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We consider pricing of a specialised critical illness and life insurance contract for breast cancer (BC) risk. We compare (a) an industry-based Markov model with (b) a recently developed semi-Markov model, which accounts for unobserved BC cases and progression through clinical stages of BC, and (c) an alternative Markov model derived from (b). All models are calibrated using population data in England and data from the medical literature. We show that the semi-Markov model aligns best with empirical evidence. We then consider net premiums of specialized life insurance products under various scenarios of cancer diagnosis and treatment. The results show strong dependence on the time spent with diagnosed or undiagnosed pre-metastatic BC. This proves to be significant for refining cancer survival estimates and accurately estimating related age dependence by cancer stage. In contrast, the industry-based model, by overlooking this critical factor, is more sensitive to the model assumptions, underscoring its limitations in cancer estimates.
Pulmonary atresia with intact ventricular septum is a rare congenital cardiac lesion with significant anatomical heterogeneity. Surgical planning of borderline cases remains challenging and is primarily based on echocardiography. The aim was to identify echocardiographic parameters that correlate with surgical outcome and to develop a discriminatory calculator.
Methods:
Retrospective review of all pulmonary atresia with intact ventricular septum cases at a statewide tertiary paediatric cardiac centre was performed between 2004 and 2020. Demographic, clinical, and echocardiographic data were collected. Logistic regression was used to develop a discriminatory tool for prediction of biventricular repair.
Results:
Forty patients were included. Overall mortality was 27.5% (n = 11) and confined to patients managed as univentricular (11 vs 0, p = 0.027). Patients who underwent univentricular palliation were more likely to have an associated coronary artery abnormality (17 vs 3, p = 0.001). Fifteen surviving patients (51.7%) achieved biventricular circulation while 14 (48.3%) required one-and-a-half or univentricular palliation. Nineteen patients (47.5%) underwent percutaneous pulmonary valve perforation. No patients without tricuspid regurgitation achieved biventricular repair. The combination of tricuspid valve/mitral valve annulus dimension ratio and right ventricle/left ventricle length ratio identified biventricular management with a sensitivity of 93% and specificity of 96%. An online calculator has been made available.
Conclusion:
Pulmonary atresia with intact ventricular septum is a challenging condition with significant early and interstage morbidity and mortality risk. Patient outcomes were comparable to internationally reported data. Right ventricle/left ventricle length and tricuspid valve/mitral valve annulus dimension ratios identified a biventricular pathway with a high level of sensitivity and specificity. Absent tricuspid regurgitation was associated with a univentricular outcome.
This article reviews the development of mental health and psychiatric services in Australia for the international reader. The development of relevant legislation, health-care systems, and the effectiveness of treatment for people with schizophrenia is reviewed. Gaps in service delivery and future directions are considered.
Hunting, habitat loss and fragmentation have caused a rapid decline in the distribution and abundance of the clouded leopard Neofelis nebulosa across its range, and in several areas, including Taiwan, the species is now extirpated. Taiwan, a former stronghold for the species, is a candidate for its reintroduction, based on increasing prey abundance and high forest coverage. Such future reintroduction efforts, however, are hampered by a lack of analysis of potential clouded leopard habitat on the island. To address this, we explore habitat suitability for the species in Taiwan. We used a multi-scale, multivariate habitat selection model based on clouded leopard presence–absence data from extensive camera-trap surveys across its current range to predict suitable habitat in Taiwan. Our findings indicate that 38% of Taiwanese territory is potentially suitable habitat for the clouded leopard, of which 46% is under protection. This demonstrates the high potential of Taiwan's habitat for clouded leopard reintroduction.
The Maser Monitoring Organisation is a collection of researchers exploring the use of time-variable maser emission in the investigation of astrophysical phenomena. The forward directed aspects of research primarily involve using maser emission as a tool to investigate star formation. Simultaneously, these activities have deepened knowledge of maser emission itself in addition to uncovering previously unknown maser transitions. Thus a feedback loop is created where both the knowledge of astrophysical phenomena and the utilised tools of investigation themselves are iteratively sharpened. The project goals are open-ended and constantly evolving, however, the reliance on radio observatory maser monitoring campaigns persists as the fundamental enabler of research activities within the group.
