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The shallow-water equations are widely used to model interactions between horizontal shear flows and (rotating) gravity waves in thin planetary atmospheres. Their extension to allow for interactions with magnetic fields – the equations of shallow-water magnetohydrodynamics (SWMHD) – is often used to model waves and instabilities in thin stratified layers in stellar and planetary atmospheres, in the perfectly conducting limit. Here we consider how magnetic diffusion should be added to the equations of SWMHD. This is crucial for an accurate balance between advection and diffusion in the induction equation, and hence for modelling instabilities and turbulence. For the straightforward choice of Laplacian diffusion, we explain how fundamental mathematical and physical inconsistencies arise in the equations of SWMHD, and show that unphysical dynamo action can result. We then derive a physically consistent magnetic diffusion term by performing an asymptotic analysis of the three-dimensional equations of magnetohydrodynamics in the thin-layer limit, giving the resulting diffusion term explicitly in both planar and spherical coordinates. We show how this magnetic diffusion term, which allows for a horizontally varying diffusivity, is consistent with the standard shallow-water solenoidal constraint, and leads to negative semidefinite Ohmic dissipation. We also establish a basic type of antidynamo theorem.
We characterize hyperbolic groups in terms of quasigeodesics in the Cayley graph forming regular languages. We also obtain a quantitative characterization of hyperbolicity of geodesic metric spaces by the non-existence of certain local $(3,0)$-quasigeodesic loops. As an application, we make progress towards a question of Shapiro regarding groups admitting a uniquely geodesic Cayley graph.
Spatial analysis and disease mapping have the potential to enhance understanding of tuberculosis (TB) dynamics, whose spatial dynamics may be complicated by the mix of short and long-range transmission and long latency periods. TB notifications in Nam Dinh Province for individuals aged 15 and older from 2013 to 2022 were analyzed with a variety of spatio-temporal methods. The study commenced with an analysis of spatial autocorrelation to identify clustering patterns, followed by the evaluation of several candidate Bayesian spatio-temporal models. These models varied from simple assessments of spatial heterogeneity to more complex configurations incorporating covariates and interactions. The findings highlighted a peak in the TB notification rate in 2017, with 98 cases per 100,000 population, followed by a sharp decline in 2021. Significant spatial autocorrelation at the commune level was detected over most of the 10-year period. The Bayesian model that best balanced goodness-of-fit and complexity indicated that TB trends were associated with poverty: each percentage point increase in the proportion of poor households was associated with a 1.3% increase in TB notifications, emphasizing a significant socioeconomic factor in TB transmission dynamics. The integration of local socioeconomic data with spatio-temporal analysis could further enhance our understanding of TB epidemiology.
Garbarino et al. (J Econ Sci Assoc. https://doi.org/10.1007/s40881-018-0055-4, 2018) describe a new method to calculate the probability distribution of the proportion of lies told in “coin flip” style experiments. I show that their estimates and confidence intervals are flawed. I demonstrate two better ways to estimate the probability distribution of what we really care about—the proportion of liars—and I provide R software to do this.
This editorial considers the value and nature of academic psychiatry by asking what defines the specialty and psychiatrists as academics. We frame academic psychiatry as a way of thinking that benefits clinical services and discuss how to inspire the next generation of academics.
Accelerating COVID-19 Treatment Interventions and Vaccines (ACTIV) was initiated by the US government to rapidly develop and test vaccines and therapeutics against COVID-19 in 2020. The ACTIV Therapeutics-Clinical Working Group selected ACTIV trial teams and clinical networks to expeditiously develop and launch master protocols based on therapeutic targets and patient populations. The suite of clinical trials was designed to collectively inform therapeutic care for COVID-19 outpatient, inpatient, and intensive care populations globally. In this report, we highlight challenges, strategies, and solutions around clinical protocol development and regulatory approval to document our experience and propose plans for future similar healthcare emergencies.
To tackle Britain's housing crisis, we need a commitment to build more than 300,000 new homes a year (the government's current commitment) and at least 150,000 of new homes should be social homes for rent.
The principles underlying Labour's housing policy should be that ‘levelling up’ means nothing less than demolishing inequality. Residential property and housing development are major economic sectors. Relatively cheap borrowing and house price inflation have been significant drivers of inequality, not only in higher end owner occupation, but also in the private rented sector, where incentives to private landlords have allowed them to outrun the capacity of ordinary renters to buy in. The private rented sector has also been fuelled by the ‘right’ to buy council homes with a high proportion no longer in owner occupation long term.
