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While global financial capital is abundant, it flows into corporate investments and real estate rather than climate change actions in cities. Political will and public pressure are crucial to redirecting funds. Studies of economic impacts underestimate the costs of climate disasters, especially in cities, so they undermine political commitments while understating potential climate-related returns. The shift of corporate approaches towards incorporating environmental, social, and governance (ESG) impacts offers promise for private-sector climate investments but are recently contested. Institutional barriers remain at all levels, particularly in African cities. Since the Global North controls the world's financial markets, new means of increasing funding for the Global South are needed, especially for adaptation. Innovative financial instruments and targeted use of environmental insurance tools can upgrade underdeveloped markets and align urban climate finance with ESG frameworks. These approaches, however, require climate impact data collection, programs to improve cities' and countries' creditworthiness, and trainings. This title is also available as open access on Cambridge Core.
Howard Thurman, the great 20th-century African American thinker and pastor, has often been characterized as holding an antagonistic view of the Apostle Paul, based primarily on several passages in his most important work, Jesus and the Disinherited (1949). One of those passages describes the anti-Pauline position of his grandmother, a former slave, Nancy Ambrose. In this article we argue that Thurman was, in contrast to his grandmother, oftentimes an admirer of Paul. Our thorough consideration of Thurman’s published and unpublished work, as well as the work of his various intellectual and religious mentors, uncovers that he had a much more nuanced position on Paul than is normally described. He saw Paul as a profoundly radical and original thinker, who was nonetheless compromised by his Roman citizenship, distancing himself from his fellow Jews. For Thurman, a mentor to many in the civil rights movement, the question of citizenship was crucial, and he used Paul to help explore the complex intellectual, religious, and social situations of African Americans, caught between two worlds, ambivalent about trying to fit into a world that was ambivalent about them. In this way, for Thurman, Paul was a model of personal struggle and religious complexity.
Despite an early surge in copper-ore mining during the sixth and fifth millennia BC (the ‘boom’), evidence for metal production in the Balkans dwindles in the fourth millennium (the ‘bust’). Here, the authors present new evidence for copper mining at Curak in south-west Serbia, c. 3800 cal BC, during this apparent downturn. By integrating field surveys, excavations and provenance analyses, they explore activity at the site, challenging the visibility bias in the archaeological record of this region for this key period. Rather than a societal collapse, the authors argue, fewer artefacts may instead reflect a widening Balkan sphere of influence.
Female genital schistosomiasis (FGS) is a chronic disease manifestation of the waterborne parasitic infection Schistosoma haematobium that affects up to 56 million women and girls, predominantly in sub-Saharan Africa. Starting from early childhood, this stigmatizing gynaecological condition is caused by the presence of Schistosoma eggs and associated toxins within the genital tract. Schistosoma haematobium typically causes debilitating urogenital symptoms, mostly as a consequence of inflammation, which includes bleeding, discharge and lower abdominal pelvic pain. Chronic complications of FGS include adverse sexual and reproductive health and rights outcomes such as infertility, ectopic pregnancy and miscarriage. FGS is associated with prevalent human immunodeficiency virus and may increase the susceptibility of women to high-risk human papillomavirus infection. Across SSA, and even in clinics outside endemic areas, the lack of awareness and available resources among both healthcare professionals and the public means FGS is underreported, misdiagnosed and inadequately treated. Several studies have highlighted research needs and priorities in FGS, including better training, accessible and accurate diagnostic tools, and treatment guidelines. On 6 September, 2024, LifeArc, the Global Schistosomiasis Alliance and partners from the BILGENSA Research Network (Genital Bilharzia in Southern Africa) convened a consultative, collaborative and translational workshop: ‘Female Genital Schistosomiasis: Translational Challenges and Opportunities’. Its ambition was to identify practical solutions that could address these research needs and drive appropriate actions towards progress in tackling FGS. Here, we present the outcomes of that workshop – a series of discrete translational actions to better galvanize the community and research funders.
The Personalized Advantage Index (PAI) shows promise as a method for identifying the most effective treatment for individual patients. Previous studies have demonstrated its utility in retrospective evaluations across various settings. In this study, we explored the effect of different methodological choices in predictive modelling underlying the PAI.
