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Intellectual property rights - and the very concept of such rights - are coming under attack in our modern world, in which there is widespread sharing of content across a spectrum which extends from agreed open access to outright piracy. Institutions and legal systems that protect intellectual property, both domestically and internationally, stand in need of justification. In this book five different philosophical justifications for intellectual property are presented and defended. Additionally, all of the major criticisms of intellectual property are examined and ultimately rejected. The discussion includes the issues and controversies surrounding generative artificial intelligence and the challenges which it poses to current systems of intellectual property protection. As a result of this thorough and wide-ranging analysis, readers in philosophy, law, political science, information science, and media studies will be in a better position to determine the benefits and burdens of patents, copyrights, trademarks, and trade secrets.
This collection profiles understudied figures in the book and print trades of the eighteenth century. With an explicit focus on intervening in the critical history of the trades, this volume profiles seven women and three men, emphasising the broad range of material, cultural, and ideological work these people undertook. It offers a biographical introduction to each figure, placing them in their social, professional, and institutional settings. The collection considers varied print trade roles including that of the printer, publisher, business-owner, and bookseller, as well as several specific trade networks and numerous textual forms. The biographies draw on extensive new archival research, with details of key sources for further study on each figure. Chronologically organised, this Element offers a primer both on individual figures and on the tribulations and innovations of the print trade in the century of national and print expansion.
This work experimentally explores the alignment of the vorticity vector and the strain-rate tensor eigenvectors at locations of extreme upscale and downscale energy transfer. We show that the turbulent von Kármán flow displays vorticity–strain alignment behaviour across a large range of Reynolds numbers, which is very similar to previous studies on homogeneous, isotropic turbulence. We observe that this behaviour is amplified for the largest downscale energy transfer events, which tend to be associated with sheet-like geometries. These events are also shown to have characteristics previously associated with high flow field nonlinearity and singularities. In contrast, the largest upscale energy transfer events display very different structures which showcase a strong preference for vortex compression. Notably, in both cases we find that these trends are strengthened as the probed scales approach the Kolmogorov scale. We then show further evidence for the argument that strain self-amplification is the most salient feature in characterising the cascade direction. Finally, we identify possible invariant behaviour for the largest energy transfer events, even at scales near the Kolmogorov scale.
Clinical guidelines for personality disorder emphasise the importance of patients being supported to develop psychological skills to help them manage their symptoms and behaviours. But where these mechanisms fail, and hospital admission occurs, little is known about how episodes of acutely disturbed behaviour are managed.
Aims
To explore the clinical characteristics and management of episodes of acutely disturbed behaviour requiring medication in in-patients with a diagnosis of personality disorder.
Method
Analysis of clinical audit data collected in 2024 by the Prescribing Observatory for Mental Health, as part of a quality improvement programme addressing the pharmacological management of acutely disturbed behaviour. Data were collected from clinical records using a bespoke proforma.
Results
Sixty-two mental health Trusts submitted data on 951 episodes of acutely disturbed behaviour involving patients with a personality disorder, with this being the sole psychiatric diagnosis in 471 (50%). Of the total, 782 (82%) episodes occurred in female patients. Compared with males, episodes in females were three times more likely to involve self-harming behaviour or be considered to pose such a risk (22% and 70% respectively: p < 0.001). Parenteral medication (rapid tranquillisation) was administered twice as often in episodes involving females than in males (64 and 34% respectively: p < 0.001).
Conclusions
Our findings suggest that there are a large number of episodes of acutely disturbed behaviour on psychiatric wards in women with a diagnosis of personality disorder. These episodes are characterised by self-harm and regularly prompt the administration of rapid tranquillisation. This has potential implications for service design, staff training, and research.
To describe Candida auris infections from two different geographical regions within a large health-system, both of which have experienced a significant increase in the occurrence of C. auris.
Design:
Multicenter, retrospective, descriptive analysis across a large healthcare system.
Methods:
Patients were included in this study if they were admitted as an inpatient between January 1, 2021 and September 30, 2022 and had a clinical specimen that grew C. auris.
