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Water demand continues to increase in the western U.S., straining existing (and forecasted future) supplies. Water transfers – through either the sale of water rights or contractual leases of bounded duration – are now a well-established means of reallocating water to the highest economic benefit. Water is not a typical commodity, however. Significant variability in price across different geographic locations reflects differences in hydrologic conditions, demand and supply, and infrastructure development. These differences will persist even in well-functioning markets due to high transportation costs and user interconnectivity.
While sufficient data now exist to describe market activity and price trends, no study has yet performed a rigorous analysis that fully accounts for contract type (whether water rights transfer or lease) and price endogeneity. We fill this gap by estimating a simultaneous system of demand equations for rights transfers and leases that accounts for supply drivers of price determination. As one might anticipate, the demand for leases is more elastic than the demand for water rights. Accounting for contract type and price endogeneity provides a more accurate estimation of water’s market value in different locations across the western U.S. Ignoring either issue leads to significant biases with policy implications.
The relative education model holds that educational attainment reflects existing socioeconomic advantages that are associated with participation rather than spurring political participation on its own. Yet, emerging research on compensation effects suggests that greater educational attainment leads to increased political engagement among more marginal populations in which political socialization is less likely to occur outside of schools. We argue that the relative education model will better describe the relationship between education and voting patterns among more advantaged groups. We test our expectations by estimating the relative education model within racial and ethnic groups in the U.S. using data from the Current Population Survey’s (CPS) Voting and Registration Supplement from 1978 to 2020. We find that for relatively highly educated White and Asian American voters, each additional year of education yields diminishing returns to turnout. For Black and Latino voters, additional years of education are positively associated with turnout regardless of relative education. The results suggest that opportunities remain to reduce racial turnout gaps and boost political participation by addressing racial gaps in educational attainment.
Cognitive impairments are a core feature of psychotic disorders, but their long-term trajectory remains contentious. Previous meta-analyses focused on the first 5 years following psychosis onset. Here, we evaluated the change in cognitive impairments in psychotic disorders with a meta-analysis of studies with follow-ups of 5+ years. Following preregistration, databases were searched for relevant articles until July 2024. Two authors screened the reports for studies reporting on the change in cognitive impairments in global cognition, verbal learning and memory, visual learning and memory, working memory, attention, speed of processing, reasoning and problem-solving, and verbal fluency in individuals with psychotic disorders, with a minimum follow-up of 5 years. Three authors extracted data, and the PRISMA guidelines were followed. Random-effects meta-analyses and moderator analyses were conducted. Twenty-four studies comprising 2,633 patients and 1,019 controls were included in the study. Over an average of 8.46 years, cognitive impairments remained stable in all eight measures: global cognition (g = 0.09; 95% CI = 0.03–0.20), verbal memory (g = 0.05; 95% CI = −0.11, 0.21), visual memory (g = −0.16; 95% CI = −0.35, 0.03), working memory (g = 0.03; 95% CI = −0.09, 0.14), attention (g = 0.22; 95% CI = −0.36, 0.80), speed of processing (g = 0.10; 95% CI = −0.14, 0.35), reasoning and problem-solving (g = 0.16; 95% CI = −0.03, 0.35), and verbal fluency (g = 0.08; 95% CI = −0.03, 0.19). We conclude that cognitive impairments remain stable over time, consistent with the neurodevelopmental view of psychotic disorders.
Evaluate how a foundation-supported fellowship employs early health-technology assessment (eHTA) to guide the development and positioning of emerging health innovations.
Methods
We reviewed all eHTA reports conducted under the Fellowship from 2018 to 2021 (n = 10), extracting technology class, development stage, economic modeling, and recommendations. In 2023, we conducted thirty-minute structured video interviews with developers of each technology (eleven invitees, ten responses). The interview comprised Likert questions on perceived usefulness and intention to update the model in later stages, and six open-ended questions on perceived advantages, implementation barriers, and downstream actions. Likert data were summarized descriptively; open-ended responses were summarized and discussed within the research team until consensus on key themes.