Methods
Our approach involved a two-step procedure. First, we conducted a review of prior studies utilizing the PAI, evaluating each study using the Prediction model study Risk Of Bias Assessment Tool (PROBAST). We specifically assessed whether the studies adhered to two standards of predictive modeling: refraining from using leave-one-out cross-validation (LOO CV) and preventing data leakage. Second, we examined the impact of deviating from these methodological standards in real data. We employed both a traditional approach violating these standards and an advanced approach implementing them in two large-scale datasets, PANIC-net (n = 261) and Protect-AD (n = 614).
Results
The PROBAST-rating revealed a substantial risk of bias across studies, primarily due to inappropriate methodological choices. Most studies did not adhere to the examined prediction modeling standards, employing LOO CV and allowing data leakage. The comparison between the traditional and advanced approach revealed that ignoring these standards could systematically overestimate the utility of the PAI.
Conclusion
Our study cautions that violating standards in predictive modeling may strongly influence the evaluation of the PAI's utility, possibly leading to false positive results. To support an unbiased evaluation, crucial for potential clinical application, we provide a low-bias, openly accessible, and meticulously annotated script implementing the PAI.
Children with left aortic arch and aberrant right subclavian artery may present with either respiratory or swallowing symptoms beyond the classically described solid-food dysphagia. We describe the clinical features and outcomes of children undergoing surgical repair of an aberrant right subclavian artery.
Materials and methods:
This was a retrospective review of children undergoing repair of an aberrant right subclavian artery between 2017 and 2022. Primary outcome was symptom improvement. Pre- and post-operative questionnaires were used to assess dysphagia (PEDI-EAT-10) and respiratory symptoms (PEDI-TBM-7). Paired t-test and Fisher’s exact test were used to analyse symptom resolution. Secondary outcomes included perioperative outcomes, complications, and length of stay.
Results:
Twenty children, median age 2 years (IQR 1–11), were included. All presented with swallowing symptoms, and 14 (70%) also experienced respiratory symptoms. Statistically significant improvements in symptoms were reported for both respiratory and swallowing symptoms. Paired (pre- and post-op) PEDI-EAT-10 and PEDI-TBM-7 scores were obtained for nine patients, resulting in mean (± SD) scores decreasing (improvement in symptoms) from 19.9 (± 9.3) to 2.4 (± 2.5) p = 0.001, and 8.7 (± 4.7) to 2.8 (± 4.0) p = 0.006, respectively. Reoperation was required in one patient due to persistent dysphagia from an oesophageal stricture. Other complications included lymphatic drainage (n = 4) and transient left vocal cord hypomobility (n = 1).
Conclusion:
Children with a left aortic arch with aberrant right subclavian artery can present with oesophageal and respiratory symptoms beyond solid food dysphagia. A thorough multidisciplinary evaluation is imperative to identify patients who can benefit from surgical repair, which appears to be safe and effective.
We conducted a series of experiments that revealed the formation of mm-scale penitente structures in ice illuminated by broadband light under moderate vacuum conditions between 50 and 2000 Pa. The experimental apparatus consists of a 0.3 m diameter cylindrical vacuum chamber with a cooling jacket surrounding the outer radius and bottom surface. Light shines in through an optical window at the top to illuminate most of the ice surface. We observe penitente-like structures at temperatures between −15$^\circ$C and $-2^\circ$C and pressures close to the equilibrium vapor pressure at the ice surface temperature. The formation of these structures is very sensitive to slight changes in background pressure, and the structures tend to vanish with significant deviations away from the equilibrium curve, resulting in a smooth sublimated crater formation instead of penitentes. Application of the physical model by Claudin and others (2015, doi: 10.1103/PhysRevE.92.033015) at experimental conditions generally agrees with observations for penitente spacing.
Cells of magnetotactic bacteria are used as model systems for studying the magnetic properties of ferrimagnetic nanocrystals. Each individual bacterial strain produces magnetosomes (membrane-bounded magnetic crystals) that have distinct sizes, shapes, crystallographic orientations and spatial arrangements, thereby providing nanoparticle systems whose unique magnetic properties are unmatched by synthetic chemically-produced crystals. Here, we use off-axis electron holography in the transmission electron microscope to study the magnetic properties of isolated and closely-spaced bullet-shaped magnetite (Fe3O4) magnetosomes biomineralized by the following magnetotactic bacterial strains: the cultured Desulfovibrio magneticus RS-1 and the uncultured strains LO-1 and HSMV-1. These bacteria biomineralize magnetite crystals whose crystallographic axes of elongation are parallel to <100> (RS-1 and LO-1) or <110> (HSMV-1). We show that the individual magnetosome crystals are single magnetic domains and measure their projected in-plane magnetization distributions and magnetic dipole moments. We use analytical modelling to assess the interplay between shape anisotropy and the magnetically preferred <111> magneto-crystalline easy axis of magnetite.
