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This chapter explores three particular circumstances where integrity has been found to be breached in tennis, namely doping, match-fixing and other less serious offenses, such as failure to report or failure to cooperate. The chapter goes on to explain anti-doping jurisprudence in tennis, the nature of proceedings, the relevant burden of proof and the intricacies of “intent” and “fault,” as well as the standard of “no fault or negligence” and “no significant fault or negligence.” The section on anti-corruption examines match-fixing by athletes and third parties, and also by umpires and other officials, as well as the sanctions imposed under relevant rules. These offenses are typically associated with legitimate betting and may involve money laundering and other non-predicate offenses.
The National Archives of Tanzania (Idara ya Kumbukumbu za Taifa la Tanzania) were established on 28 August 1965. Since this date energies have been directed toward building an efficient archival service: better storage facilities have been acquired, trained Tanzanian personnel have been hired, and there is now seating space for ten researchers. The most significant development from the historian's point of view has been the recent organization of the German records into a concise and convenient index catalogue.
In June 1967 the West German Government Technical Aid Program sent Mr. Peter Geissler, an Archivinspektor at Hessiches Staatsarchiv, Marburg, on a two-year project to reorganize the German records. Mr. Geissler is already familiar to historians of the American Revolution for his research on the Hessian troop records at Marburg. In Deutsch-Ostafrika the old German Registry System (renewed in 1902 and in effect until 1916) had been utilized in numbering the various files. A still extant two-volume Registry lists all the documents in existence before the First World War, but many of these have since been lost, eaten by white ants, stolen, or destroyed. It is evident that only a few records concerning district political administration have survived, while land, legal, mission, public works, and education files are among the most complete. The files have been divided into two main groupings: (1) the old German Registry and other German Government Administration (G 1 - G 65); and (2) Private Archives (G 66 - G 86). Each file card contains both the new “G” number and the old German Registry designation. In addition Mr. Geissler has performed a painstaking task in listing on each card some of the outstanding names, places, etc. mentioned in the particular file.
I had originally planned to focus on some of the more important aspects of race and ethnicity in Africa south of the Sahara, with particular reference to tensions and conflicts operative within the emergent social and political systems. I soon the realized, however, that the subject was far too complex for brief presentation, at least the kind of brevity ritualistically mandatory on this ceremonial occasion. I decided, consequently, to concentrate on one aspect of the complex cited, namely, the problems and prospects of the white man, particularly as settler, in the revolutionary Africa of today. Obviously, this grand theme, given all the imponderables involved, can only be touched upon lightly and is not easily susceptible to “scientific” treatment. I shall do my best, however, in handling this value-laden problem to observe the procedures and the folkways of objective analysis.
The dominant focus on rheumatic aetiology of mitral regurgitation (MR) often overshadows other causes. This challenges optimal management when the aetiology is non-rheumatic, as exemplified below in an 8-year-old girl, hailing from Uganda, who was diagnosed and managed as rheumatic MR with unusually elevated and persistent systemic inflammatory state with chronic renal dysfunction disproportionate to her cardiac status. Further workup led towards the possibility of early onset systemic lupus erythematosus (SLE). The valvular involvement in SLE closely resembles rheumatic heart disease (RHD). A high level of clinical suspicion is essential for diagnosing childhood-onset SLE. Coexistence of RHD and SLE is extremely rare and has significant implications for management.
An adverse in utero experience negatively impacts perinatal growth in livestock. Maternal heat stress (HS) during gestation reduces placental growth and function. This progressive placental insufficiency ultimately leads to fetal growth restriction (FGR). Studies in chronically catheterized fetal sheep have shown that FGR fetuses exhibit hypoxemia, hypoglycemia, and lower anabolic hormone concentrations. Under hypoxic stress and nutrient deficiency, fetuses prioritize basal metabolic requirements over tissue accretion to support survival. Skeletal muscle is particularly vulnerable to HS-induced placental insufficiency due to its high energy demands and large contribution to total body mass. In FGR fetuses, skeletal muscle growth is reduced, evidenced by smaller myofiber size and mass, reduced satellite cell proliferation, and slower rate of protein synthesis. Disruptions in skeletal muscle growth are associated with mitochondrial dysfunction, including reduced pyruvate flux into the mitochondrial matrix and lower complex I activity in the mitochondrial electron transport chain. This review summarizes current research on the mechanisms by which HS-induced placental insufficiency affects skeletal muscle growth in the fetus, with an emphasis on myogenesis, hypertrophy, protein synthesis, and energy metabolism. The evidence presented is primarily drawn from experiments using chronically catheterized fetal sheep exposed to maternal HS during mid-gestation. Additionally, we explore emerging nutritional strategies aimed at enhancing skeletal muscle growth in animals with FGR. These strategies hold promise not only for improving reproductive efficiency in livestock affected by prenatal stress but also for their translational relevance to human pregnancies complicated by placental insufficiency.