Recently, remarkable progress has been made in understanding the formation of high mass stars. Observations provided direct evidence that massive young stellar objects (MYSOs), analogously to low-mass ones, form via disk-mediated accretion accompanied by episodic accretion bursts, possibly caused by disk fragmentation. In the case of MYSOs, the mechanism theoretically provides a means to overcome radiation pressure, but in practice it is poorly studied - only three accretion bursts in MYSOs have been caught in action to date. A significant contribution to the development of the theory has been made with the study of masers, which have proven to be a powerful tool for locating “bursting” MYSOs. This overview focuses on the exceptional role that masers play in the search and study of accretion bursts in massive protostars.
Cover crops are increasingly being included in crop rotations as a mechanism to promote diversity and provide agroecosystem services, including weed suppression. Recently, cover crop mixtures have increased in popularity in an attempt to provide a greater diversity in ecological services as compared with monocultures. Several recent studies, however, have failed to detect a positive effect of cover crop diversity on biomass production or weed suppression. Here we assessed biomass productivity and weed suppression in 19 cover crops seeded as monocultures and 19 mixtures of varying species composition and functional richness (two- and three-species mixtures) of full-season cover crops in Atlantic Canada. Cover crop biomass production and weed suppression varied by species identity, functional diversity, and species richness. As cover crop biomass increased regardless of diversity, weed biomass declined. Highly productive forbs and grasses provided the greatest weed suppression in monoculture. In line with previous observations, mixtures were not more productive or weed suppressive on average than the most productive monocultures. We observed that the inclusion of the highly productive species buckwheat (Fagopyrum esculentum Moench) and sorghum–sudangrass [Sorghum × drummondi (Nees ex Steud.) Millsp. & Chase] in a mixture increased stand evenness, productivity, weed suppression, and spatiotemporal stability. Taken together, our results suggest that effects of diversity on mixture productivity and weed suppression are species specific. This further demonstrates the importance of species selection in cover crop mixture design.
Conservation scientists are increasingly recognizing the need to evaluate the effectiveness of interventions to improve human–wildlife coexistence across different contexts. Here we assessed the long-term efficacy of the Long Shields Community Guardians programme in Zimbabwe. This community-based programme seeks to protect livestock and prevent depredation by lions Panthera leo through non-lethal means, with the ultimate aim of promoting human–lion coexistence. Using a quasi-experimental approach, we measured temporal trends in livestock depredation by lions and the prevalence of retaliatory killing of lions by farmers and wildlife managers. Farmers that were part of the Long Shields programme experienced a significant reduction in livestock loss to lions, and the annual number of lions subject to retaliatory killing by farmers dropped by 41% since the start of the programme in 2013, compared to 2008–2012, before the programme was initiated. Our findings demonstrate the Long Shields programme can be a potential model for limiting livestock depredation by lions. More broadly, our study demonstrates the effectiveness of community-based interventions to engage community members, improve livestock protection and ameliorate levels of retaliatory killing, thereby reducing human–lion conflict.
Many China watchers argue that Xi Jinping has concentrated power in his own hands in a manner unprecedented since the death of Mao Zedong and Deng Xiaoping. This article tests the extent of Xi's power consolidation by comparing the strength of his faction during his time in power to similar periods under his two immediate predecessors, Jiang Zemin and Hu Jintao. Furthermore, we investigate whether a dominant faction is emerging under Xi Jinping, replacing the power balancing between factions that was the norm throughout the reform era. Analysing factional affiliations of Chinese leaders in the top four ranks, we find that Xi has formed a dominant faction. Through statistical analysis of the promotion chances of provincial leaders, we find that Xi has been unusually successful when compared to previous leaders at promoting his clients. This suggests that Xi has boosted the power of his faction by elevating provincial leaders to an extent not seen since the death of Mao and Deng.
Ginsenosides, biologically active components of the root of Panax ginseng, have been reported to have therapeutic benefits in a number of disease states including psychiatric conditions such as major depressive disorder. Our objective was to determine if a standardised commercial ginseng extract, G115®, could reduce the signs of behavioural despair commonly observed in animal models of depression either alone or in combination with the selective serotonin reuptake inhibitor (SSRI) fluoxetine.
Methods:
Male Sprague-Dawley (SD) rats (N = 51) were divided into four groups: vehicle control, G115® ginseng root extract, fluoxetine and fluoxetine plus G115®. Rats were trained to voluntarily consume treatments twice daily for 14 days and were then tested in an open field (OF), elevated plus maze (EPM) and forced swim test (FST). Post-mortem hippocampal and prefrontal cortex tissue was analysed for expression of brain-derived neurotrophic factor (BDNF) and tropomyosin receptor kinase B (TrkB) by western blot.