Results
The eHTA subject technologies were four diagnostics, three therapeutics, two predictive algorithms, and one curative device, all preclinical. Analyses used six Markov or decision-tree frameworks, four hybrid models or simulations, and six value-based-pricing scenarios. Five technologies were potentially cost-effective, three conditionally cost-effective, one unlikely to be cost-effective without stronger evidence, and one cost-effective yet unlikely to break even. Eight developers rated eHTA “useful” or “very useful”; three had already leveraged results in grant or investor materials and two planned to do so when more data emerged. Reported barriers included evidence gaps, funding constraints, and misalignment with pharmaceutical partners on codevelopment strategies; two projects were discontinued.
Conclusions
eHTA supplies developers with early economic insight, but its guidance is most reliable when interpreted alongside budget impact, feasibility, regulatory, and adoption considerations.
From global tourism and free movement to refugees and climate-related displacement, human mobility is both a driver and an effect of what we think of as globalisation. Yet, the role of international law in constituting human mobility remains critically undervalued. In this contribution, we call for a radical rethinking of the role of international law in shaping our globe through the tenets of the mobilities paradigm in the social sciences. More specifically, we argue for the adoption of a mobile ontology of international law, which pits the constant flow of persons, goods and capital against dominant globalisation narratives predicting the end of place to take a focus on re-territorialisations of power. Taking human mobility as our starting point, we first show how mobility has been central to the foundation of key building blocks of international law. Second, we turn to the example of the global tourism regime to explore how law recursively disperses mobility around the world. Third and finally, we argue that the relationship between international law and human mobility is co-constitutive, as constant shifts in mobilities create unexpected effects, which in turn prompt further evolutions in law. We conclude by reflecting on the space for empirical and critical investigation that may open up by re-imaging (international) law as quintessentially mobile.
Addressing sea-level rise and coastal flooding requires adaptation strategies tailored to specific coastal environments. However, a lack of detailed geomorphological data on global coasts impedes effective strategy development. This research maps seven coastal environments worldwide, and for each environment analyzes the effect of coastal changes on coastal populations by including sea-level change, extreme sea-level events with varying return periods and population growth from 1950 to 2050. It identifies the historical exposure of low-lying deltaic and estuarine flood areas (>48% of total population) and reveals that flood exposure will significantly increase for barrier islands and strandplains by 2050 (with over a 40% rise in exposure), particularly along African coastlines. Population growth emerges as the primary factor behind the increased exposure. While sea-level rise is projected to contribute between 26% and 65% of the increased inundated area by 2050 compared to a 10-year extreme sea-level event, varying by coastal environment. The findings highlight the critical need for mitigation measures that account for the distinct responses of different coastal types to sea-level rise, posing various risks over varying timescales.
This chapter investigates what Primo Levi called the space “which separates the victims from the persecutors.” It uses historical examination, an anthropological approach to morality, and a historiographical review of writing to assess such “gray zones.” These can include stealing food, the role of Jewish physicians, the Sonderkommandos, or decisions made by prisoner functionaries.
Wildfire smoke causes respiratory health concerns. The study estimates respiratory hospitalization risk from wildfires, determines distance to a hospital, and identifies concentrations of smoke-sensitive groups far from a hospital to facilitate public health and emergency preparedness in Oregon using spatial analysis.
Methods
Statistically significant environmental factors were identified with regression and used with wildfire and pollution concentrations to predict respiratory hospitalizations. A weighted overlay of the significant factors formed a statewide risk layer. Proximity to the hospital nearest to each Census block was determined by driving distance. Clusters of smoke-sensitive groups, determined by relevant Census demographics, were identified through a Hot Spot Analysis.
Results
This process allowed for highlighting locations of smoke-sensitive groups in areas at high risk for respiratory hospitalization from wildfire smoke who were far from a hospital. The results allow local officials to identify the type and magnitude of needs they can expect in the event of a wildfire.
Conclusions
The results demonstrate a process to facilitate wildfire preparedness in Oregon. This process could be adapted to inform wildfire resilience strategies in other regions facing similar challenges, such as California. Understanding local needs allows officials to target communications more effectively, stage resources more efficiently, and identify gaps that can be addressed before a disaster strikes.
