behaviours and physical activity in the intervention group; the control group did not show changes to the same extent. The programme did not result in statistically significant differential changes over time between intervention and control group in cancer-related fatigue (0·8; 95 % CI −1·6, 3·2) or HRQoL (1·3; 95 % CI −2·2, 4·8). A person-centred lifestyle programme improved the lifestyle of CRC survivors, but the programme was not effective in reducing cancer-related fatigue or in improving HRQoL.
Shock trains compress incoming supersonic flow through a series of shock wave/turbulent boundary layer interactions (STBLIs) that occur in rapid streamwise succession. In this work, the global flow changes across the entire turbulent shock train are analysed as the confluence of local changes imparted by individual STBLIs. For this purpose, wall-resolved large eddy simulations are used on a constant area, back-pressured channel configuration with an entry Mach number of 2.0. Local changes due to individual STBLIs are evaluated in terms of deviations from incoming, near-equilibrium boundary layers, by systematically examining properties of the mean flow structure and turbulent statistics. The first STBLI in the train induces a strongly separated region, which interrupts inner layer dynamics and incites wall-normal deflection of turbulent structures, leading to prominent outer layer Reynolds stress amplification and related transport phenomena. Downstream of the first STBLI, the thickened, turbulent wall layer repeatedly interacts with subsequent shock waves in the train, resulting in cyclic attenuation and amplification of turbulent stresses, localised incipient separations and variations in mean momentum flux gradients. Decreases in mean Mach number along the shock train result in downstream shocks weakening to the point that interactions with the turbulent boundary layer impart negligible changes on the local flow. Consequently, after a sufficient streamwise extent, the boundary layers asymptote towards a new equilibrium state, thus recovering certain classical properties of near-wall turbulence. Among the features that reappear are a self-similar, adverse pressure gradient velocity profile and the restoration of the autonomous roller-streak cycle.