Results:
One-way Analysis of Variance revealed no significant group differences in the OF or plus-maze performance on any variable examined. In the FST, fluoxetine significantly reduced immobility time and increased latency to immobility. The effects of fluoxetine were further significantly potentiated by co-administration of G115®. Post-mortem tissue analysis revealed significant group differences in BDNF expression in the left hippocampus and left prefrontal cortex without any accompanying changes in TrkB expression.
Conclusions:
We conclude that oral G115® significantly potentiates the antidepressant-like effect of fluoxetine in the FST in the absence of potentially confounding effects on locomotion and anxiety.
Negative interactions with humans resulting from livestock predation is a major factor influencing the decline of African lion Panthera leo populations across Africa. Here we investigate lion depredation within two Maasai communities in southern Kenya where people and lions coexist in the absence of any formal protected areas. We explore the factors that increase the frequency and severity of lion attacks on pastoralists and their livestock and assess the effectiveness of livestock guarding to reduce damage. Finally, we examine in which circumstances lion depredation triggers retaliation by people. Over a period of 26 months, lions attacked livestock 29 times, resulting in 41 livestock deaths and 19 injuries. There were also two attacks on people. Lions preferred cattle over the more numerous sheep and goats. Attacks on livestock occurred mostly during the dry season and were not affected by changes in prey density or variation in pastoral settlement that brought livestock into closer proximity with lions. Livestock were guarded during 48.2% of lion attacks. Active guarding at pasture disrupted the majority of lion attacks, resulting in lower mortality rates. Passive guarding in corrals at night also disrupted attacks but did not lead to lower livestock mortality.
Large carnivores have extensive spatial requirements, with ranges that often span geopolitical borders. Consequently, management of transboundary populations is subject to several political jurisdictions, often with heterogeneity in conservation challenges. In continental Asia there are four threatened leopard subspecies with transboundary populations spanning 23 countries: the Persian Panthera pardus saxicolor, Indochinese P. pardus delacouri, Arabian P. pardus nimr and Amur P. pardus orientalis leopards. We reviewed the status of these subspecies and examined the challenges to, and opportunities for, their conservation. The Amur and Indochinese leopards have the majority (58–100%) of their remaining range in borderlands, and the Persian and Arabian leopards have 23–26% of their remaining ranges in borderlands. Overall, in 18 of 23 countries the majority of the remaining leopard range is in borderlands, and thus in most countries conservation of these subspecies is dependent on transboundary collaboration. However, we found only two transboundary initiatives for Asian leopards. Overall, we highlighted three key transboundary landscapes in regions that are of high importance for the survival of these subspecies. Recent listing of the leopard in the Bonn Convention on the Conservation of Migratory Species of Wild Animals is important, but more international collaboration is needed to conserve these subspecies. We provide a spatial framework with which range countries and international agencies could establish transboundary cooperation for conserving threatened leopards in Asia.
The ability to transact with machines has existed for over two thousand years: Hero of Alexandria invented a coin-operated holy water dispenser in the first century AD/ce. As the capability of machines has increased over time, so has the complexity of human interactions with them. In a legal sense, transacting suggests that the action generates rights and obligations between parties. In an effort to produce a societally ‘fair’ result, the law has developed mechanisms to allow appropriate remedies when a party transacts with a machine.
The common law solution has traditionally been the notion of unilateral contract or standing offer. A unilateral contract can be formed when an offer is made, not to a specific individual, but to a class of people, or the world at large, and it remains open until accepted by someone (acceptance is usually through conduct).
A vending machine operates on this mechanism. The seller uses the machine to offer a bottle of water for £1 and the purchaser accepts the offer by placing a pound coin in the slot and pressing the ‘vend’ button. The transaction cannot be revoked, once the buyer has inserted the money. If the machine fails to vend, the law provides that there is a breach of contract between the purchaser and the proprietor of the vending machine, and provides remedies accordingly. Alternatively, the English courts have held that a parking ticket machine makes a standing offer capable of being accepted by users of the car park, with a binding contract formed when the ticket is accepted by the driver.
