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MMS Analysis of a Dayside Compressed Magnetospheric Separatrix in the Presence of Cold Ions and a Moderate Guide Field
No full textThis study reports on a dayside magnetic reconnection event with a moderate guide field (0.4 times the reconnecting magnetic field) detected by the Magnetospheric Multiscale (MMS) mission. The spacecraft traversed the compressed magnetospheric separatrix, observing cold ions with densities up to 10 cm(-3) and a large magnetosheath density up to 150 cm(-3). We provide a detailed analysis of current densities, generalized Ohm's law, and energy conversion processes in both the spacecraft (J.E) and the fluid (J.E') frames during the separatrix crossing. The normal electric field is directed away from the separatrix due to the cold ion drift on the magnetosphere side and to the magnetosheath ion drift in the presence of a guide field in the exhaust region. In the spacecraft frame, energy transfers from the plasma to the fields (J.E approximate to J(perpendicular to).E-perpendicular to<0) due to the convective field associated with the earthward motion of the magnetopause and the ion diamagnetic current associated with the large density gradient. In the fluid frame, energy conversion reverses due to the magnetic field-aligned current density and electric field produced by the divergence of the electron pressure tensor (J.E'approximate to J(parallel to).E-parallel to'). Additionally, we give insights into the local changes in electromagnetic, bulk flow, and thermal energies. We show that flow and thermal energy variations of the plasma are mostly driven by the compressible term of the electron pressure strain at the separatrix
Optimizing Healthcare Payments : Regulation, Payment Schemes and Value-Adjustment
No full textEssay I:First-Degree Price Discrimination achieves efficiency in monopoly settings by having the producer appropriate the total surplus, while uniform pricing leads to higher consumer surplus but is inefficient. The market for multi-indication drugs – those that have multiple uses – has two features that distinguish it from a static monopoly model. Firstly, the monopoly is time-bound and is followed by a competitive market. Secondly, manufacturers have private information about which groups of patients their drug could be useful for and must incur a cost to reveal each one. I extend Bergemann et. al (2015) to this setting to develop a mechanism which maximises consumer surplus and achieves weakly higher efficiency than First-Degree Price Discrimination (which can be inefficient as the monopolist does not internalise the long-term benefit). By conditioning market segmentation on the manufacturer's revealed information, a regulator can incentivise it to conduct costly trials for the most socially beneficial uses of their drugs and maximise achievable total and consumer surplus. Ex-post, First-Degree Price Discrimination may appear as a specific case as a result of the segmentation - as such, I reveal conditions under which First-Degree Price Discrimination may be efficient. I also provide solutions for achieving market segmentation that minimizes variance in prices or individual consumer surplus while still achieving the primary aims of maximising achievable surplus. In doing so I make the case for regulators to use market segmentation as a tool to provide incentives for manufacturers. Essay II: Advanced Therapy Medicinal Products (ATMPs) are novel, expensive, one-time treatments that have the potential to cure certain medical conditions, but their long-term effectiveness carries inherent risk. Risk-sharing agreements (RSAs) have been proposed as a means to mitigate the negative impacts of this uncertainty. However, traditional models of RSAs often fail to account for the irreversibility of ATMPs and their long-term implications for payers’ budgets and future decision-making, as well as the fact that payers and manufacturer interact repeatedly. In this paper, I develop a model in which a payer and a manufacturer engage in an infinitely repeated stochastic game. Patients arrive following an overlapping-generations framework, and the price of treatment is negotiated based on the state of the budget and population health. Effective ATMPs free up resources in the budget for future incoming patients and increase demand. The outcomes of this game are analysed under two distinct payment structures: one where payments are made upfront for each patient and another where payments are contingent on the continued effectiveness of the ATMP. Results