It remains unknown whether severe mental disorders contribute to fatally harmful effects of physical illness.
Aims
To investigate the risk of all-cause death and loss of life-years following the onset of a wide range of physical health conditions in people with severe mental disorders compared with matched counterparts who had only these physical health conditions, and to assess whether these associations can be fully explained by this patient group having more clinically recorded physical illness.
Method
Using Czech national in-patient register data, we identified individuals with 28 physical health conditions recorded between 1999 and 2017, separately for each condition. In these people, we identified individuals who had severe mental disorders recorded before the physical health condition and exactly matched them with up to five counterparts who had no recorded prior severe mental disorders. We estimated the risk of all-cause death and lost life-years following each of the physical health conditions in people with pre-existing severe mental disorders compared with matched counterparts without severe mental disorders.
Results
People with severe mental disorders had an elevated risk of all-cause death following the onset of 7 out of 9 broadly defined and 14 out of 19 specific physical health conditions. People with severe mental disorders lost additional life-years following the onset of 8 out 9 broadly defined and 13 out of 19 specific physical health conditions. The vast majority of results remained robust after considering the potentially confounding role of somatic multimorbidity and other clinical and sociodemographic factors.
Conclusions
A wide range of physical illnesses are more likely to result in all-cause death in people with pre-existing severe mental disorders. This premature mortality cannot be fully explained by having more clinically recorded physical illness, suggesting that physical disorders are more likely to be fatally harmful in this patient group.
As governments increasingly adopt algorithms and artificial intelligence (AAI), we still know comparatively little about citizens’ support for algorithmic government. In this paper, we analyze how many and what kind of reasons for government use of AAI citizens support. We use a sample of 17,000 respondents from 16 OECD countries and find that opinions on algorithmic government are divided. A narrow majority of people (55.6%) support a majority of reasons for using algorithmic government, and this is relatively consistent across countries. Results from multilevel models suggest that most of the cross-country variation is explained by individual-level characteristics, including age, education, gender, and income. Older and more educated respondents are more accepting of algorithmic government, while female and low-income respondents are less supportive. Finally, we classify the reasons for using algorithmic government into two types, “fairness” and “efficiency,” and find that support for them varies based on individuals’ political attitudes.
People with schizophrenia (PSZ) are impaired in attentional prioritization of non-salient but relevant stimuli over salient distractors during visual working memory (VWM) encoding. Conversely, guidance of top–down attention by external predictive cues is intact. Yet, it is unknown whether this preserved ability can help PSZ encode more information in the presence of salient distractors.
Methods
We employed a visuospatial change-detection task using four Gabor patches with differing orientations in 66 PSZ and 74 healthy controls (HCS). Two Gabor patches flickered which were designated either as targets or distractors and either a predictive or a non-predictive cue was displayed to manipulate top–down attention, resulting in four conditions.
Results
We observed significant effects of group, salience and cue as well as significant interactions of salience by cue, group by salience and group by cue. Across all conditions, PSZ stored significantly less information in VWM than HCS. PSZ stored significantly less non-flickering than flickering information with a non-predictive cue. However, PSZ stored significantly more flickering and non-flickering information with a predictive cue.
Conclusions
Our findings indicate that control of attentional selection is impaired in schizophrenia. We demonstrate that additional top–down information significantly improves performance in PSZ. The observed deficit in attentional control suggests a disturbance of GABAergic inhibition in early visual areas. Moreover, our findings are indicative of a mechanism for enhancing attentional control in PSZ, which could be utilized by pro-cognitive interventions. Thus, the current paradigm is suitable to reveal both preserved and compromised cognitive component processes in schizophrenia.
An ideal vision model accounts for behavior and neurophysiology in both naturalistic conditions and designed lab experiments. Unlike psychological theories, artificial neural networks (ANNs) actually perform visual tasks and generate testable predictions for arbitrary inputs. These advantages enable ANNs to engage the entire spectrum of the evidence. Failures of particular models drive progress in a vibrant ANN research program of human vision.