Around two thousand years after Hero of Alexandria's death, a computer scientist and cryptographer, Nick Szabo, predicted how the rise of computer networks and algorithms would change the way in which contracts were made. He developed a concept of ‘smart contracts’, which minimise the human interaction with and automate the execution and performance of the contract by translating contractual obligations into computer code. In this context, Szabo perceives the vending machine as an ‘autonomous transfer of property’.
From the perspective of contract law, the vending machine is not a party to the contract, nor is it a (human) agent acting on the seller's behalf. Rather, it is merely the parties’ chosen method of making a contract.
Sports victory constitutes an important part of propaganda in authoritarian states. The heavy state investment in sports industries and sports culture in China illustrates the political importance of sports. However, few studies have systematically examined the exact impact of sports propaganda on public opinion. Using a survey experiment conducted in two Chinese cities, this article finds that broadcast highlighting national sports achievements has significant positive effects on general satisfaction and compliance with the local governments. These results expand on the small, but growing, literature on the effects of sports on political opinions and help detail the specific ways in which sports can affect political attitudes.
X-ray micro-computed tomography (μCT) is a technique which can obtain three-dimensional images of a sample, including its internal structure, without the need for destructive sectioning. Here, we review the capability of the technique and examine its potential to provide novel insights into the lifestyles of parasites embedded within host tissue. The current capabilities and limitations of the technology in producing contrast in soft tissues are discussed, as well as the potential solutions for parasitologists looking to apply this technique. We present example images of the mouse whipworm Trichuris muris and discuss the application of μCT to provide unique insights into parasite behaviour and pathology, which are inaccessible to other imaging modalities.
Ira Aldridge -- a black New Yorker -- was one of nineteenth-century Europe's greatest actors. He performed abroad for forty-three years, winning more awards, honors, and official decorations than any of his professional peers. Billed as the "African Roscius," Aldridge developed a repertoire initially consisting of Shakespeare's Othello, melodramas about slavery, and farces that drew on his ability to sing and dance. By the time he began touring in Europe he was principally a Shakespearean actor, playing such classic characters as Shylock, Macbeth, Richard III, and King Lear. Although his frequent public appearances made him the most visible black man in the world by mid-nineteenth century, today Aldridge tends to be a forgotten figure, seldom mentioned in histories of British and European theater. This collection restores the luster to Aldridge's reputation by examining his extraordinary achievements against all odds. The early essays offer biographical information, while later essays examine his critical and popular reception throughout the world. Taken together, these diverse approaches to Aldridge offer a fuller understanding and heightened appreciation of a remarkable man who had an exceptionally interesting life and a spectacular career. Contributors: Cyril Bruyn Andrews, Nikola Batusic, Philip A. Bell, Keith Byerman, Ruth M. Cowhig, Nicholas M. Evans, Joost Groeneboer, Ann Marie Koller, Joyce Green MacDonald, Herbert Marshall, James J. Napier, Krzysztof Sawala, Gunner Sjögren, James McCune Smith, Hazel Waters, and Stanley B. Winters.
Bernth Lindfors is Professor Emeritus of English and African literatures at The University of Texas at Austin.
Extensive areas of tropical forests have been, and continue to be, disturbed as a result of selective timber extraction. Although such anthropogenic disturbance typically results in the loss of biodiversity, many species persist, and their conservation in production landscapes could be enhanced by a greater understanding of how biodiversity responds to forest management practices. We conducted intensive camera-trap surveys of eight protected forest areas in Sabah, Malaysian Borneo, and developed estimates of Sunda clouded leopard Neofelis diardi population density from spatially explicit capture–recapture analyses of detection data to investigate how the species’ abundance varies across the landscape and in response to anthropogenic disturbance. Estimates of population density from six forest areas were 1.39–3.10 individuals per 100 km2. Our study provides the first evidence that the population density of the Sunda clouded leopard is negatively affected by hunting pressure and forest fragmentation, and that among selectively logged forests, time since logging is positively associated with abundance. We argue that these negative anthropogenic impacts could be mitigated with improved logging practices, such as reducing the access of poachers by effective gating and destruction of road access points, and by the deployment of anti-poaching patrols. By calculating a weighted mean population density estimate from estimates developed here and from the literature, and by extrapolating this value to an estimate of current available habitat, we estimate there are 754 (95% posterior interval 325–1,337) Sunda clouded leopards in Sabah.