Planning and levelling up
We believe that for too long Labour has failed to recognise that the planning system, and in particular planning policy, provide wellestablished tools to enable us to fulfil our policy objectives. So long as the National Planning Policy Framework and local development plans contain the right locational social objectives, planning authorities will be able to decide whether a proposal (whether for housing or another form of development) is in conformity with those objectives and make planning decisions accordingly. They will also be able to use planning agreements, not merely to facilitate but also positively to promote socially acceptable development, such as affordable housing. The use of these powers will be critical in enabling authorities to insist on key regional development sites being invested in rather than those where the biggest profits can be made. Labour should review and implement changes to financial viability assessments and appraisals that are currently used to drastically reduce the number of affordable houses being delivered in developments across the country. It has already been noted that changes on viability could increase the numbers of affordable homes.
Labour had rightly pledged to end the inclusion of ‘hope value’ in the valuation of land being purchased by local authorities under a Compulsory Purchase Order (CPO). This will enable more land to be purchased for socially acceptable development.
Ambitious reform, and resources, are necessary so that all three housing sectors – homeownership, the social rented sector and the private rented sector (PRS) – become accessible, affordable and safe. These sectors cannot be considered in isolation from one another. The proposals to enhance the rights of renters and homeless applicants considered in this chapter will be of limited practical benefit without measures to significantly increase the availability of all forms of housing, considered in Chapter 6.
The core value of any Labour programme for housing and law reform should be a commitment to housing as a human right. This would mean that Labour will respect and implement Article 11 of the International Covenant on Economic, Cultural and Social Rights: ‘[T] he right of everyone to an adequate standard of living for himself and his family, including adequate food, clothing and housing, and to the continuous improvement of living conditions.’
The rights we propose are meaningless if they cannot be enforced. The legal aid sector is in a crisis of sustainability and Law Society research shows that 26 million people do not have access to a local legal aid housing lawyer. This chapter concludes with proposals to significantly increase the availability of advice and representation for people experiencing housing issues.
Private rented sector
After 40 years of little or no regulation of the PRS, the government published, on 17 May 2023, the Renters’ (Reform) Bill, implementing its pledge to abolish s.21 ‘no fault’ evictions four years after having committed to do so. At the time of writing, the Bill had (on 15 May 2024) passed its Second Reading in the House of Lords. It is now doubtful when it will come into force owing to amendments from Conservative MPs, which have been accepted by the government, and which postpone implementation until the Lord Chancellor has assessed the operation of the process for obtaining possession orders in the County Court. Abolition of s.21, along with the establishment of a PRS Ombudsman and a database for residential landlords are welcome and we support them. However, a number of the new mandatory grounds for possession are open to abuse.
OBJECTIVES/GOALS: More young adults (age <50 years) are diagnosed with metastatic gastric cancer (mGC) every year. We will evaluate the association between environmental risk factors (including historical racial residential segregation) clinical, pathologic, molecular features and H.pylori associated early-onset mGC (mE-GC). METHODS/STUDY POPULATION: This retrospective matched case-control study of patients (1:2 by diagnosis year) with mGC (early-onset [E-GC; <50 years]; vs older-onset [O-GC; >50 years]) from 2000-2022 from the Los Angeles Cancer Surveillance Program (LA-CSP) will be enriched by a chart-abstracted cohort from USC Norris Comprehensive Cancer (NCCC). This annotated database captures sociodemographic, medical, and pathologic features of patients treated for mGC at NCCC. It will link to LA-CSP data exploring neighborhood features (obesity rate, poverty, insurance, access to care, ethnic enclave, historical segregation, etc.) of cases and controls to identify, characterize, and compare geographic “hotspot” neighborhoods of mE-GC. We hypothesize younger Hispanic and Asian patients are at higher risk of H.pylori associated mGC. RESULTS/ANTICIPATED RESULTS: From 2000-2022, 339 patients (mE-GC n = 113; mO-GC n=226) were treated at NCCC. We will have characterized clinical and pathological features of mE-GC vs mO-GC. We determined the proportion of H. pylori associated mE-GC vs mO-GC. We will have established the geographical distribution of patients with mE-GC vs mO-GC to identify high-risk neighborhoods. We will link neighborhood risk factors such as food scarcity, poverty, health care access, ethnic enclaves, to the distinct clinical and pathological features of mE-GC, including H. pylori status. Descriptive statistics, chi-square, t-tests, and multivariable regression will be used to compare mE-GC to mO-GC. After controlling for underlying demographics and tumor features, we anticipate clusters of mE-GC and mO-GC in areas of historical racial segregation. DISCUSSION/SIGNIFICANCE: Linking neighborhood and individual risk factors for mE-GC will inform early detection and prevention efforts for vulnerable individuals in high-risk neighborhoods. Building community partnerships within these neighborhoods is essential for developing interventions targeting H. pylori treatment to reduce health disparities in mE-GC.