Vaccination against hepatitis B virus (HBV) is effective at preventing vertical transmission. Sierra Leone, Liberia, and Guinea are hyperendemic West African countries; yet, childhood vaccination coverage is suboptimal, and the determinants of incomplete vaccination are poorly understood. We analyzed national survey data (2018–2020) of children aged 4–35 months to assess complete HBV vaccination (receiving 3 doses of the pentavalent vaccine) and incomplete vaccination (receiving <3 doses). Statistical analysis was conducted using the complex sample command in SPSS (version 28). Multivariate logistic regression was used to identify determinants of incomplete immunization. Overall, 11,181 mothers were analyzed (4,846 from Sierra Leone, 2,788 from Liberia, and 3,547 from Guinea). Sierra Leone had the highest HBV childhood vaccination coverage (70.3%), followed by Liberia (64.6%) and Guinea (39.3%). Within countries, HBV vaccination coverage varied by socioeconomic characteristics and healthcare access. In multivariate regression analysis, factors that were significantly associated with incomplete vaccination in at least one country included sex of the child, Muslim mothers, lower household wealth index, <4 antenatal visits, home delivery, and distance to health facility vaccination (all p < 0.05). Understanding and addressing modifiable determinants of incomplete vaccination will be essential to help achieve the 2030 viral hepatitis elimination goals.
We report a case of hypoplastic left heart syndrome and with subsequent aortopathy and then found to have hereditary haemorrhagic telangiectasia/juvenile polyposis syndrome due to a germline SMAD4 pathologic variant. The patient’s staged palliation was complicated by the development of neoaortic aneurysms, arteriovenous malformations, and gastrointestinal bleeding thought to be secondary to Fontan circulation, but workup revealed a SMAD4 variant consistent with hereditary haemorrhagic telangiectasia/juvenile polyposis syndrome. This case underscores the importance of genetic modifiers in CHD, especially those with Fontan physiology.
Eigenvectors of the observability and controllability Gramians represent responsive and receptive flow structures that enjoy a well-established connection to resolvent forcing and response modes. However, whereas resolvent modes have demonstrated great potential to guide sensor and actuator placement, observability and controllability modes have been leveraged exclusively in the context of model reduction via input and output projections. In this work, we introduce interpolatory, rather than orthogonal, input and output projections, that can be leveraged for sensor and actuator placement and open-loop control design. An interpolatory projector is an oblique projector with the property of preserving certain entries in the vector being projected. We review the connection between the resolvent operator and the Gramians, and present several numerical examples where we perform both orthogonal and interpolatory input and output projections onto the dominant forcing and response subspaces. Input projections are used to identify dynamically relevant disturbances, place sensors to measure disturbances, and place actuators for feedforward control in the linearized Ginzburg–Landau equation. Output projections are used to identify coherent structures and place sensors aiming at state reconstruction in the turbulent flow in a minimal channel at $Re_{\tau }=185$. The framework does not require data snapshots and relies only on knowledge of the steady or mean flow.
Electroconvulsive therapy (ECT) is the most effective intervention for patients with treatment resistant depression. A clinical decision support tool could guide patient selection to improve the overall response rate and avoid ineffective treatments with adverse effects. Initial small-scale, monocenter studies indicate that both structural magnetic resonance imaging (sMRI) and functional MRI (fMRI) biomarkers may predict ECT outcome, but it is not known whether those results can generalize to data from other centers. The objective of this study was to develop and validate neuroimaging biomarkers for ECT outcome in a multicenter setting.
Methods
Multimodal data (i.e. clinical, sMRI and resting-state fMRI) were collected from seven centers of the Global ECT-MRI Research Collaboration (GEMRIC). We used data from 189 depressed patients to evaluate which data modalities or combinations thereof could provide the best predictions for treatment remission (HAM-D score ⩽7) using a support vector machine classifier.
Results
Remission classification using a combination of gray matter volume and functional connectivity led to good performing models with average 0.82–0.83 area under the curve (AUC) when trained and tested on samples coming from the three largest centers (N = 109), and remained acceptable when validated using leave-one-site-out cross-validation (0.70–0.73 AUC).
Conclusions
These results show that multimodal neuroimaging data can be used to predict remission with ECT for individual patients across different treatment centers, despite significant variability in clinical characteristics across centers. Future development of a clinical decision support tool applying these biomarkers may be feasible.