324139 research outputs found
Sort by
Beyond limit groups: formal solutions and the profinite topology
Get PDFIn this thesis we explore limit groups from two different angles. One of them is model-theoretic (wherein limit groups serve as our main tool), while the other pertains to the profinite topology on limit groups (where we uncover insightful results on limit groups and residually free groups).
First, we generalize Merzlyakov’s theorem about the first-order theory of free groups to acylindrically hyperbolic groups. We consequently deduce that if G is an acylindrically hyperbolic group, and E(G) denotes the unique maximal finite normal subgroup of G, then G and the HNN extension G∗˙E(G) = ⟨G, t ∣ [t, g] = 1, ∀g ∈ E(G)⟩ (which is simply G ∗ Z if E(G) is trivial) have the same ∀∃-theory.
The second part of this thesis focuses on limit groups over coherent right-angled Artin groups. We prove that cyclic subgroup separability is preserved under exponential completion for groups that belong to a class that includes all coherent RAAGs and toral relatively hyperbolic groups. We thus infer that the cyclic subgroups of limit groups over coherent RAAGs are closed in the profinite topology.
In the last part of the thesis, we turn to study “classical” limit groups (over free groups), as well as residually free groups. We show that the virtual second Betti number of a finitely generated, residually free group G is finite if and only if G is either free, free abelian or the fundamental group of a closed surface. Relying on these results, and employing techniques involving rank gradients of pro-p groups, we show that direct products of free and surface groups are profinitely rigid among finitely presented, residually free groups
Post-fracture care and predictors of anti-osteoporotic treatment in Switzerland: a nationwide health claims analysis
Get PDFSummaryThis retrospective study using Swiss health insurance claims data found that 88% of hip and 77% of vertebral fracture patients did not receive osteoporosis treatment within 6 months post-fracture.PurposeThe treatment gap in osteoporosis in Switzerland has previously been estimated at 83% based on T-scores and/or FRAX thresholds. However, real-world data on treatment rates following fractures remain limited. This study analysed treatment rates and their predictors in hospitalised patients aged ≥ 50 years with recent vertebral, hip or other fractures and the associated direct economic burden.MethodsThis retrospective cohort study utilised claims data from the largest Swiss health insurance provider. The incidence of vertebral, hip and other fractures was assessed by age and sex, and treatment rates and predictors of anti-osteoporotic therapies at 12 months post-fracture were analysed. Additionally, hospitalisation duration, associated costs and care trajectories (nursing home placement, rehabilitation, home care services) were described for each fracture site, as well as mortality within 12 and 24 months post-fracture.ResultsFrom 2021 to 2023, there were 2458 vertebral, 6229 hip and 11,314 non-hip, non-vertebral fractures (59%, 70% and 74% in women, respectively). Inpatient rehabilitation was required in 8–11% of cases, and 18–21% of patients newly transitioned to nursing home placement within 3 months post-fracture. DXA scans were performed within 12 months in 10% of hip and 21% of vertebral fracture patients and represented the strongest predictor of treatment initiation (odds ratio 10.2, 9.1–11.5), with female sex, older age and greater comorbidity showing weaker effects. Treatment rates within 6 months post-fracture were 11.7% for hip fractures (including 5.0% denosumab, 2.6% zoledronate, 2.1% alendronate), 23% for vertebral fractures (including 9.4% denosumab, 4.7% zoledronate, 3.6% ibandronate, 2.7% anabolic agents) and 12.5% for other fractures, with 8%, 13% and 11% of patients, respectively, already receiving osteoporosis therapy prior to the fracture.ConclusionOsteoporosis treatment rates after hip and vertebral fractures were low, with 88% and 77% of patients, respectively, not receiving treatment within 6 months. DXA scans, specialist consultations and comorbidity burden were the strongest predictors of post-fracture treatment, highlighting key patient- and system-level factors that could guide interventions to close the treatment gap
Integration of contraception provision in emergency obstetric and neonatal care: A scoping review
Get PDFBackground: Emergency obstetric and neonatal care (EmONC) provides a framework to assess the capacity of health systems and mitigate maternal mortality. Given the high unmet need for contraception, integrating contraception provision and EmONC services could improve maternal and newborn health outcomes. Objectives: This scoping review aimed to examine the integration of contraceptive and EmONC services and identify opportunities for future work in this space. Method: A comprehensive search strategy was developed with sexual reproductive health and rights (SRHR) experts and librarians incorporating EmONC and contraceptive‐specific terms. PubMed, EMBASE, CINAHL, Web of Science, and Cochrane Library were searched. Studies published before 2000 or those not in English were excluded. Nine reviewers conducted screening and full text reviews using Covidence with conflicts resolved through biweekly meetings. Data was analyzed descriptively. Results: Of 7105 screened articles, 28 ultimately met inclusion criteria. Most were