show that when the health benefits of the ATMP are comparable to those of an outside option, the RSA improves efficiency. However, when the health benefits of the ATMP are significantly higher, the efficiency of upfront payment can improve. Essay III: (with Erik Grönqvist, Per Johansson and August Wadell Leimdörfer)How should limited resources for health care be prioritized? Health economic evaluation can inform decision makers if new medical treatments are good value for money. The standard cost-effectiveness framework maximizes QALY gains without considering the distribution of these gains across individuals or groups. However, the way health is produced matters for most people. With general preferences for equity in society, also disease severity would matter for welfare when prioritizing. With public preferences over both disease severity and cost-effectiveness, and policymakers need to balance equity with efficiency. We provide evidence for how the public trades disease severity for cost-effectiveness from a novel striped-down discrete choice experiment, and we also provide a method for adjusting the ICER threshold to account for disease severity
Lesbian, Gay, Bisexual, Transgender and Queer People's Experiences of Stigma Across the Spectrum of Inpatient Psychiatric Care : A Systematic Review
No full textLesbian, gay, bisexual, transgender, queer and other diverse sexual orientations and gender identity groups (LGBTQ+) face high rates of poor mental health. In the most severe and emergent of instances, inpatient psychiatric care may be required. LGBTQ+ people report experiences of mistreatment in healthcare settings broadly, such as denial of healthcare services and harassment from healthcare providers and other patients. However, little is known about the experiences of LGBTQ+ people in inpatient psychiatric care settings, specifically. The purpose of this review was to assess the existing literature for descriptions of LGBTQ+ people's experiences within inpatient psychiatric care. We searched multiple databases (i.e., PubMed, PsychINFO, CINAHL, Web of Science and Google Scholar) for peer-reviewed articles that described the experiences of LGBTQ+ people within inpatient psychiatric care that were published in English. The included articles (N = 14) were analysed using a conceptual model of stigma and organised within those strata (structural, interpersonal and individual stigma) across the inpatient experience, (admission, inpatient unit, and discharge). Themes identified included: noninclusive intake tools and pervasive misgendering during the admission process; lack of healthcare infrastructure, inadequate training and lack of cultural humility, pervasive discrimination and victimization, silencing of LGBTQ+ patients, and feelings of fear and shame while on inpatient units, and lack of community resources during the discharge process. Clinicians should consider the perspectives and experiences of LGBTQ+ people to enact identity-affirming care practices that may increase mental healthcare engagement and improve long-term mental health outcomes
To Hop or Not to Hop – Unveiling Different Modes of Ion Transport in Solid Polymer Electrolytes Through Molecular Dynamics Simulations
No full textIn this work, a quantitative method is developed to estimate different ion transport mechanisms in solid polymer electrolyte (SPE) systems. The well-explored poly(ethylene oxide) (PEO) is studied along with the poly(ɛ-caprolactone) (PCL) at different molecular weights and LiTFSI salt concentrations. By tracking the cation coordination changes, three transport mechanisms are categorized, i.e., ion hopping, continuous motion (successive change of the coordination sphere), and vehicular transport. The observed dominant transport mechanism is the continuous motion, and changes from polymer-mediated to anion-mediated with increasing salt concentration. Furthermore, a higher influence of polymer-mediated vehicular transport is observed in PCL systems than in PEO systems, and a correlation is found between the anion-mediated continuous motion and the cation transference number, irrespective of polymer and salt concentrations. In both systems, ion hopping is essentially absent, as can be expected in systems with strong ion–polymer interactions. The results illustrate both how the usual description of ion transport in polymer electrolytes as coupled to segmental motions is too simplistic to catch the full essence of the ion transport phenomena, whereas the frequently used notion of “ion hopping” in the majority of cases is incorrect for SPEs.