OBJECTIVES/GOALS: To introduce the new Team Science Community Toolkit, co-created by community and academic partners, and showcase its potential to empower Community Organizations (COs) in achieving equity in community-engaged research (CER). METHODS/STUDY POPULATION: In response to the challenges faced by COs in CER collaborations, qualitative interviews were conducted with CO staff from historically marginalized communities. These interviews informed the development of the Team Science Community Toolkit, a collaborative effort involving a Community Advisory Board (CAB) and Team Science experts from Northwestern University. The toolkit, designed using a community-based participatory research approach, incorporates the Science of Team Science and User-Centered Design principles. Integrated into the NIH-sponsored COALESCE website, it includes templates, checklists, and interactive tools, along with a real-world simulation, to support COs in all stages of the research process. RESULTS/ANTICIPATED RESULTS: Focus groups and usability testing involving external community experts validated the toolkit’s content and usability. Participants expressed enthusiasm and a sense of empowerment, indicating that the toolkit allows them to actively shape research processes and infuse their specific voices and needs into their partnerships. The toolkit is designed to support breaking down barriers like jargon and cultural adaptability to improve accessibility and open conversation. The impact of this Team Science focused toolkit is under evaluation. This presentation will showcase the toolkit, detail its collaborative development, and explore potential applications, ultimately offering a path to more equitable and valuable community-based research. DISCUSSION/SIGNIFICANCE: By providing COs with the resources and knowledge to participate as equal partners in research collaborations, it enhances self-advocacy, transparency, and equity. The toolkit has the potential to utilize Team Science to foster productive communication in community-academic research partnerships.
We recently reported on the radio-frequency attenuation length of cold polar ice at Summit Station, Greenland, based on bi-static radar measurements of radio-frequency bedrock echo strengths taken during the summer of 2021. Those data also allow studies of (a) the relative contributions of coherent (such as discrete internal conducting layers with sub-centimeter transverse scale) vs incoherent (e.g. bulk volumetric) scattering, (b) the magnitude of internal layer reflection coefficients, (c) limits on signal propagation velocity asymmetries (‘birefringence’) and (d) limits on signal dispersion in-ice over a bandwidth of ~100 MHz. We find that (1) attenuation lengths approach 1 km in our band, (2) after averaging 10 000 echo triggers, reflected signals observable over the thermal floor (to depths of ~1500 m) are consistent with being entirely coherent, (3) internal layer reflectivities are ≈–60$\to$–70 dB, (4) birefringent effects for vertically propagating signals are smaller by an order of magnitude relative to South Pole and (5) within our experimental limits, glacial ice is non-dispersive over the frequency band relevant for neutrino detection experiments.
We build upon Brace, Langer, and Hall’s (2000, The Journal of Politics 62: 387–413) original measure of American state supreme court justice ideology – the PAJID scores. To do so, we gather new data on 1,666 state supreme court justices who served between 1970 and 2019 and update the PAJID scores throughout this period. Testing indicates that PAJID scores are a valid measure of state supreme court justices’ policy preferences and compare favorably, though less efficiently, to others such as Bonica and Woodruff (2015, The Journal of Law, Economics, and Organization 31: 472–98) and Windett, Harden, and Hall (2015, Political Analysis 23: 461–9). Given limited data availability for other ideological measures pre-1990 and post-2010, we conclude that these updated PAJID scores should prove attractive to scholars studying state courts during these periods and among those who desire additional state supreme court ideological data for robustness checks.