retrospective or cross‐sectional in design and conducted in hospital settings. Fourteen studies explicitly referenced integration of contraception and EmONC services primarily at the time of emergency cesarean or incomplete abortions. Copper intrauterine devices and permanent sterilization were the most common methods provided. Barriers to integration included cultural stigma, routine deferral to outpatient settings, provider hesitation and gaps in training. Facilitators proposed included staff training, antenatal contraceptive counseling, and improved interprofessional communication. Conclusion: Given the dearth of literature on contraception in conjunction with EmONC services, there is a demonstrated need to standardize integration within EmONC indicators, metrics, and classifications. Strengthening provider training and institutional policies at national and international levels could enhance integration and improve outcomes
On making a success of life: ‘human flourishing’ and healthcare
Get PDFTo talk of ‘human flourishing’ in healthcare is to enter contested space. This article considers rival views of flourishing and their significance for healthcare, compassion and professional practice. It argues that ‘making a success of life’ is ultimately not in our hands and so criticises quasi-Aristotelian interpretations of the Sermon on the Mount that call for an intentional formation and achievement of virtuous character as a condition of flourishing. Close attention is paid to the moral concepts and instruction arising from the Psalms and the beatitudes of Matthew’s gospel. Practical foci cluster around forms of decomposition in civic, economic and biotechnological dimensions of healthcare. These are explored through a reading of the beatitudes, guided by William Tyndale, John Wesley, Martin Luther King Jr and Rebekah Eklund, and against the background of divine providential and eschatological agency. What making a success of life means for healthcare is identified by attention to the poor in spirit (over against covetousness and arrogance), the merciful (in dealing with good and evil), the pure in heart (in discerning the presence of God among healthcare staff and patients), the peacemakers (contending with the violence which permeates society) and those persecuted for righteousness’ sake (such as whistleblowers)
Patient and clinician views on inpatient antibiotic shared decision-making: a qualitative study
Get PDFBackground: Shared decision making (SDM) is a collaborative process between patients and prescribers and identified as a strategy to support antimicrobial stewardship. SDM can improve patient and clinician satisfaction and reduce antibiotic prescribing. However, little is known about how to implement antibiotic SDM in secondary care. Objectives: Identify opportunities for antibiotic SDM between patients and clinicians in secondary care. Methods: Semi-structured interviews were conducted with senior decision makers (registrar or consultant grade) and adult patients who had received antibiotics during their medical or surgical admission, recruited from three secondary care Trusts in England. Interviews explored participants’ views on opportunities for SDM when prescribing antibiotics in secondary care, guided by the ‘Start Smart, Then Focus’ framework. Interviews were audio recorded, transcribed verbatim and analysed thematically. Results: 18 clinicians and 20 patients were interviewed. Two themes were identified. In ‘Pushing back against SDM’, participants challenged the amenability and prioritization of SDM for antibiotics in inpatient settings, related to clinicians being seen as main decision makers, with patients not seeking further involvement. This was reinforced by the perceived urgency of treatment, the fast-paced hospital environment, and the view that antibiotic decisions were either too complex or too straightforward to invite shared input. In ‘If not SDM, then what?’, participants endorsed bi-directional communication and information provision as alternative priorities, highlighting its value. Conclusions: SDM was not well understood or endorsed for antibiotic prescribing decision making in secondary care. Further work is warranted to educate and upskill clinicians in SDM as a concept within secondary care
Regularizing fairness in optimal policy learning with distributional targets
Get PDFA decision maker typically (i) incorporates training data to learn about the relative effectiveness of treatments, and (ii) chooses an implementation mechanism that implies an “optimal” predicted outcome distribution according to some target functional. Nevertheless, a fairness-aware decision maker may not be satisfied achieving said optimality at the cost of being “unfair” against a subgroup of the population, in the sense that the outcome distribution in that subgroup deviates too strongly from the overall optimal outcome distribution. We study a framework that allows the decision maker to regularize such deviations, while allowing for a wide range of target functionals and fairness measures to be employed. We establish regret and consistency guarantees for empirical success policies with (possibly) data-driven preference parameters, and provide numerical results. Furthermore, we briefly illustrate the methods in two empirical settings
An American mosque and the migrating imam: The Shi‘i revival between Lebanon, Iraq, and the USA
