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This article focuses on the Italian inventor, telephone pioneer and opera house technician Antonio Meucci (1808–1889), exploring the shifting relationships between Meucci’s experiments and his operatic connections across his transatlantic career. Meucci first developed an acoustic telephone while working at Florence’s Teatro della Pergola, before discovering the transmission of sound via electricity during his tenure as chief machinist at Havana’s Teatro Tacón in the 1840s. These experiments were further refined after his relocation to New York, where he continued to be part of a network of Italian musicians, thinkers, journalists and scientific practitioners while seeking to patent his invention. Feted among the Italian diasporic community in the USA – both for his technological innovations and for his close relationship with Italian revolutionary Giuseppe Garibaldi – at the time of his death Meucci was nonetheless embroiled in a lengthy legal case against Alexander Graham Bell over the primacy of the telephone’s invention, a dispute not fully resolved until the twenty-first century. This article accordingly unfolds in three main parts, focusing in turn on Florence, Havana and New York. Meucci’s experiments – and his complex emigrant environment – collectively highlight the Italian opera house as a global and multidimensional site of technological and sonic innovation, during a period when the telephone gradually moved from conceptual fantasy to material reality. At the same time, Meucci’s career can challenge direct links between Italian sonic environments and Italy itself. Ultimately, I argue, the complex and changing relationships between opera and the telephone invite more nuanced approaches to histories of music and technology, while demonstrating the centrality of the Italian opera house and its sounds – within, across, and beyond the stage – to nineteenth-century auditory cultures more broadly.
Family caregivers play a critical yet often overlooked role in healthcare, facing the dual challenge of providing clinical care while managing their emotional well-being. Although several studies have investigated the supportive care needs and services for caregivers of advanced cancer patients integrated into specialized palliative care inpatient units, little is known about cancer caregiver integration and support structures in German outpatient cancer care. This qualitative study addresses this gap by exploring the experiences of family caregivers in Germany, using a dyadic approach to assess their needs, identify referral strategies, and evaluate oncologists’ perspectives on improving caregiver integration and support.
Methods
Thematic analysis was conducted on semi-structured interviews with 14 advanced cancer patients, 15 family caregivers, and 3 oncologists. MAXQDA software facilitated the identification of key themes and codes.
Results
Three interconnected themes emerged: (1) The Impact of Illness on the Dyadic Relationship, (2) Communication with Physicians and Understanding of Healthcare Information, and (3) Challenges and Preferences in Navigating Healthcare Services and Psychosocial Support.
Significance of results
The findings highlight the need for enhanced support in caregiving to improve cancer care quality, emphasizing that early palliative care integration is vital for addressing caregiver needs as a core component of comprehensive cancer care. Healthcare practices should adopt personalized, proactive support strategies from diagnosis, implement regular needs assessments, and leverage digital healthcare tools to enhance the efficacy and efficiency of caregiver support.
This editorial argues for integrated, developmentally informed models of mental health care for adolescents that address pervasive structural misalignments across health, education and social care. Adolescent admissions must be understood within a whole-system and lifespan framework, recognising varied reasons for admission and long-term impacts on engagement, trust and identity.
On February 6, 1968, leaders of the Southern Christian Leadership Conference drafted a letter addressed to the president, Congress, and the U.S. Supreme Court. The letter argued that the U.S. constitution facilitated economic and social second-class citizenship because the constitution did not protect economic and social rights but instead protected only civil and political rights. The letter’s authors demanded that the nation repent for its continued subordination of the poor and minorities and atone by recognizing economic and social rights. In this article, the authors recover the draft letter—a proposed economic and social bill of rights—and assert it was and remains a morally compelling call to recognize and protect positive fundamental rights under the constitution. The authors maintain that while the SCLC leaders who drafted the letter were clear that law alone could not end the sinful conditions that created racism and poverty, they were becoming more adamant that a radical redesign of the constitution was a necessary step toward building a beloved community.
Evaluate how a foundation-supported fellowship employs early health-technology assessment (eHTA) to guide the development and positioning of emerging health innovations.