We report a lab experiment to study subjects’ preferences over their ordinal rank in an earnings distribution. Following an assignment of unequal earnings, subjects can select a monetary transfer from exactly one individual to another, not including themselves. This can potentially change their own position in the distribution, as well as influence overall inequality. The experiment varies whether the initial earnings assignment is random or is affected by preliminary competition. It also varies the reference group from a complete to a partial network. A majority of observed transfers reduce inequality by moving earnings from those with the highest rank to the lowest rank in the distribution. Rank-improving transfers are substantially more common for preliminary competition losers than winners. Transfers to individuals outside of the reference group are not uncommon, and they usually target as the source the individuals high in the income distribution. While generally weak overall, own rank preferences appear to be more common among men than women.
While virtually all academics who study human ‘race’ agree that it is a social construct, members of the general public still commonly regard ‘race’ as a biological property (i.e., they think that ‘races’ are genetically distinct). Even though empirical data from genetics and other fields do not support biological conceptions of race, this erroneous viewpoint is widely held, suggesting that there are impediments to effective communication of the relevant science. Here, we suggest five such impediments: (1) belief in genetic determinism, together with an over-reliance on an essentialist view of human groups, (2) overly simplistic interpretation of biological inheritance, (3) belief in the naturalistic fallacy and the associated naturalization of non-biological variation among racialized groups, (4) failure of the academic and educational communities to take responsibility for teaching the science of ‘race’ and racism, and (5) apologism towards racist founders of academic fields, including the evolutionary sciences. We address how and why each of these factors supports the spread of racism and suggest strategies for containing this spread.
The macro-social and environmental conditions in which people live, such as the level of a country’s development or inequality, are associated with brain-related disorders. However, the relationship between these systemic environmental factors and the brain remains unclear. We aimed to determine the association between the level of development and inequality of a country and the brain structure of healthy adults.
Methods
We conducted a cross-sectional study pooling brain imaging (T1-based) data from 145 magnetic resonance imaging (MRI) studies in 7,962 healthy adults (4,110 women) in 29 different countries. We used a meta-regression approach to relate the brain structure to the country’s level of development and inequality.
Results
Higher human development was consistently associated with larger hippocampi and more expanded global cortical surface area, particularly in frontal areas. Increased inequality was most consistently associated with smaller hippocampal volume and thinner cortical thickness across the brain.
Conclusions
Our results suggest that the macro-economic conditions of a country are reflected in its inhabitants’ brains and may explain the different incidence of brain disorders across the world. The observed variability of brain structure in health across countries should be considered when developing tools in the field of personalized or precision medicine that are intended to be used across the world.
We apply a synthesis review to revisit the concept, measurement, and operationalisation of social inclusion and exclusion in the context of comparative social policy, integrating the vast literature on the concepts, with the aim of elucidating a clearer understanding of the concepts for use by scholars and policymakers around the planet. In turn, we outline the conceptual development of the concepts, how they have been operationalised through social policy, and how they have been measured at the national and individual levels. Through our review, we identify limitations in extant conceptualisation and measurement approaches and suggest directions for refining conceptual and measurement frameworks to enhance their utility in social inclusion policy, emphasising the concepts’ multidimensional, multilevel, dynamic, and relational essence and highlighting their connection to related concepts such as social capital, social integration, and social citizenship.
Bipolar depression remains difficult to treat, and people often experience ongoing residual symptoms, decreased functioning and impaired quality of life. Adjunctive therapies targeting novel pathways can provide wider treatment options and improve clinical outcomes. Garcinia mangostana Linn. (mangosteen) pericarp has serotonogenic, antioxidant anti-inflammatory and neurogenic properties of relevance to the mechanisms of bipolar depression.
Aims
The current 28-week randomised, multisite, double-blind, placebo-controlled trial investigated mangosteen pericarp extract as an adjunct to treatment-as-usual for treatment of bipolar depression.
Method
This trial was prospectively registered on the Australia New Zealand Clinical Trials Registry (no. ACTRN12616000028404). Participants aged 18 years and older with a diagnosis of bipolar I or II and with at least moderate depressive symptoms were eligible for the study. A total of 1016 participants were initially approached or volunteered for the study, of whom 712 did not progress to screening, with an additional 152 screened out. Seventy participants were randomly allocated to mangosteen and 82 to a placebo control. Fifty participants in the mangosteen and 64 participants in the placebo condition completed the treatment period and were analysed.
Results
Results indicated limited support for the primary hypothesis of superior depression symptom reduction following 24 weeks of treatment. Although overall changes in depressive symptoms did not substantially differ between conditions over the course of the trial, we observed significantly greater improvements for the mangosteen condition at 24 weeks, compared with baseline, for mood symptoms, clinical impressions of bipolar severity and social functioning compared with controls. These differences were attenuated at week 28 post-discontinuation assessment.
Conclusions
Adjunctive mangosteen pericarp treatment appeared to have limited efficacy in mood and functional symptoms associated with bipolar disorder, but not with manic symptoms or quality of life, suggesting a novel therapeutic approach that should be verified by replication.