Understanding the dynamics of staircases in salt fingering convection presents a long-standing theoretical challenge to fluid dynamicists. Although there has been significant progress, particularly through numerical simulations, there are a number of conflicting theoretical explanations as to the driving mechanism underlying staircase formation. The Phillips effect proposes that layering in stirred stratified flow is due to an antidiffusive process, and it has been suggested that this mechanism may also be responsible for salt fingering staircases. However, the details of this process, as well as mathematical models to predict the evolution and merger dynamics of staircases, have yet to be established. We generalise the theory of the Phillips effect to a three-component system (e.g. temperature, salinity, energy) and demonstrate a regularised nonlinear model of layering based on mixing length parametrisations. The model predicts both the inception of layering and its long-term evolution through mergers, while generalising, and remaining consistent with, previous results for double-diffusive layering based on flux ratios. Our model of salt fingering is formulated using spatial averaging processes, and closed by a mixing length parametrised in terms of the kinetic energy and the ratio of the temperature and salt gradients. The model predicts a layering instability for a bounded range of parameter values in the salt fingering regime. Nonlinear solutions show that an initially unstable linear buoyancy gradient develops into layers, which proceed to merge through a process of stronger interfaces growing at the expense of weaker ones. Our results indicate that these mergers are responsible for the characteristic increase of buoyancy flux through thermohaline staircases.
We examine how institutional selection procedures affect the ideology of state supreme court chief justices. We argue that institutional selection methods empower those charged with choosing chief justices to select court leaders who reflect their own preferences, and we test this theory using data from all 50 American states from 1970 to 2017. Our results show that states that use popular elections to select chief justices tend to produce court leaders whose preferences reflect the electorate, and states that use commission-assisted elite appointment tend to produce chief justices whose preferences mirror those of political elites. While we find that peer election systems produce leaders with preferences similar to median court preferences, court preferences are also associated with other methods of chief justice selection.
Disasters have the potential to cause a surge of patients, some of which may require admission to an intensive care unit (ICU). Due to the high resource requirements of ICUs, normal standards of care may need to be altered to treat more people with limited resources, a care model referred to as crisis standards of care (CSC). The pragmatic implementation of CSC in ICUs due to patient surges from disasters has not been well explored in the literature.
Method:
This scoping review guided by the Joanna Briggs institute methodology for scoping reviews searched medical databases including CINHAL, PubMed, ProQuest and SCOPUS. Articles were included if they reflected on the actual implementation of CSC delivered in ICU as a result of a patient surge from a disaster. Quantitative data was extracted into tables and qualitative content was thematically analyzed.
Results:
A total of 17 papers were included in the review. The disaster event that dominated the results was COVID-19. Most papers relayed subjective accounts of how care models were impacted by patient surges. Common themes included the repurposing of other clinical areas to accommodate ICU patients, resource shortages (particularly ventilators) and staff shortages. Moral strain was felt when processes such as palliation and treatment modality were altered due to resource restrictions.
Conclusion:
This review highlights the dearth of high-quality research in implementing CSC in ICUs. Understanding the pragmatic experiences of CSC shows not only the logistical insufficiencies that have been experienced, but the moral and clinical repercussions that these insufficiencies have caused. Inadequate preparation for future disasters, particularly short notice disasters, may lead to further implementation of CSC resulting in poorer outcomes for patients and detrimental impacts on healthcare workers. More research into the practical application of CSC in ICU may help mitigate the impact of patient surges from disasters.
The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron variant (B.1.1.529) rapidly replaced Delta (B.1.617.2) to become dominant in England. Our study assessed differences in transmission between Omicron and Delta using two independent data sources and methods. Omicron and Delta cases were identified through genomic sequencing, genotyping and S-gene target failure in England from 5–11 December 2021. Secondary attack rates for named contacts were calculated in household and non-household settings using contact tracing data, while household clustering was identified using national surveillance data. Logistic regression models were applied to control for factors associated with transmission for both methods. For contact tracing data, higher secondary attack rates for Omicron vs. Delta were identified in households (15.0% vs. 10.8%) and non-households (8.2% vs. 3.7%). For both variants, in household settings, onward transmission was reduced from cases and named contacts who had three doses of vaccine compared to two, but this effect was less pronounced for Omicron (adjusted risk ratio, aRR 0.78 and 0.88) than Delta (aRR 0.62 and 0.68). In non-household settings, a similar reduction was observed only in contacts who had three doses vs. two doses for both Delta (aRR 0.51) and Omicron (aRR 0.76). For national surveillance data, the risk of household clustering, was increased 3.5-fold for Omicron compared to Delta (aRR 3.54 (3.29–3.81)). Our study identified increased risk of onward transmission of Omicron, consistent with its successful global displacement of Delta. We identified a reduced effectiveness of vaccination in lowering risk of transmission, a likely contributor for the rapid propagation of Omicron.