Results:
A total of 321 patients were included. The clinical outcomes of included patients were comparable between geographical regions (Western and Eastern), with the exception of patients who experienced mortality or transitioned to hospice care at discharge (Western 32.1% vs Eastern 19.1%, P = .014). Over one-third of patients required mechanical ventilation at any point during their admission, while greater than half of the total study population had receipt of a blood transfusion. Approximately 25.2% of all patients received hemodialysis, while 24.3% received total parental nutrition during their hospital stay. More than 50% of patients in both regions required an admission to the intensive care unit at any time-frame during their stay. Fluconazole-resistant isolates were more prevalent in the Western region, but both regions demonstrated a high prevalence of resistance.
Conclusion:
Patients identified with C. auris were characterized by significant underlying morbidity and disease burden. Further studies are warranted to identify infection prevention best practices to reduce transmission and reduce mortality through earlier identification and appropriate antifungal therapy.
A number of philosophers have recently argued that there is such a thing as ‘epistemic blame’: blame targeted at epistemic norm violations qua epistemic norm violations. However, Smartt (2024) and Matheson and Milam (2022) have recently provided several arguments in favour of thinking epistemic blame either doesn’t exist or is never justified. This paper argues that these challenges are unsuccessful and along the way evaluates the prospects for various accounts of epistemic blame. It also reflects on the dialectic between sceptics and realists about epistemic blame and what choice points are available for moving the debate forward.
The modal auxiliary form must plus perfect aspect (must have +V-en) has recently acquired the meaning of direct evidentiality in Multicultural London English, the new London dialect. Because the new meaning is a recent innovation we have a rare opportunity to witness its development at first hand, unlike earlier changes in the history of must. Our analysis supports the view that the classic definition of evidentiality in terms of information source is too narrow to explain the expression of evidentiality in spoken interaction, and that a broader definition in terms of epistemic authority is more appropriate. We argue that the direct evidential meaning is a coherent further step in the semantic changes undergone by must during its history. It represents a previously undocumented pathway in the grammaticalisation of evidentiality. It also supports the view that evidentiality is not a purely lexical phenomenon in English.
Governments are increasingly implementing policies to improve population diets, despite food industry resistance to regulation that may reduce their profits from sales of unhealthy foods. However, retail food environments remain an important target for policy action. This study analysed publicly available responses of industry actors to two public consultations on regulatory options for restricting unhealthy food price and placement promotions in retail outlets in Scotland.
Design:
We conducted a qualitative content analysis guided by the Policy Dystopia Model to identify the discursive (argument-based) and instrumental (tactic-based) strategies used by industry actors to counter the proposed food retail policies.
Setting:
Scotland, UK, 2017-2019.
Participants:
N/A
Results:
Most food and retail industry responses opposed the policy proposals. Discursive strategies employed by these actors commonly highlighted the potential costs to the economy, their industries and the public in the context of a financial crisis, and disputed the potential health benefits of the proposals. They claimed that existing efforts to improve population diets, such as nutritional reformulation, would be undermined. Instrumental strategies included using unsubstantiated and misleading claims, building a coordinated narrative focused on key opposing arguments and seeking further involvement in policy decision-making.
Conclusions:
These findings can be used by public health actors to anticipate and prepare for industry opposition when developing policies targeted at reducing the promotion of unhealthy food in retail settings. Government action should ensure robust management of conflicts of interest and establishment of guidance for the use of supporting evidence as part of the public health policy process.
Staphylococcus aureus bacteriuria (SABU) may represent bacteremia in a subset of patients. We describe the impact of a microbiology alert recommending follow-up blood cultures (FUBC) for patients with SABU in a large integrated health system.
Methods:
We conducted a quasi-experimental implementation study in adult ambulatory patients with documented SABU. We excluded patients with confirmed SAB up to 14 days prior to index SABU culture and with blood cultures obtained on the day of SABU. The primary outcome was rate of FUBC (collected between 1 and 5 days of SABU) among all cases of SABU. Secondary outcomes included percentage of patients with early SAB (collected between 1 and 5 days of SABU). We used interrupted time series analysis to compare rates of FUBC pre vs postintervention.
Results:
A total of 2 540 patients were identified; 1 213 (48%) were male. By the end of the postintervention period, the rate of FUBC (20.6%) had increased by 6.3 percentage points (P = .005) compared to the counterfactual (14.2%) had no intervention taken place (44.5% relative increase). Early SAB detection due to FUBC increased from .6% preintervention to 2.0% postintervention (P = .004).
