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The virtues of the scapular tip free flap for reconstruction of complex midface oncologic defects have been claimed by many. To obtain optimal functional and aesthetic results, precise positioning of the free flap used for reconstruction is paramount.
Methods
Four cases illustrate our approach to midface reconstruction with angular branch-based scapular tip flaps. A standard surgical navigation device was used both to plan bone cuts for the oncologic resection and to optimise the positioning of the flap.
Results
Case 1 illustrates the usefulness of navigation for reconstruction of total palato-septectomy defects, using a horizontally positioned flap. Optimal neo-palate height, alignment of the anterior nasal spine and nasal projection were obtained. For cases 2–4, vertical inset of the flap yielded optimal midface projection and orbital floor position.
Conclusion
Surgical navigation systems are useful adjuncts for midface reconstruction.
Edited by
Lisa Vanhala, University College London,Elisa Calliari, International Institute for Applied Systems Analysis, Vienna and Euro-Mediterranean Centre on Climate Change, Venice
We present a systematic search for Odd Radio Circles (ORCs) and other unusual radio morphologies using data from the first year of the Evolutionary Map of the Universe (EMU) survey. ORCs are rare, enigmatic objects characterised by edge-brightened rings of radio emission, often found in association with distant galaxies. To identify these objects, we employ a hybrid methodology combining supervised object detection techniques and visual inspection of radio source candidates. This approach leads to the discovery of five new ORCs and two additional candidate ORCs, expanding the known population of these objects. In addition to ORCs, we also identify 55 Galaxies with Large-scale Ambient Radio Emission (GLAREs), which feature irregular, rectangular, or circular shapes of diffuse radio emission mostly surrounding central host galaxies. These GLAREs may represent different evolutionary stages of ORCs and studying them could offer valuable insights into their evolutionary processes. We also highlight a subset of Starburst Radio Ring Galaxies, which are star-forming galaxies exhibiting edge-brightened radio rings surrounding their central star-forming regions. We emphasise the importance of multi-wavelength follow-up observations to better understand the physical properties, host galaxy characteristics, and evolutionary pathways of these radio sources.
EU’s political mediation in internal constitutional matters as part of its evolving vision of the rule of law – Dimensions of the EU’s dialogic rule of law: ontological, organic, and legitimising – The idea of the rule of law as embedded in intrincate political and social processes – The rule of law as the core driving force in creating spaces and boundaries for dialogue, interaction, and definition of the EU’s multilevel constitutional system – Balancing inherent dialogue with decisive and strong action against member states breaching the rule of law – Multiple forms of the ideal of the rule of law within the EU’s composite constitutional framework – No one-size-fits-all response: context-sensitive approaches to rule of law deviations – Institutionalising and legally integrating mediation as an instrument in the EU’s Rule of Law Framework.
Spousal age differences are highest in Sub-Saharan Africa, where trends in age at first marriage indicate an increase for both men and women. However, the net outcome for spousal age difference is difficult to predict without explicit analysis of these distributions. This study examines differentials in spousal age for women in first union. Further, it examines differences within population sub-groups and across countries, focusing on the influence of age at marriage and educational attainment. The analysis pools 144 survey datasets from the Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS) conducted between 1980 and 2020 in 34 countries. OLS regression analysis was used to predict the spousal age difference at marriage with five-year cohorts used to study time trends. The analysis finds a decline of 1.7 years in the spousal age difference at first marriage between the earliest (1980–1984) and most recent (2014–2019), indicating that there has been minimal reduction in age at first marriage over four decades, despite rising ages at marriage for females. Increasing age at first marriage and educational attainment of women partly explain the decline observed over time.
While existing research on policy diffusion has provided substantial evidence regarding the drivers of policy adoption across jurisdictions, limited attention has been given to the dynamics of policy textual learning across different levels of government. We fill this gap by using regression analysis to examine the patterns of policy textual learning evident in the clause similarity of seven environmental statutory policies in China. Within China’s decentralized and multilevel environmental governance, our findings reveal that horizontal policy textual learning is more prominent than vertical learning. Temporal distance negatively impacts policy textual learning, whereas spatial distance, contrary to traditional policy diffusion perspectives, does not universally explain multilevel policy textual learning. Additionally, subsequent versions of policy texts are not necessarily similar to earlier ones, challenging conventional assumptions about the adoption and adaptation of policies over time.
Edited by
Lisa Vanhala, University College London,Elisa Calliari, International Institute for Applied Systems Analysis, Vienna and Euro-Mediterranean Centre on Climate Change, Venice
This chapter provides a detailed overview of the broad theoretical framework developed for the book. It begins by reviewing the extensive literature on climate change policy adoption and argues that existing theories have been overly focused on mitigation policies in the Global North. It details the broad-based analytical framework which guides the case study analysis and which incorporates considerations of: (a) countries’ vulnerability to climate change impacts; (b) international engagement on the issue of loss and damage; (c) national institutional factors; and (d) the role of ideas, including knowledge and norms. The chapter delves into each element of the framework and discusses the limitations of the research design. It then turns to describing the book’s abductive and iterative methodological approach, which moves between existing theoretical propositions and data gathered through the analysis of law and policy documents and more than seventy-five interviews with national stakeholders across the case studies. The chapter concludes by highlighting the epistemic value of the book’s approach, which has involved partnering with researchers in the Global South to co-develop, undertake, and write up the research.