Methods
We reviewed all eHTA reports conducted under the Fellowship from 2018 to 2021 (n = 10), extracting technology class, development stage, economic modeling, and recommendations. In 2023, we conducted thirty-minute structured video interviews with developers of each technology (eleven invitees, ten responses). The interview comprised Likert questions on perceived usefulness and intention to update the model in later stages, and six open-ended questions on perceived advantages, implementation barriers, and downstream actions. Likert data were summarized descriptively; open-ended responses were summarized and discussed within the research team until consensus on key themes.
Results
The eHTA subject technologies were four diagnostics, three therapeutics, two predictive algorithms, and one curative device, all preclinical. Analyses used six Markov or decision-tree frameworks, four hybrid models or simulations, and six value-based-pricing scenarios. Five technologies were potentially cost-effective, three conditionally cost-effective, one unlikely to be cost-effective without stronger evidence, and one cost-effective yet unlikely to break even. Eight developers rated eHTA “useful” or “very useful”; three had already leveraged results in grant or investor materials and two planned to do so when more data emerged. Reported barriers included evidence gaps, funding constraints, and misalignment with pharmaceutical partners on codevelopment strategies; two projects were discontinued.
Conclusions
eHTA supplies developers with early economic insight, but its guidance is most reliable when interpreted alongside budget impact, feasibility, regulatory, and adoption considerations.
This paper introduces the concept of self-fulfilling testimonial injustice: a distinctive form of epistemic injustice whereby credibility deficits become true by shaping the very conditions that sustain them. Much of the literature on testimonial injustice has rightly emphasized cases in which credibility deficits are rooted in false beliefs, themselves underwritten by ethically bad affective investments. Yet such a focus risks obscuring a structurally significant variant: namely, those credibility deficits that are rendered true through self-fulfilling mechanisms. Drawing on insights from economics and psychology, I distinguish between motivated cognition-based and cognitive bias-based testimonial injustice, which together furnish the background conditions under which self-fulfilling testimonial injustice can take hold. I develop this account by drawing on both theoretical and experimental work on labor market discrimination, which illuminates the ways in which credibility deficits may become self-fulfillingly entrenched. Finally, I explore the distinctive harms of this form of injustice, focusing on its corrosive effects on epistemic self-confidence or self-trust and epistemic self-esteem, and suggest that its insidiousness and relative invisibility render it both difficult to detect and potentially more pervasive than has hitherto been acknowledged.
This article analyzes the interconnected translation processes that led the Paris city council to conceptualize, address, and act upon “homelessness” through counting. By translation, we mean a range of semiotic processes that connect social worlds, their objects, practices, genres, and bodies of expertise. These are usually imagined as separate: For example, auditing and volunteering, science and government, charity and policing, poverty and social hygiene. Our analysis is based on ethnographic data collected in Paris, France, between January and August 2023, during two editions of the Nuit de la Solidarité [Night of Solidarity], a large-scale effort by the city council, in collaboration with numerous volunteers, to count homeless people in Paris. Linking translation scholarship with academic work on quantification and liberal governmentality, we demonstrate that the semiotic process of translation is deeply interconnected with the political work performed by numbers and counting techniques, imbuing them with meaning and ensuring their capacity to exert power. Translation, we show, serves not only to link governance techniques across geopolitical borders but also to integrate various political projects and normalize and naturalize the structural inequalities that define cities like Paris.
As the population ages, the provision of adult long-term care (LTC) is one of the major challenges facing the UK and other developed nations. LTC funding for the elderly is complex, reflecting the range and level of services provided, with the total cost depending on the duration of LTC required. Institutional care settings (e.g., nursing/residential care homes) represent the most expensive form of LTC. Planning and funding for institutional LTC requires an understanding of the factors affecting the mortality (and hence duration and cost of care) of such LTC recipients. Using data provided by Bupa, one of the largest LTC providers in Britain, this paper investigates factors affecting the mortality of residents of institutional LTC facilities over the period 2016-2019. Consistent with existing research, most residents were female and had a higher average age profile compared with male residents. For those residents who died during the investigation period, the average length of stay was approximately 1.6 times longer for females relative to males. For both males and females, new residents experienced higher mortality in the first-year post admission compared to existing residents. Variations in the mortality of the residents were analysed by condition, funding status and care type on admission.