In a world of growing health inequity and ecological injustice, how do we revitalize medicine and public health to tackle new problems? This groundbreaking collection draws together case studies of social medicine in the Global South, radically shifting our understanding of social science in healthcare. Looking beyond a narrative originating in nineteenth-century Europe, a team of expert contributors explores a far broader set of roots and branches, with nodes in Sub-Saharan Africa, South America, Oceania, the Middle East, and Asia. This plural approach reframes and decolonizes the study of social medicine, highlighting connections to social justice and health equity, social science and state formation, bottom-up community initiatives, grassroots movements, and an array of revolutionary sensibilities. As a truly global history, this book offers a more usable past to imagine a new politics of social medicine for medical professionals and healthcare workers worldwide. This title is also available as open access on Cambridge Core.
New far ultraviolet imaging of the galaxy NGC 205 is presented, which shows the emission is significantly offset ($\sim5^{\prime\prime}$ NW) from the optical and infrared centers of the galaxy. Spectral energy distribution (SED) modelling is applied to investigate the spatial dependence of the star formation history (SFH) of NGC 205, using data from far ultraviolet to far infrared. The SED model includes young and old stellar populations, gas emission, dust emission and dust absorption. The old stellar population has a total mass of $1.1\times10^8$ M$_{\odot}$ whereas the young population has a much smaller total mass of 3 200 M$_{\odot}$. The best forms of SFH for old and young stars are found to be exponentially declining bursts with start times $t_0$ yr ago and e-folding times $\tau$ yr. The old stellar population has uniform $t_0$ = 9.5 Gyr, with $\tau$ decreasing with radius from 1 Gyr to 500 Myr. The young stellar population has $t_0$ = 900 Myr and $\tau$ = 800 Myr, both uniform across NGC 205. The young and old stellar mass surface densities are exponential in radius with scale lengths of 40 and 110 pc, respectively. The dust heating has a $\sim$ 40% contribution from young stars and $\sim$ 60% from old stars.
This article explores and discusses the change processes and pedagogical dilemmas ignited by introducing wild pedagogies to pedagogical employees in Danish early childhood institutions. By analysing experiments aimed at developing new play and learning environments, carried out as part of a large design-based research project, we discuss how existing “roots” of early childhood education in Denmark provide a fertile soil for the introduction of wild pedagogies. We identify two “shoots of change” with a potential for pushing the status quo in relations between children, adults, and more-than-human nature. Centreing on altering the place of nature in early childhood education and carving out time for more open approaches, these shoots are in close dialogue with wild pedagogies. By experimenting with these shoots of change, pedagogical dilemmas became more visible, important, and present to the participants. Attending to and exploring such dilemmas are crucial aspects of keeping socio-cultural change processes in motion.
We study continuous-time Markov chains on the nonnegative integers under mild regularity conditions (in particular, the set of jump vectors is finite and both forward and backward jumps are possible). Based on the so-called flux balance equation, we derive an iterative formula for calculating stationary measures. Specifically, a stationary measure $\pi(x)$ evaluated at $x\in\mathbb{N}_0$ is represented as a linear combination of a few generating terms, similarly to the characterization of a stationary measure of a birth–death process, where there is only one generating term, $\pi(0)$. The coefficients of the linear combination are recursively determined in terms of the transition rates of the Markov chain. For the class of Markov chains we consider, there is always at least one stationary measure (up to a scaling constant). We give various results pertaining to uniqueness and nonuniqueness of stationary measures, and show that the dimension of the linear space of signed invariant measures is at most the number of generating terms. A minimization problem is constructed in order to compute stationary measures numerically. Moreover, a heuristic linear approximation scheme is suggested for the same purpose by first approximating the generating terms. The correctness of the linear approximation scheme is justified in some special cases. Furthermore, a decomposition of the state space into different types of states (open and closed irreducible classes, and trapping, escaping and neutral states) is presented. Applications to stochastic reaction networks are well illustrated.