Conclusion:
The microbiology alert initiative increased FUBC in patients with SABU by 44%, but the overall rate of FUBC remained low. The intervention increased early SAB detection. Risk-targeted strategies are needed to optimize FUBC collection in patients with SABU.
We propose CTREND, a new trend factor for cryptocurrency returns, which aggregates price and volume information across different time horizons. Using data on more than 3,000 coins, we employ machine learning methods to exploit information from various technical indicators. The resulting signal reliably predicts cryptocurrency returns. The effect cannot be subsumed by known factors and remains robust across different subperiods, market states, and alternative research designs. Moreover, it survives the impact of transaction costs and persists in big and liquid coins. Finally, an asset pricing model that incorporates CTREND outperforms competing factor models, providing a superior explanation of cryptocurrency returns.
Exposure to environmentally transmitted parasites should increase with population density due to accumulation of infective parasites in space. However, resource competition also increases with density, lowering immunity and increasing susceptibility, offering an alternative pathway for density-dependent infection. To test the relationships between these two processes and parasitism, we examined associations between host density, resource availability, immunity, and counts of 3 common helminth parasites using a long-term study of red deer. We found evidence that immunity increased with resource availability while parasite counts declined with immunity. We also found that greater density correlated with reduced resource availability, and while density was positively associated with both strongyle and tissue worm burdens, resource availability was independently and negatively associated with the same burdens. Our results support separate roles of density-dependent exposure and susceptibility in driving infection, providing evidence that resource competition is an important driver of infection, exacerbating effects of density-dependent increases in exposure.
Heartwater is a tick-borne disease (TBD) of wild and livestock ruminants that threatens food security and the economy throughout much of Africa. Furthermore, the geographic range of heartwater is expanding and is predicted to continue doing so. Despite this, our understanding of heartwater dynamics lags far behind that of many other TBDs. We are therefore limited in our ability to design effective disease control strategies. In this study, we derive and analyse a mathematical model of heartwater dynamics. We analyse our model to predict the most influential parameters for disease risk, both in terms of new outbreaks and in heartwater-endemic regions. We show that the host-finding efficiency of ticks is the most influential parameter affecting outbreak risk. Also, outbreak risk is highly sensitive to the impact of the heartwater pathogen on tick fitness – a previously unexplored concept for any TBD system. In areas where heartwater is established, we show that disease can be controlled via enzootic stability (prolonged host immunity attained via frequent pathogen exposure). However, the maintenance of enzootic stability was dependent on several ecological and physiological parameters. Regarding practical output, we suggest prioritizing tick control measures during periods when ticks are most active in terms of dispersing towards hosts, so as to mitigate heightened outbreak risk. In addition, given the specificity of conditions required for enzootic stability, we caution against relying solely on enzootic stability for long-term heartwater protection. More broadly, our study highlights important tick life history parameters that have been neglected by previous TBD models.
Background: Treatment-resistant obsessive compulsive disorder (trOCD) is a condition characterized by intrusive thoughts (obsessions) and uncontrollable behaviours (compulsions) unresponsive to conventional therapies. Lesioning both anterior limbs of the internal capsule is effective in ablating the circuitry underlying trOCD pathophysiology. The newest capsulotomy method is MR-guided focused ultrasound (MRgFUS). Here we measured neural networks changes of trOCD patients after MRgFUS capsulotomy using resting state functional MRI (rs-fMRI). Methods: Yale-Brown Obsessive-Compulsive Scale (YBOCS) scores and rs-fMRI data were collected in 6 trOCD patients preoperatively, postoperatively at 3-months and 1-year, along with rs-fMRI from 6 age and sex-matched controls. Independent component analysis, dual regression using the FMRIB software library, and node-node approaches were used with the CONN Toolbox. We also performed a systematic review of existing studies about trOCD resting state networks. Results: TrOCD patients demonstrated significant improvement 1-year postoperatively (mean YBOCS reduction of 41 ± 7%). Dual regression analysis 3-months postoperatively showed significantly greater sensorimotor network signal in controls compared to trOCD groups. Node-node analysis in trOCD found connectivity changed in networks associated with the cortico-striato-thalamo-cortico loop, particularly the salience and limbic networks at 1-year postoperatively. Conclusions: TrOCD patients who underwent MRgFUS capsulotomy demonstrated differences in sensorimotor and cortico-striatal connectivity and significant clinical improvement postoperatively.