We discuss the logical principle of extensionality for set-valued operators and its relation to mathematical notions of continuity for these operators in the context of systems of finite types as used in proof mining. Concretely, we initially exhibit an issue that arises with treating full extensionality in the context of the prevalent intensional approach to set-valued operators in such systems. Motivated by these issues, we discuss a range of useful fragments of this full extensionality statement where these issues are avoided and discuss their interrelations. Further, we study the continuity principles associated with these fragments of extensionality and show how they can be introduced in the logical systems via a collection of axioms that do not contribute to the growth of extractable bounds from proofs. In particular, we place an emphasis on a variant of extensionality and continuity formulated using the Hausdorff-metric and, in the course of our discussion, we in particular employ a tame treatment of suprema over bounded sets developed by the author in previous work to provide the first proof-theoretically tame treatment of the Hausdorff metric in systems geared for proof mining. To illustrate the applicability of these treatments for the extraction of quantitative information from proofs, we provide an application of proof mining to the Mann iteration of set-valued mappings which are nonexpansive w.r.t. the Hausdorff metric and extract highly uniform and effective quantitative information on the convergence of that method.
Researchers propose wider individual and societal benefits (or broad elements of value) be included in economic evaluations (EEs) of medicines. This study investigates opinions of Australian stakeholders regarding the inclusion of broader value elements in reimbursement decisions for medicines for rare diseases in Australia.
Method
Stakeholders were invited via email to complete an online survey about their views on broader elements of value in HTA. Responses were summarised using descriptive statistics and compared using chi-square statistics.
Results
Forty-four respondents (academia (n=11), private sector (n=33)) completed the survey between October 2023 and May 2024. Only 27% of stakeholders agree the current information about the sources of value considered in reimbursement decisions is sufficient. Stakeholders consistently agree labour productivity (>50%), adherence (>80%), reducing uncertainty due to a new diagnostic (>70%), disease severity (>71%), value to caregivers (>70%), and equity (>70%) should be considered in HTA. The majority (>70%) agreed managed entry agreements (MEA), risk share arrangements (RSA), and multi criteria decision analysis (MCDA) be used in reimbursement decision making for medicines for rare diseases. Significantly fewer academic stakeholders (40%) versus private sector (77%), believe an increased willingness-to-pay threshold be applied to medicines for rare disease.
Conclusions
Academic and private sector stakeholders hold similar views when considering medicines for non-rare and rare diseases. Stakeholders favour considering more value elements in HTA than referred to in the Pharmaceutical Benefits Advisory Committee (PBAC) guidelines. This study highlights further advice is needed on the factors considered in reimbursement decisions and how that would influence guidelines.
Problem-solving therapy (PST) is a brief psychological intervention often implemented for depression. Currently, there are no tools with well-evidenced reliability to measure PST fidelity. This pilot study aimed to measure the inter-rater reliability and agreement of the Problem-Solving Therapy Fidelity (PROOF) scale, comprising binary 14-item adherence and an 8-item competence subscales. Transcripts were from the TENDAI trial, a Zimbabwe-based PST intervention for depression and medication adherence. Seven transcripts were each rated by seven specialists, and two transcripts were each rated by two non-specialists. Inter-rater agreement was assessed using percent agreement and inter-rater reliability was assessed using Gwet’s AC1. The PROOF subscales demonstrated promising inter-rater agreement among specialists (adherence = 90.4%, competence = 82.5%) and non-specialists (adherence = 92.9%, competence = 68.8%). Inter-rater reliability analyses yielded a Gwet’s AC1 of 0.411–0.778 and 0.619–0.959 for adherence and competence among specialists, and 0.529–1.00 for adherence in non-specialists. The PROOF scale has the potential to fill the gap of fidelity tools for PST delivery.