The critical points of vorticity in a two-dimensional viscous flow are essential for identifying coherent structures in the vorticity field. Their bifurcations as time progresses can be associated with the creation, destruction or merging of vortices, and we analyse these processes using the equation of motion for these points. The equation decomposes the velocity of a critical point into advection with the fluid and a drift proportional to viscosity. Conditions for the drift to be small or vanish are derived, and the analysis is extended to cover bifurcations. We analyse the dynamics of vorticity extrema in numerical simulations of merging of two identical vortices at Reynolds numbers ranging from 5 to 1500 in the light of the theory. We show that different phases of the merging process can be identified on the basis of the balance between advection and drift of the critical points, and identify two types of merging, one for low and one for high values of the Reynolds number. In addition to local maxima of positive vorticity and minima of negative vorticity, which can be considered centres of vortices, minima of positive vorticity and maxima of negative vorticity can also exist. We find that such anti-vortices occur in the merging process at high Reynolds numbers, and discuss their dynamics.
The use of explosive weapons in populated areas (EWIPA) has a disproportionate impact on civilians. Many humanitarian organizations utilize varying sheltering guidelines to recommend safe positions for civilians affected by explosive threats. It is not known whether these recommendations are standardized or derived from evidence. This study aimed to identify existing recommendations and potential gaps in literature relevant to sheltering guidelines for civilians during explosive events.
Methods
A scoping review was conducted of the literature including indexed databases and grey literature to identify reports that described sheltering guidelines for civilians during explosive events. Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) methodology was followed.
Results
The search identified 3582 peer-reviewed records. After title/abstract and full text screening, only 2 peer-reviewed reports remained eligible. These were combined with 13 gray literature reports obtained from humanitarian organizations and internet searches. The peer-reviewed reports included mine and unexploded ordnance guidelines, not guidelines for EWIPA or aerial bombardments. There is a substantial knowledge gap and heterogeneity in existing sheltering guidelines from explosive events, particularly those appropriate for protection from EWIPA.
Conclusions
Findings from this scoping review demonstrate a need for the creation and standardization of evidence-based civilian sheltering guidelines to mitigate the threat of explosive weapons to civilians in conflict.
Natural disasters are becoming more frequent. The crises that follow are becoming more impactful along with diverse emergency-prone hazards and security contexts. EMTs play a crucial role in emergency and disaster response offering timely medical assistance, stabilizing patients, and ensuring safe transport to medical facilities. EMTs must have public health competencies to evaluate, prioritize, and resource all types of medical and public health emergencies.
Objectives:
Define the essential competencies for leading/coordinating actions between public health and disaster medicine to reliably prepare EMTs for lasting success.
Method/Description:
We hosted an international colloquium targeted at EMT capacity building and training.
Results/Outcomes:
EMTs work in environments with limited resources, including medical supplies, equipment, personnel, which impacts their ability to provide care. EMTs provide care to individuals and communities during recovery and provide medical assistance for displaced individuals, addressing acute health concerns and chronic conditions. They empower individuals and communities to take active roles in their recovery fostering empowerment, preparedness, and cohesion. EMTs ensure continuity of care and effectively address emerging health concerns.
Conclusion:
Continued investment is needed in public health training, resources, and support systems to enhance the effectiveness of EMTs in disaster management: 1) training equips EMTs with critical team competencies, 2) adequate resources, including medical supplies, equipment/transportation, are essential for EMTs, 3) investment in mental health support systems to address the psychological impacts of disaster response and recovery, 4) funding research initiatives and embracing technological advancements helps identify best practices and develop evidence-based protocols, 5) establish (international) regulatory framework, registration, and individual competency certification to professionalize EMT cadre.
C-reactive protein (CRP) level in blood is a standard marker for systemic inflammation. Inflammation is central in chronic subdural hematoma (CSDH) pathophysiology, and inflammatory biomarkers may hold clinical potential in assessing the level of inflammation induced by a CSDH. This study explores the role of CRP in patients with CSDH by (1) measuring systemic and subdural CRP levels, (2) investigating CRP as a potential predictor for recurrent CSDH and (3) comparing CRP levels between the first and second operations in patients with CSDH recurrence.
Methods:
CRP levels were measured both in systemic blood and subdural fluid from adult CSDH patients. Recurrence rate and mortality within 90 days were recorded. In total, 111 patients were included, of whom 25 were operated on for CSDH recurrence.