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.
Very long baseline interferometry (VLBI) astrometry is used to determine the three-dimensional position and proper motion of astronomical objects. A typical VLBI astrometric campaign generally includes around ten observations, making it challenging to characterise systematic uncertainties. Our study on two bright pulsars, B0329+54 and B1133+16, involves analysis of broadband Very Long Baseline Array (VLBA) data over $\sim30$ epochs (spanning approximately 3.5 yr). This extended dataset has significantly improved the precision of the astrometric estimates of these pulsars. Our broadband study suggests that, as expected, the primary contribution to systematic uncertainties in L-band VLBI astrometry originates from the ionosphere. We have also assessed the effectiveness of the modified total electron content (TEC) mapping function, which converts vertical TEC to slant TEC, in correcting ionospheric dispersive delays using global TEC maps. The astrometric parameters (parallax and proper motion) obtained from the multiple datasets, calibrated using the traditional and the modified TEC mapping functions, are consistent. However, the reduced chi-square values from least-squares fitting and precision of the fitted astrometric parameters show no significant improvement, and hence, the effectiveness of the new TEC mapping function on astrometry is unclear. For B0329+54, the refined parallax estimate is $0.611^{+0.013}_{-0.013}$ mas, with best-fit proper motion of $\mu_{\alpha} = 16.960^{+0.011}_{-0.010}\, \textrm{mas}\,{\rm yr}^{-1}$ in R.A. and and $\mu_{\delta} = -10.382^{+0.022}_{-0.022}\,\textrm{mas}\,{\rm yr}^{-1}$ in Dec. These correspond to a distance of $1.64^{+0.03}_{-0.03}$ kpc and a transverse velocity of $\sim 154\, \textrm{km}\,{\rm s}^{-1}$. For B1133+16, the new estimated parallax is $2.705^{+0.009}_{-0.009}$ mas, with proper motions of $\mu_{\alpha} = -73.777^{+0.008}_{-0.008}\, \textrm{mas}\,{\rm yr}^{-1}$ and $\mu_{\delta} = 366.573^{+0.019}_{-0.019}\, \textrm{mas}\,{\rm yr}^{-1}$, implying a distance of $370^{+1}_{-1}$ pc and a transverse velocity of $\sim 656\, \textrm{km}\,{\rm s}^{-1}$. The proper motions of B0329+54 and B1133+16 are consistent within $1\sigma$ of the most precise values reported in the literature to date while achieving more than a twofold improvement in precision. Similarly, the parallax measurements for both pulsars show a $\sim 73\%$ enhancement in precision, with differences of approximately $\lt 1\sigma$ compared to the most precise published values to date.
Russian nation-building policy has often been described as ambiguous, blending a rhetorical commitment to the state’s multinational character together with more exclusionary rhetoric and policies. Drawing from original survey questions on national identity commissioned in December 2022, I find that Russian citizens continue to endorse a multinational vision of the Russian state during wartime. Respondents are simultaneously likely to exclude minorities from being fully considered as “true Rossians” [istinnye rossiiane], while socioeconomic and political factors are meaningfully associated with these patterns. In line with previous scholarship, these findings underscore the blurriness of the russkii/rossiiskii distinction in practice: just as russkii should not always be interpreted as an exclusively ethnic term, rossiiskii should not be seen as a non-ethnic category, either. The findings in the Russian case carry implications for understanding how nation-builders in multiethnic contexts may seek to cater to ethnic majorities while simultaneously signaling commitments to ethnic diversity.