Plastic pollution, once seen mainly as an ocean issue, is now understood as a threat across the entire life cycle of plastics – impacting climate, biodiversity and human health. Scientific evidence shows that every stage, from fossil fuel extraction to use to waste (mis)management, harms the environment and disproportionately affects vulnerable populations, violating basic human rights, including the rights to life, health, food, water, information and a clean, healthy and sustainable environment. The proposed Global Plastics Treaty should explicitly integrate human rights to strengthen its effectiveness. Doing so would align it with existing international agreements, such as the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights, the Aarhus Convention and the Escazú Agreement, reinforcing obligations to protect people from pollution. Hazardous chemicals in plastics, often hidden or underreported by industry, pose direct and indirect threats to human health and well-being. Recognizing the right to science and access to information is key for public participation and accountability. Many countries, including regional blocs and alliances, support a rights-based approach for the Global Plastics Treaty. Human rights can be embedded in all parts of the treaty, from its preamble to implementation mechanisms. This integration not only enhances environmental protection but also ensures social justice. Without such an approach, governments risk future legal challenges for failing to protect citizens from the harms of plastic pollution.
A technique developed to accurately simulate the amplification of back-reflected light through a multi-petawatt laser system is presented. Using the Frantz–Nodvik equation, we developed an iterative algorithm to simulate the amplification of the main beam as it propagates through solid-state multipass amplifiers, while also accounting for back-reflections from experimental targets and the residual gain within the crystals. Our technique builds on the theoretical model by estimating the energy levels after multiple passes through all amplifiers and refining the simulated data using a brute-force optimization algorithm. We also demonstrate an application of this tool aimed at evaluating machine safety: optimizing the laser system to minimize crystal gain in the post-pulse regime and, consequently, the amplification of back-reflections, while taking advantage of the B-integral.
The logistics, costs, and capacity needed to complete extensive archaeological pedestrian surveys to inventory cultural resources present challenges to public land managers. To address these issues, we developed a workflow combining lidar-derived imagery and deep learning (DL) models tailored for cultural resource management (CRM) programs on public lands. It combines Python scripts that fine-tune models to recognize archaeological features in lidar-derived imagery with denoising QGIS steps that improve the predictions’ performance and applicability. We present this workflow through an applied case study focused on detecting historic agricultural terraces in the Piedmont National Wildlife Refuge, Georgia, USA. For this project, we fine-tuned pretrained U-Net models to teach them to recognize agricultural terraces in imagery, identified the parameter settings that led to the highest recall for detecting terraces, and used those settings to train models on incremental dataset sizes, which allowed us to identify the minimum training size necessary to obtain satisfying models. Results present effective models that can detect most terraces even when trained on small datasets. This study provides a robust methodology that requires basic proficiencies in Python coding but expands DL applications in federal CRM by advancing methods in lidar and machine learning for archaeological inventorying, monitoring, and preservation.
An analysis is presented of the suspensions of small, electrified particles in a gas. Two limits of interest for the electrodynamic particulate suspension technique are considered, corresponding to large and small values of the ratio $t_{coll}/t_s$ of the mean time between particle collisions to the viscous adaptation time required for the particles to reach their terminal velocities. The effect of the particle inertia can be neglected when this ratio is large, and only the distribution of particle charges at each point of the suspension needs to be computed. The way this distribution approaches an equilibrium form, determined elsewhere in the continuum regime when the mean free path of the particles is small compared with the suspension size, is described, as well as the connection between continuum regime and quasi-neutrality of the suspension. In the opposite case when $t_{coll}/t_s$ is small, the inertia of the particles plays an important role, and the joint distribution of particle charges and velocities is required. A Boltzmann equation is proposed for this distribution function, taking advantage of the fact that the charges of the particles have little effect on the redistribution of momentum and energy in the collisions. The equilibrium distribution function in the continuum regime is computed approximately, and hydrodynamic equations for the particle phase analogous to the Euler equations for a monoatomic gas are derived. The simplification of these equations when the particle inertia is negligible at the scale of the suspension is worked out.
In this interview Christian Joerges reconstructs his intellectual biography. A childhood marked, like that of his entire generation, by the Second World War, a harsh post-war period and, from an early age, a complex relationship with German identity on the shadow of Nazi crimes. A high school and university education in a Frankfurt where intellectual life is thriving amidst the ruins. And where a young Joerges discovers the beauty of theory thanks to Wiethölter. The experience in the United States where a pluralistic student movement is energised by the opposition to the Vietnam war. The construction of a law faculty in Bremen, with the almost impossible goal of transforming the teaching of law in Germany. The almost 20 years of Florentine experience, in the shadow of history and with the determination to imagine a Europe capable of being progressive. And without omitting reflections on the dark legacies of European law and on ordoliberalism, two phenomena that many European scholars have discovered thanks to Joerges.
