Collisions are crucial in governing particle and energy transport in plasmas confined in a magnetic mirror trap. Modern gyrokinetic codes model transport in magnetic mirrors, but some utilize approximate model collision operators. This study focuses on a Pastukhov-style method of images calculation of particle and energy confinement times using a Lenard-Bernstein model collision operator. Prior work on parallel particle and energy balances used a different Fokker-Planck plasma collision operator. The method must be extended in non-trivial ways to study the Lenard-Bernstein operator. To assess the effectiveness of our approach, we compare our results with a modern finite element solver. Our findings reveal that the particle confinement time scales like a exp(a2) using the Lenard-Bernstein operator, in contrast to the more accurate scaling that the Coulomb collision operator would yield a2 exp(a2), where a2 is approximately proportional to the ambipolar potential. We propose that codes solving for collisional losses in magnetic mirrors utilizing the Lenard-Bernstein or Dougherty collision operator scale their collision frequency of any electrostatically confined species. This study illuminates the collision operator’s intricate role in the Pastukhov-style method of images calculation of collisional confinement.

The presence of a penicillin allergy label in a patient’s medical chart is associated with negative clinical and economic outcomes. Given that less than 10% of reported reactions are truly immunoglobulin E-mediated, removal of unverified penicillin allergy labels is a public health priority and an area of ongoing implementation research. The Veterans Health Administration (VHA) is the largest integrated healthcare system in the United States, with almost 9 million veterans currently enrolled. However, studies analyzing the impact of the penicillin allergy label in this population are limited to single facilities and largely focus on short-term outcomes of allergy documentation correction, usage of β-lactams, and avoidance of antibiotic-related side effects. Broader, national VHA studies focusing on health outcomes and costs are lacking. As with non-VHA facilities, penicillin allergy evaluations are limited owing to the absence of formal allergy/immunology services at most VHA facilities. Pharmacy-driven screening and referral for clinic-based penicillin skin testing is a promising and frequently discussed modality in the literature, but its scalability within the VHA is not yet proven. Broader, evidence-based strategies that can be adapted to the available resources of individual VHA facilities, including those without on-site access to allergy providers, are needed.

Recent scholarship on affective polarization documents partisan animosity in people's everyday lives. But does partisan dislike go so far as to deny fundamental rights? We study this question through a moral dilemma that gained notoriety during the COVID-19 pandemic: triage decisions on the allocation of intensive medical care. Using a conjoint experiment in five countries we analyze the influence of patients’ partisanship next to commonly discussed factors determining access to intensive medical care. We find that while participants’ choices are consistent with a utilitarian heuristic, revealed partisanship influences decisions across most countries. Supporters of left or right political camps are more likely to withhold support from partisan opponents. Our findings offer comparative evidence on affective polarization in non-political contexts.

During the past decade, genetics research has allowed scientists and clinicians to explore the human genome in detail and reveal many thousands of common genetic variants associated with disease. Genetic risk scores, known as polygenic risk scores (PRSs), aggregate risk information from the most important genetic variants into a single score that describes an individual’s genetic predisposition to a given disease. This article reviews recent developments in the predictive utility of PRSs in relation to a person’s susceptibility to breast cancer and coronary artery disease. Prognostic models for these disorders are built using data from the UK Biobank, controlling for typical clinical and underwriting risk factors. Furthermore, we explore the possibility of adverse selection where genetic information about multifactorial disorders is available for insurance purchasers but not for underwriters. We demonstrate that prediction of multifactorial diseases, using PRSs, provides population risk information additional to that captured by normal underwriting risk factors. This research using the UK Biobank is in the public interest as it contributes to our understanding of predicting risk of disease in the population. Further research is imperative to understand how PRSs could cause adverse selection if consumers use this information to alter their insurance purchasing behaviour.

Most stars form in crowded stellar environments. Such star forming regions typically dissolve within ten million years, while others remain bound as stellar groupings for hundreds of millions to billions of years, and then become the open clusters or globular clusters that are present in our Milky Way galaxy today. A large fraction of stars in the Galaxy hosts planetary companions. To understand the origin and dynamical evolution of such exoplanet systems, it is necessary to carefully study the effect of their environments. Here, we combine theoretical estimates with state-of-the-art numerical simulations of evolving planetary systems similar to our own solar system in different star cluster environments. We combine the planetary system evolution code, and the star cluster evolution code, integrated in the multi-physics environment. With our study we can constrain the effect of external perturbations of different environments on the planets and debris structures of a wide variety of planetary systems, which may play a key role for the habitability of exoplanets in the Universe.

U-Th isochron ages of tufas formed on shorelines suggest that the last pluvial event in Lake Lahontan and Searles Lake was synchronous at about 16,500 cal yr B.P. (equivalent to a radiocarbon age of between 14,000 and 13,500 yr B.P.), whereas the timing of this pluvial event determined by radiocarbon dating is on the order of 1000 yr younger. The timing of seven distinct periods of near desiccation in Searles Lake during late-glacial time has been reinvestigated for U-Th age determination by mass spectrometry. U-Th dating of evaporite layers in the interbedded mud and salt unit called the Lower Salt in Searles Lake was hampered by the uncertainty in assessing the initial 230Th/232Th of the samples. The resulting ages, corrected by a conservative range of initial 230Th/232Th ratios, suggest close correlation of the abrupt changes recorded in Greenland ice cores (Dansgaard-Oeschger events) and wet–dry conditions in Searles Lake between 35,000 and 24,000 cal yr B.P.

Although rare, typhoid fever cases acquired in the United States continue to be reported. Detection and investigation of outbreaks in these domestically acquired cases offer opportunities to identify chronic carriers. We searched surveillance and laboratory databases for domestically acquired typhoid fever cases, used a space–time scan statistic to identify clusters, and classified clusters as outbreaks or non-outbreaks. From 1999 to 2010, domestically acquired cases accounted for 18% of 3373 reported typhoid fever cases; their isolates were less often multidrug-resistant (2% vs. 15%) compared to isolates from travel-associated cases. We identified 28 outbreaks and two possible outbreaks within 45 space–time clusters of ⩾2 domestically acquired cases, including three outbreaks involving ⩾2 molecular subtypes. The approach detected seven of the ten outbreaks published in the literature or reported to CDC. Although this approach did not definitively identify any previously unrecognized outbreaks, it showed the potential to detect outbreaks of typhoid fever that may escape detection by routine analysis of surveillance data. Sixteen outbreaks had been linked to a carrier. Every case of typhoid fever acquired in a non-endemic country warrants thorough investigation. Space–time scan statistics, together with shoe-leather epidemiology and molecular subtyping, may improve outbreak detection.

The woylie Bettongia penicillata is categorized as Critically Endangered, having declined by c. 90% between 1999 and 2006. The decline continues and the cause is not fully understood. Within a decline diagnosis framework we characterized the nature of the decline and identified potential causes, with a focus on the species’ largest populations, located in south-west Western Australia. We described the spatio-temporal pattern of the decline, and several attributes that are common across sites. We categorized the potential causes of the decline as resources, predators, disease and direct human interference. Based on the available evidence the leading hypothesis is that disease may be making woylies more vulnerable to predation but this remains to be tested. No substantial recoveries have been sustained to date, and one of the three remaining indigenous populations now appears to be extinct. Therefore, verifying the factors causing the decline and those limiting recovery is becoming increasingly urgent. Active adaptive management can be used to test putative agents, such as introduced predators. Insurance populations and ecological monitoring should also be included in an integrated conservation and management strategy for the species.