This work introduces GalProTE, a proof-of-concept Machine Learning model, leveraging Transformer Encoder architecture to efficiently determine the stellar age, metallicity, and dust attenuation of galaxies from optical spectra. Designed to address the challenges posed by the vast datasets produced by modern astronomical surveys, GalProTE offers a significant improvement in processing speed while maintaining accuracy. Using the E-MILES spectral library, we generate a dataset of 111936 diverse templates by expanding the original 636 simple stellar population models with varying extinction levels, combinations of multiple spectra, and noise modifications. This ensures robust training over the spectral range of 4750–7100 Å at a resolution of 2.5 Å. GalProTE architecture employs four parallel attention-based encoders with varying kernel sizes to capture diverse spectral features. The model demonstrates a mean squared error (MSE) of 0.27% with a standard deviation of 0.10% between the input spectra and the GalProTE-generated spectra for the synthetic test dataset. Performance evaluation against real data from two galaxies in the PHANGS-MUSE survey (NGC4254 and NGC5068) demonstrates its ability to extract physical parameters efficiently, with spectral fit residuals showing a mean of -0.02% and 0.28%, and standard deviations of 4.3% and 5.3%, respectively. To contextualize these results, we compare age, metallicity and dust attenuation maps generated by GalProTE with those of pPXF, a state-of-the-art spectral fitting tool. While pPXF achieves robust results, it requires approximately 11 sec per spectrum. In contrast, GalProTE processes a spectrum in less than 4 ms – a speedup factor exceeding 2750, while also consuming 68 times less power per spectrum. The comparison with pPXF maps from PHANGS-MUSE underscores GalProTE’s capacity to enhance traditional methods through machine learning, paving the way for faster, more energy-efficient, and more comprehensive analyses of galactic properties. This study demonstrates the potential of GalProTE as an efficient, scalable, and sustainable solution for processing large astronomical surveys.
High density should drive greater parasite exposure. However, evidence linking density with infection generally uses density proxies or measures of population size, rather than measures of individuals per space within a continuous population. We used a long-term study of wild sheep to link within-population spatiotemporal variation in host density with individual parasite counts. Although four parasites exhibited strong positive relationships with local density, these relationships were mostly restricted to juveniles and faded in adults. Furthermore, one ectoparasite showed strong negative relationships across all age classes. In contrast, population size – a measure of global density – had limited explanatory power, and its effects did not remove those of spatial density, but were distinct. These results indicate that local and global density can exhibit diverse and contrasting effects on infection within populations. Spatial measures of within-population local density may provide substantial additional insight to temporal metrics based on population size, and investigating them more widely could be revealing.
Rates of youth anxiety, depression, and self-harm have increased substantially in recent years. Expansion of clinical service capacity is constrained by workforce shortages and system fragmentation, and even substantial investment may not achieve the scale of growth required to address unmet need. Preventive strategies – such as strengthening social cohesion – are therefore essential to alleviate mounting pressures on the mental health system, yet their potential to compensate for these constraints remains unquantified.
Methods
This study employed a system dynamics model to explore the interplay between service capacity and social cohesion on youth mental health outcomes. The model was developed for a population catchment characterized by a mix of urban, suburban, and rural communities. Primary outcomes were prevalence of psychological distress and mental disorders, and incidence of mental health-related emergency department (ED) presentations among young people aged 15–24 years, projected over a 10-year time horizon. Two-way sensitivity analyses of services capacity and social cohesion were conducted.
Results
Changes to specialized mental health services capacity growth had the greatest projected impact on youth mental health outcomes. Heatmaps revealed thresholds where improvements in social cohesion could offset negative impacts of constrained service capacity. For example, if services capacity growth was sustained at only 80% of baseline, improving social cohesion could still reduce years lived with symptomatic disorder by 6.3%. To achieve a similar scale of improvement without improvements in social cohesion, the current growth rate in services capacity would need to be more than double. Combining a doubling of service capacity growth with reversing the decline in social cohesion could reduce ED presentations by 25.6% and years with symptomatic mental disorder by 19.2%. A doubling of specialized, headspace, and GP services capacity growth could prevent 24,060 years lived with symptomatic mental disorder among youth aged 15–24.
Conclusions
This study provides a quantitative framework for understanding how social cohesion improvements can help mitigate workforce constraints in mental health systems, demonstrating the value of integrating service expansion with social cohesion enhancement strategies.
Emergency department (ED) visits in the United States by patients living with cancer are increasing. although the ED admission rate for this population is higher than for the noncancer population, not all cancer patients require prolonged hospitalization. Observation care offers a promising alternative to admission for the management of many common oncologic emergencies that require care outside the scope of what is achievable during an ED visit.