Excavations at the Infantas complex in Chillón Valley, Perú, revealed a U-shaped monumental centre with a central mound, clay staircase and columned atrium. Aligned with structures from the Rímac and Lurín valleys, these complexes anchored ritual-political power, serving as hubs for ideological integration and territorial organisation in early Andean societies.
This study examines how human activities influenced soil development at two contrasting Arctic sites: Maiva, a 19th-century farmstead, and Snuvrejohka, a seasonal Sámi reindeer herding settlement in the Lake Torneträsk region, northern Sweden. Using geochemical and geophysical soil analyses, we explore the spatial distribution and vertical development of anthropogenic signals in the soil. At Maiva, prolonged agricultural use and earthworm bioturbation have led to extensive soil mixing and altered soil horizons, resulting in elevated phosphate, lead, and organic matter concentrations in Ap and Ah horizons. In contrast, Snuvrejohka displays more stratified profiles with localized chemical enrichment around hearths, primarily within E horizons. These results highlight how different land-use practices leave distinct geochemical fingerprints in Arctic soils and emphasize the need for sampling strategies adapted to site-specific soil formation processes. Our findings demonstrate that even short-term or seasonal human activities can leave distinct and detectable signatures in Arctic soils. Through an integrated approach combining soil science, geoarchaeological methods, and historical data, this study provides new insights into the reconstruction of past land-use practices and highlights the vulnerability of archaeological soil records in Arctic environments facing rapid climate-driven change.
Explorations of ideology retain special significance in contemporary studies of judicial politics. While some existing methodologies draw on voting patterns and coalition alignments to map a jurist’s latent features, many are otherwise reliant on supplemental proxies – often directly from adjacent actors or via assessments from various prognosticators. We propose an alternative that not only leverages observable judicial behavior, but does so through jurists’ articulations on the law. In particular, we adapt a hierarchical factor model to demonstrate how latent ideological preferences emerge through the written text of opinions. Relying on opinion content from Justices of the Supreme Court, we observe a discernible correlation between linguistic choices and latent expressions of ideology irrespective of known preferences or voting patterns. Testing our method against Martin-Quinn, we find our approach strongly correlates with this validated and commonly used measure of judicial ideology. We conclude by discussing the intuitive power of text as a feature of ideology, as well as how this process can extend to judicial actors and institutions beyond the Supreme Court.
Health technology assessment of medical devices (HTA-MDs) presents unique challenges compared to pharmaceuticals. Total MD expenditure continues to grow in Europe, and countries typically conduct their own HTA-MDs evaluations, with varying institutionalization arrangements. European Union’s (EU’s) HTA Regulation aims to establish collaborative clinical assessments across Member States, potentially expediting the path from EU safety certification of MDs to pricing and reimbursement decisions. This study aims to identify emergent configurations among institutionalizations of HTA-MDs in the EU, European Economic Area (EEA), and European Free Trade Association (EFTA) countries.
Methods
Publicly available data were cross-sectionally collected for EU, EEA, and EFTA countries until August 2024 to allow a cross-country analysis of HTA-MDs institutionalizations. Countries were included if they had at least one publicly mandated body for HTA-MDs. Data sources were scientific databases, institutional websites, and HTA bodies’ documentation. A framework of 16 elements, qualitatively describing the institutionalization of HTA-MDs, was developed based on a document review and used as a dataset for agglomerative hierarchical cluster analysis to identify patterns of HTA-MDs institutionalization.
Results
The 21 included countries formed three clusters: Cluster 1 featured regulatory-focused, legally bound HTA-MDs systems with mandatory assessments determining reimbursement decisions; Cluster 2 was characterized by regulatory functions, external expert collaboration, formal prioritization processes, and organized Horizon Scanning; Cluster 3 showed recommendatory functions, nonmandatory assessments, and limited impact on reimbursement decisions.
Conclusions
HTA-MDs institutionalizations could benefit from implementing prioritization processes of evaluations, establishing networks of collaborative assessment centers, and ensuring links between evaluations and reimbursement decisions.