Get PDFThis article reconstructs the religious and political activities of the Lebanese Shi‘i scholar Mohamad Jawad Chirri, who founded the first purpose-built Shi‘i mosque in the United States in 1963. It uses Chirri’s biography to explain the institutional, ideological, and political concerns structuring the global Shi‘i revival of the mid-twentieth century, as well as the strategies adopted by Islamic revivalist figures to achieve their institutional ambitions in a competitive and increasingly globalized religious marketplace. A hypermobile activist who lived and travelled between southern Lebanon, southern Iraq, Michigan, and West Africa, Chirri’s institutional initiatives and public activism took place outside the purview of the centres of Shi‘i religious authority in southern Iraq and Iran. The article argues that Chirri’s work, thought, and legacy complicate diffusionist understandings of Islamic revivalist activity as an ideologically coherent project of politicization or radicalization in the years surrounding the 1979 Islamic Revolution in Iran. The ‘global’ Shi‘i revival should instead be understood as an entanglement of institutional projects linked by transnational familial, professional, and financial networks emerging in the 1950s
Nanodiamond Regulated Electrolyte Enhances Thermal, Chemical and Structural Properties for Highly Reversible Zn Metal Anodes
Get PDFAqueous zinc‐ion batteries (AZIBs) suffer from inevitable internal resistance‐induced heat generation and competing hydrogen evolution, leading to high external cooling energy consumption and potential safety hazards. In this report, an electrolyte engineering strategy is proposed, involving nanodiamond (ND) additives to the commercial electrolyte. The ND particles assist in the reconstruction of the hydrogen bond network, reducing the desolvation energy of Zn2+, promoting the preferential deposition of (002) oriented Zn crystals, and effectively inhibiting water decomposition, Zn dendrite growth and heat‐induced side reactions. Importantly, compared to commercial counterparts, ND‐related electrolytes show relatively low impedance and high specific heat capacity (thermal conductivity), resulting in much reduced heat evolution and temperature rise. Such improvements are due to the key properties of nanodiamond, including its large specific surface area, abundant surface functional groups, and exceptional thermal conductivity. These collective enhancements not only minimize thermal and chemical side reactions but also reduce the internal pressure build‐up, as evidenced by only a 26% volume‐change in ND‐based pouch batteries, compared to a 76% rise with commercial electrolytes. Consequently, both coin cells and pouch batteries with the ND‐modified electrolyte exhibit much improved long‐term cyclability, specific capacity, rate capacity and coulombic efficiency, compared to those without NDs
From sequence to function: bridging single-molecule kinetics and molecular diversity
Get PDFBiological function is fundamentally determined by nucleic acid and protein sequence. Beyond encoding genetic information, nucleic acids also display complex physicochemical parameters that shape structure, dynamics, and interactions. Understanding how sequence variation sculpts the energetic landscapes underlying these properties requires methods that capture both molecular diversity and dynamic behavior. Single-molecule techniques are ideally suited to this task, but conventional formats remain time and cost intensive. Recent breakthroughs have enabled highly multiplexed approaches for observing molecular dynamics across millions of individual molecules representing thousands of sequences or barcoded entities. Though still in development, these methods have begun to bridge sequence, structure, dynamics, and function at scale, opening new opportunities in drug discovery, molecular diagnostics, and functional genomics
Interplay of age and sex with clinic and ambulatory blood pressure and mortality
Get PDFBACKGROUND: To explore associations of clinic and 24-hour ambulatory blood pressure monitoring (ABPM) with cardiovascular death (CVD), parameters were modeled for age and sex in this large cohort in primary care.METHODS: In the Spanish ABPM Registry 59.124 patients had complete data on mortality, age, sex and all ABPM. Office, mean, 24-hour, daytime and nighttime systolic (SBP), diastolic blood pressure (DBP) and pulse pressure (PP) were related to CVD according to age and sex and were modelled with restricted cubic splines to get trajectories. During a median of 9.7 years, 2361 patients had CVD (1229 males, 1132 females).RESULTS: Non-linear relationships for office, 24-hour mean, daytime and nighttime SBP, DBP and PP (p<0.0001 for all) for both sexes were observed. Until 75 years, SBP was higher in males than females but differences were minimized after approximately 60-70 years (p for interaction <0.0001). High SBP and PP associated with CVD without heterogeneity between sexes and across ageing. The increase and level of SBP and PP was higher at a higher age in females than males (p for interaction <0.0001). CVD was age-dependent and ABPM, in particular nighttime BP did more closely associate with risk than office BP in younger than in older individuals.CONCLUSIONS: 24-hour mean, nighttime blood pressure and PP were closely associated with risk being stronger in elderly females than males after 75 years corresponding to a rise in BP in older females. Guidelines should continue to mandate evaluation 24-hour ABPM data for risk prediction