Results:
Systemic CRP levels (2.54 mg/L (1.40–9.75)) were higher than subdural levels (2.09 mg/L [0.99–5.22]) (p < 0.0001) but within the clinically defined normal CRP range of < 3 mg/L. Neither systemic nor subdural CRP levels could predict recurrence. Both systemic and subdural CRP levels in recurrent CSDH patients were higher at the time of the second surgery compared to the first surgery (psystemic = 0.004 and psubdural < 0.0001).
Conclusion:
This is the first study to establish a correlation between systemic and subdural CRP levels in CSDH patients. The increased levels of CRP at the time of the second surgery may demonstrate a constantly evolving inflammatory process toward the development of a recurrence.
Objectives/Goals: The goal of this study is to resolve the complexity of the adipose precursor cells and identify potential therapeutic targets/mechanism to treat obesity, diabetes, cancer cachexia, and related metabolic conditions in both white and brown adipose tissues. Methods/Study Population: White and brown adipose precursor cells were isolated from neonatal P0 mice and expanded in culture for single-cell RNA sequencing analysis. Unsupervised machine learning was used to unbiasedly cluster and categorize sequenced cells. Differentially expressed genes were used to identify populations via pathway analysis. Populations were then validated with published datasets via integration, reference mapping, and module scoring to ensure our dataset is reflective of known literature. Then, white and brown datasets were combined and unbiasedly clustered. Finally, signaling inferences using CellChat was used to identify significant signals being sent to and received from each cluster based on ligand–receptor pairs. Results/Anticipated Results: ScRNAseq revealed 7 subclusters in both white and brown adipose tissues. Differential expression and trajectory inferences revealed that white and brown precursors develop into two distinct fates: committed adipogenic precursors (CAPs), where these cells will be mature lipid-laden adipocytes; or fibro-adipogenic precursors-like (FAPLs), where these cells preferably stay in a fibroblast-like, antiadipogenic phenotype. Integrating white and brown cells with subsequent reclustering reveals that white and brown FAPLs are highly similar to one another by being clustered together. Cell signaling inferences and pathway analysis reveal that white and brown FAPLs may participate in the regulation of adipogenesis and angiogenesis of the adipose tissue. Discussion/Significance of Impact: Our results demonstrated that brown and white precursor cells share a common regulatory subpopulation with similar gene expression profiles, highlighting a more interconnected regulatory landscape in adipose tissue than previously understood. These findings reveal novel mechanisms of systemic metabolism and provide new therapeutic targets.
Objectives/Goals: Nucleoside transport by ENT2 facilitates transit of the lupus anti-DNA autoantibody Deoxymab into cells and across the blood–brain barrier into brain tumors. This work examines the Deoxymab-nucleoside interactions that contribute to membrane crossing and apply them in brain tumor therapeutics. Methods/Study Population: Deoxymab interactions with individual nucleosides, nucleobases, and pentose sugars are examined by surface plasma resonance (SPR) and cell penetration assays in a panel of cell lines including glioblastoma, breast cancer, and normal breast epithelial cells. Deoxymab-conjugated gold nanoparticles are generated and tested for binding to normal human astrocytes and glioma cells, and the impact of supplemental nucleosides on this binding is determined. Deoxymab-gold nanoparticles are tested for brain tumor localization by systemic and local administration in mice bearing orthotopic glioblastoma brain tumors and enhancement of laser interstitial thermal therapy (LITT) examined. Results/Anticipated Results: Individual nucleosides significantly increase the efficiency of cell penetration by Deoxymab in all cell lines tested. In contrast, component nucleobases and pentose sugars significantly suppress the uptake of the autoantibody into cells. Deoxymab-conjugated gold nanoparticles bind DNA in vitro and to astrocytes in culture and are anticipated will enhance the efficacy if LITT in vivo by associating with DNA released by necrotic tumors and/or by locally administered nucleosides in brain tumor environments and subsequently act as heat sink to amplify LITT impact. Discussion/Significance of Impact: Deoxymab is a DNA-targeting, cell-penetrating autoantibody. These findings establish nucleosides as the components of DNA that promote autoantibody membrane crossing through ENT2 activity and indicate potential for use of Deoxymab-gold nanoparticles in combination with LITT for brain tumor therapy.