In South America, investment chapters have been used by some governments, notably in Chile, Colombia and Peru, to replace outdated bilateral investment treaties and extend countries’ investment protection commitments. In other countries, such as Brazil, investment chapters are a means to rethink the governance of foreign investment altogether. This chapter traces the evolution of South America’s PTA investment chapters from 2001 to 2022, focusing on the types of reforms adopted and the domestic factors that shape the reforms governments are willing to accept. It finds that PTA investment chapters exhibit an increasing diversity of reforms over time, although the vast majority of agreements are designed to maintain traditional investment protection standards. This variation is partly driven by the legitimacy crisis of international investment law. Arguably, this crisis has created more political space for South American preferences in investment treaty lawmaking. However, who dominates reform debates is just as important for countries’ reform preferences as their experience with investor-state arbitration. Regardless of reform preferences, the main outcome of PTA investment chapters has been further fragmentation in an already complex and incomplete area of international economic law. This fragmentation, if allowed to continue, may exacerbate the very challenges that governments are seeking to address through their reform efforts in order to promote sustainable and inclusive development.
The addition and refreezing of liquid water to Greenland’s accumulation area are increasingly important processes for assessing the ice sheet’s present and future mass balance, but uncertain initial conditions, complex infiltration physics and limited field data pose challenges. Satellite-based L-band radiometry offers a promising new tool for observing liquid water in the firn layer, although further validation is needed. This paper compares time series of liquid water amount (LWA) from three percolation zone sites generated by a localized point-model, a regional climate model, in situ measurement, and L-band radiometric retrievals. LWA integrates the interplay of liquid water generation and refreezing, which often occur simultaneously and repeatedly within firn layers on diurnal, episodic, and seasonal scales offering insights into methods for measuring and modeling meltwater processes. The four LWA records showed average discrepancies of up to 62% nRMSE, reflecting shortcomings inherent to each method. Better agreement between series occurred after excluding the regional climate model record, lowering nRMSE to 8–13%. The agreement between L-band radiometry and other LWA records inspires confidence in this observational tool for understanding firn meltwater processes and serving as a validation target for simulations of water processes in Greenland’s melting firn layer.
We study the dispersion of bubble swarms rising in initially quiescent water using three-dimensional Lagrangian tracking of deformable bubbles and tracer particles in an octagonal bubble column. Two different bubble sizes (3.5 mm and 4.4 mm) and moderate gas volume fractions ($0.52\,\%{-}1.20\,\%$) are considered. First, we compare the dispersion inside bubble swarms with that for single-bubble cases, and find that the horizontal mean squared displacement (MSD) in the swarm cases exhibits oscillations around the asymptotic scaling predicted for a diffusive regime. This occurs due to wake-induced bubble motion; however, the oscillatory behaviour is heavily damped compared to the single-bubble cases due to the presence of bubble-induced turbulence (BIT) and bubble–bubble interactions in the swarm. The vertical MSD in bubble swarms is nearly an order of magnitude faster than in the single-bubble cases, due to the much higher vertical fluctuating bubble velocities in the swarms. We also investigate tracer dispersion in BIT, and find that concerning the time to transition away from the ballistic regime, larger bubbles with a higher gas void fraction transition earlier than tracers, consistent with Mathai et al. (2018, Phys. Rev. Lett., vol. 121, 054501). However, for bubble swarms with smaller bubbles and a lower gas void fraction, they transition at the same time. This differing behaviour is due to the turbulence being more well-mixed for the larger bubble case, whereas for the smaller bubble case, the tracer dispersion is highly dependent on the wake fluctuations generated by the oscillating motion of nearby bubbles.
Edited by
Lisa Vanhala, University College London,Elisa Calliari, International Institute for Applied Systems Analysis, Vienna and Euro-Mediterranean Centre on Climate Change, Venice
Chapter 5 presents the facts concerning phonological convergence among the Balkan languages, focusing on shared processes affecting consonants and vowels, on prosodic units (including clitic behavior), on morphophonemic alternations, and on expressive uses of sounds. The vast majority of phonological Balkanisms are highly localized in nature, leading to the conclusion that we see here not Balkan phonology but rather Balkan phonologies. Despite the general inattentiveness on the part of scholars to phonology in the Balkan sprachbund, it is demonstrated here that there is robust convergence in this domain of grammar, albeit at local levels.
The first year of university is a developmentally significant transition that involves substantial stressor exposure and, for some, heightened anxiety. Parenting may influence the association between stressor exposure and anxiety symptoms, with some research showing that parental care and overprotection throughout childhood and adolescence are associated with the experience of anxiety. However, how these factors interact and relate to anxiety symptoms in early adulthood is not clear. To address this issue, we examined interactions between parenting characteristics (care and overprotection) and stressors experienced during the transition to university, and how they relate to anxiety symptoms in 240 first-year undergraduates (Mage = 18.2, SD = 1.18, 75% female, 51.7% White). Results revealed a significant interaction between parental overprotection and stressor exposure, such that higher parental overprotection and higher levels of recent stressor exposure were associated with more anxiety symptoms (β = 0.52, p = .008). These findings demonstrate continued evidence for associations between experiences of parenting and psychopathology in emerging adulthood and suggest that overprotective parenting behaviors may exacerbate effects of stress exposure.