Refractory depression is a devastating condition with significant morbidity, mortality, and societal cost. Approximately 15% of patients with major depressive disorder are refractory to currently available treatments. We hypothesized metabolic abnormalities contributing to treatment refractory depression are associated with distinct findings identifiable in the cerebrospinal fluid (CSF). Our hypothesis was confirmed by a previous small case-controlled study. Here we present a second, larger replication study.
Methods
We conducted a case-controlled, targeted, metabolomic evaluation of 141 adolescent and adult patients with well-characterized history of depression refractory to three maximum-dose, adequate-duration medication treatments, and 36 healthy controls. Plasma, urine, and CSF metabolic profiling were performed by coupled gas chromatography/mass spectrometry, and high-performance liquid chromatography, electrospray ionization, tandem mass spectrometry.
Results
Abnormalities were identified in 67 of 141 treatment refractory depression participants. The CSF abnormalities included: low cerebral folate (n = 20), low tetrahydrobiopterin intermediates (n = 11), and borderline low-tetrahydrobiopterin intermediates (n = 20). Serum abnormalities included abnormal acylcarnitine profile (n = 12) and abnormal serum amino acids (n = 20). Eighteen patients presented with two or more abnormal metabolic findings. Sixteen patients with cerebral folate deficiency and seven with low tetrahydrobiopterin intermediates in CSF showed improvement in depression symptom inventories after treatment with folinic acid and sapropterin, respectively. No healthy controls had a metabolite abnormality.
Conclusions
Examination of metabolic disorders in treatment refractory depression identified an unexpectedly large proportion of patients with potentially treatable abnormalities. The etiology of these abnormalities and their potential roles in pathogenesis remain to be determined.
I gather new data on local media coverage of state supreme court elections and examine its effects on voter participation. I find that, even when controlling for campaign expense and advertising, media coverage can increase voter engagement in state supreme court contests. While some of this effect is attributable to salient campaigns themselves, content and statistical analyses show that the media provide voters with unique information such as candidate qualifications that can also stimulate their participation.
Growth patterns of breastfed infants show substantial inter-individual differences, partly influenced by breast milk (BM) nutritional composition. However, BM nutritional composition does not accurately indicate BM nutrient intakes. This study aimed to examine the associations between both BM intake volumes and macronutrient intakes with infant growth. Mother–infant dyads (n 94) were recruited into the Cambridge Baby Growth and Breastfeeding Study (CBGS-BF) from a single maternity hospital at birth; all infants received exclusive breast-feeding (EBF) for at least 6 weeks. Infant weight, length and skinfolds thicknesses (adiposity) were repeatedly measured from birth to 12 months. Post-feed BM samples were collected at 6 weeks to measure TAG (fat), lactose (carbohydrate) (both by 1H-NMR) and protein concentrations (Dumas method). BM intake volume was estimated from seventy infants between 4 and 6 weeks using dose-to-the-mother deuterium oxide (2H2O) turnover. In the full cohort and among sixty infants who received EBF for 3+ months, higher BM intake at 6 weeks was associated with initial faster growth between 0 and 6 weeks (β + se 3·58 + 0·47 for weight and 4·53 + 0·6 for adiposity gains, both P < 0·0001) but subsequent slower growth between 3 and 12 months (β + se − 2·27 + 0·7 for weight and −2·65 + 0·69 for adiposity gains, both P < 0·005). BM carbohydrate and protein intakes at 4–6 weeks were positively associated with early (0–6 weeks) but tended to be negatively related with later (3–12 months) adiposity gains, while BM fat intake showed no association, suggesting that carbohydrate and protein intakes may have more functional relevance to later infant growth and adiposity.