This study estimates productivity losses resulting from intellectual decrement due to paediatric lead exposure in low- and middle-income countries (LMICs). The published literature on blood lead levels in LMICs was reviewed and summarised. Intelligence Quotient decrement and consequent productivity losses were calculated for a one-year cohort of 5-year-old children in each country. We calculated the present value of lifetime earnings as the discounted average earning potential for workers in a specific economy. Blood lead level (BLL) data for children were available for 39 countries and could be interpolated for additional 82 countries, resulting in 121 countries in the final analysis. Total lead-attributable productivity losses in LMICs ranged from USD 305 billion in our high discount scenario to USD 499 billion in our low discount scenario for each one-year cohort of 5-year-old children (2019 USD). As a share of GDP, these costs ranged from 0.7 to 4.2% by region, depending on discount scenario used. Total economic impacts were generally consistent with previous estimates and further validate those efforts with a substantially expanded dataset. Differences in the findings resulted primarily from the use of a more conservative dose–response model in the present study. Improved reporting of BLLs is essential and could be facilitated through a centralised registry of study results.
We evaluated the impact of recent revisions to the Clinical and Laboratory Standards Institute (CLSI) aminoglycoside breakpoints on susceptibility within Enterobacterales and Pseudomonas aeruginosa at a Canadian academic hospital. While the aminoglycoside breakpoint changes minimally affected overall susceptibility, the impact of these changes was notable within beta-lactamase producing Enterobacterales.
To understand the scenarios where health care worker (HCW) masking is most impactful for preventing nosocomial transmission.
Methods:
A mathematical agent-based model of nosocomial spread with masking interventions. Masking adherence, community prevalence, disease transmissibility, masking effectiveness, and proportion of breakroom (unmasked) interactions were varied. The main outcome measure is the total number of nosocomial infections in patients and HCW populations over a simulated three-month period.
Results:
HCW masking around patients and universal HCW masking reduces median patient nosocomial infections by 15% and 18%, respectively. HCW-HCW interactions are the dominant source of HCW infections and universal HCW masking reduces HCW nosocomial infections by 55%. Increasing adherence shows a roughly linear reduction in infections. Even in scenarios where a high proportion of interactions are unmasked “breakroom” interactions, masking is still an effective tool assuming adherence is high outside of these areas. The optimal scenarios where masking is most impactful are those where community prevalence is at a medium level (around 2%) and transmissibility is high.
Conclusions:
Masking by HCWs is an effective way to reduce nosocomial transmission at all levels of mask effectiveness and adherence. Increases in adherence to a masking policy can provide a small but important impact. Universal HCW masking policies are most impactful should policymakers wish to target HCW infections. The more transmissible a variant in circulation is, the more impactful HCW masking is for reducing infections. Policymakers should consider implementing masking at the point when community prevalence is optimum for maximum impact.
This article examines professional diviners employed by the Qing (1636–1912) government to assist in local administration. Known as yin-yang officers, these officials served among the technical and religious specialists embedded in prefectural and county governments across the empire. Although they held marginal or unranked positions within the formal bureaucracy, yin-yang officers played a vital role in both administrative and ritual life at the grassroots level. By tracing their training, sources of authority, and everyday responsibilities, this article sheds light on the Qing’s local technical and religious bureaucracy—an often-overlooked dimension of imperial statecraft that bridged ritual, cosmological knowledge, healing and divination, and official governance. It argues for the importance of examining imperial bureaucracy from below, showing how these unsalaried, low-level figures helped sustain the empire’s overstretched administrative apparatus well into the early twentieth century.
To assess whether antibiotic duration (AD) and one-year antibiotic-free days (AFD) are associated with key in-hospital and post-discharge outcomes among critically ill adults.
Design:
Prospective observational study.
Setting:
611-bed, quaternary care academic medical center in the United States.
Patients:
126 critically ill adults (mean age 68.1 ± 15.6 yr, 51.6% male, median APACHE II score 20.5 [IQR 15–25]); 71.4% met sepsis criteria.
Methods:
Secondary infection was defined as ≥3 consecutive antibiotic days within a year after the index sepsis admission. Multivariate analyses adjusted for age, APACHE II score, BMI, and glucocorticosteroid dose. Time-to-event analysis employed Cox proportional hazards modeling; cumulative infection burden was assessed via nonparametric tests using normalized antibiotic exposure (AD as a proportion of days alive).
Results:
Within 30 days, longer AD correlated with increased hospital stay; each additional antibiotic day added ∼0.93 hospital days (P < 0.001) in adjusted linear regression. AD did not predict one-year mortality (OR 1.01, P = 0.739) or readmission (OR 1.01, P = 0.771). Normalized antibiotic exposure significantly differed by cumulative secondary infection episodes (P = 0.0033), with higher exposure among patients experiencing two or more secondary infections (P = 0.026 and P = 0.036, respectively). Cox regression showed a significant association between AD and time to first secondary infection (HR 1.10, 95% CI: 1.04–1.15, P = 0.001), indicating that longer AD predisposed to secondary infection or recurrent antibiotic use.
Conclusions:
Extended AD, in critically ill patients, prolongs hospitalization without reducing mortality or readmission rates. These findings highlight the importance of robust antibiotic stewardship practices, where shorter, targeted regimens may minimize unintended complications.