Over the past decade the European Union (EU) has transformed sustainability into a dense matrix of legally binding ESG reporting obligations for companies. Compliance increasingly hinges on firms’ ability to collect and verify thousands of datapoints deep into global supply chains – an exercise that is costly, error-prone and may yield non-comparable results. (Semi-)centralised ESG data-sharing arrangements – shared hubs where suppliers post one or more verified sets of sustainability figures that all their customers can reuse – can restore some efficiency by eliminating duplicate requests and supplying standardised, audit-ready inputs, but this amplifies competition-law risk. Drawing on competition law and policy and recent Dutch banking practice, the paper devises a set of legal “firewalls” and access rules that neutralise collusive potential resulting from the information exchange that takes place while safeguarding smaller market players from exclusion. These safeguards are essential to ensure that ESG data collaboration supports – not hinders – the EU’s Twin Transition towards a green and digital economy.
The aim of this study was to describe how the detection of protozoan and helminth parasites has been affected by the introduction of polymerase chain reaction (PCR) and changes in test algorithms. We extracted data about faecal samples tested for parasites (n = 114839) at five Norwegian clinical microbiology laboratories. Samples were classified into prePCR or postPCR depending on whether they were submitted before or after the introduction of PCR, and into diagnostic episodes (n = 99320). The number of diagnostic episodes increased 3.7-fold from prePCR to postPCR. Giardia positive episodes doubled, the positivity rate decreased from 2.0% to 1.3%. Cryptosporidium was hardly detected prePCR and increased to a positivity rate of 1.2%. Entamoeba histolytica was rarely found. Episodes examined for helminths decreased 51%, the number of positive episodes decreased 34%. Samples from immigrants were more likely to be positive for Giardia, E. histolytica, or helminths and less likely to be Cryptosporidium positive. During the COVID-19 pandemic, the number of Giardia and helminth-positive episodes decreased. Cryptosporidium-positive episodes remained unchanged. The implementation of multiplex PCR for protozoa led to a doubling of Giardia cases and a better test for Cryptosporidium. Fewer microscopy examinations raise concerns that helminth infections may be overlooked.
Let n be a positive integer, let $0<p\leqslant p'\leqslant \frac 12$, and let $\ell \leqslant pn$ be a nonnegative integer. We prove that if $\mathcal {F},\mathcal {G}\subseteq \{0,1\}^n$ are two families whose cross intersections forbid $\ell $—that is, they satisfy $|A\cap B|\neq \ell $ for every $A\in \mathcal {F}$ and every $B\in \mathcal {G}$ – then, setting $t:= \min \{\ell ,pn-\ell \}$, we have the subgaussian bound
Multicenter clinical trials are essential for evaluating interventions but often face significant challenges in study design, site coordination, participant recruitment, and regulatory compliance. To address these issues, the National Institutes of Health’s National Center for Advancing Translational Sciences established the Trial Innovation Network (TIN). The TIN offers a scientific consultation process, providing access to clinical trial and disease experts who provide input and recommendations throughout the trial’s duration, at no cost to investigators. This approach aims to improve trial design, accelerate implementation, foster interdisciplinary teamwork, and spur innovations that enhance multicenter trial quality and efficiency. The TIN leverages resources of the Clinical and Translational Science Awards (CTSA) program, complementing local capabilities at the investigator’s institution. The Initial Consultation process focuses on the study’s scientific premise, design, site development, recruitment and retention strategies, funding feasibility, and other support areas. As of 6/1/2024, the TIN has provided 431 Initial Consultations to increase efficiency and accelerate trial implementation by delivering customized support and tailored recommendations. Across a range of clinical trials, the TIN has developed standardized, streamlined, and adaptable processes. We describe these processes, provide operational metrics, and include a set of lessons learned for consideration by other trial support and innovation networks.
The peace agreement signed by the Colombian government and the FARC guerrilla group in 2016 marked a historic turning point for the country and its long history of civil war. The Colombian state agreed with the FARC to carry out a rural reform to ensure redistribution and access to land, the right to food and a boost to the rural economy that would allow farmers to live in dignity. The peace agreement includes commitments to change some elements of the state’s current agricultural and industrial policies, which could raise questions from Colombia’s trading partners about their trade-related implications. This chapter argues that such measures are consistent with Colombia’s obligations under the WTO Agreement on Agriculture and Colombia’s preferential trade agreements. Right to food measures (such as domestic support for small agricultural producers in the 2016 Peace Agreement’s rural reform) are within policy space under the Agreement on Agriculture because they do not affect international trade. Other government policies fall within Colombia’s international trade commitments because they aim to enable a food economy system in which rural communities can harvest their food and build improved productivity networks that meet their economic and social needs. This chapter shows how local attempts to implement a particular agricultural policy are framed within international trade rules.