Geological carbon storage site characterization using a dual element seismic recording technology
No full textGeologic carbon storage in saline acquirers is a feasible and scalable way of reducing atmospheric carbon dioxide (CO2). Since 2022, Denmark has stepped up site characterization at five suitable onshore locations for this purpose with a particular focus on four-way domal structures. A dual-element recording system incorporating landstreamer and wireless recorders was innovated and upscaled in a cost- and time-effective way for this purpose at the R & oslash;dby structure (one of the five sites). The dual-element recording allows a better imaging of the near-surface structures but also because of its broadband nature, it helps to retain higher resolution for imaging toplap structures and smaller faults in the area. The landstreamer data better image fault structures offsetting the Bunter Sandstone Formation, which is the primary reservoir, and the overlying geological seals such as Fjerritslev, & Oslash;rslev and Falster Formations. The Vedsted Formation, which a secondary seal in the region, appears unfaulted in the landstreamer data. The landstreamer data also reveal glacial valleys, near the surface, which are a source of groundwater. The two complementary datasets, from the landstreamer and nodal data, help to de-risk geological carbon storage in Denmark and is a solution we recommend to be adapted for onshore sites elsewhere in the world specially where the logistical acquisition challenges are not significant
Co-nationals under construction : Poland’s diaspora policy 1989–2023
No full textStates’ interest in ‘their’ diasporas – broadly referring to co-nationals residing abroad – has become a rapidly proliferating phenomenon, and diaspora policy programmes are now prevalent in countries worldwide. This includes countries that do not require diasporas for state-building purposes, which is puzzling in relation to earlier explanations for the spread of state-led diaspora engagement. A further issue that warrants more attention is the problematisation of ‘the diaspora’ in state policy, as previous research has often treated it as a neutral, given demographic entity, rather than as a political categorisation of people abroad. Focusing on Poland as a paradigmatic case of diaspora policymaking, this dissertation addresses two research questions, explored in two respective parts. The first part concerns how nation-states construct and alter diaspora target groups and their policy treatment – a question arising from the need to ‘disaggregate the diaspora’, as identified in previous literature. It begins with the development of a diaspora policy design framework to investigate policies from the perspective of their target groups, arguing that differences in benefit deservingness can be understood as an interaction between the groups’ respective resources and constructions of their belonging. The framework’s usefulness is then demonstrated through an analysis of Polish diaspora policy, based on rich material spanning a thirty-year period during which diaspora policy saw steady growth and increasing sophistication. As the findings show, Polish diaspora policy has consistently relied on divergent perceptions of co-nationals abroad, initially divided into two main groups – one in ‘the West’ and one in ‘the East’ – and later incorporating the ‘labour diaspora’. These groups have been assigned divergent, and evolving, benefits and obligations. Furthermore, the policy discourse has continuously centred on evoking national sentiments, partly to encourage diasporic homeland return. The second part of the dissertation therefore investigates how nation-states can forge national attachments among diasporas abroad. The focus is on education – a central tool for building national identity – and the analysis examines a set of Polish textbooks developed for diaspora pupils in different parts of the world, through a novel approach that builds on Herder’s (1833) model of national unification. The analysis reveals certain regional tailoring, though also a concomitant and coherent reproduction of nationalist narratives, constructing the homeland as an enchanted place to which the diaspora should feel a special connection. Taken together, this dissertation sheds new light on how diasporas are made, both as objects of policy and as homeland-oriented subjects.
Using machine learning involving diagnoses and medications as a risk prediction tool for post-acute sequelae of COVID-19 (PASC) in primary care
No full textBackground: The aim of our study was to determine whether the application of machine learning could predict PASC by using diagnoses from primary care and prescribed medication 1 year prior to PASC diagnosis. Methods: This population-based case-control study included subjects aged 18-65 years from Sweden. Stochastic gradient boosting was used to develop a predictive model using diagnoses received in primary care, hospitalization due to acute COVID- 19, and prescribed medication. The variables with normalized relative influence (NRI) ≥ 1% showed were considered predictive. Odds ratios of marginal effects (ORME) were calculated. Results: The study included 47,568 PASC cases and controls. More females (n = 5113) than males (n = 2815) were diagnosed with PASC. Key predictive factors identified in both sexes included prior hospitalization due to acute COVID- 19 (NRI 16.1%, ORME 18.8 for females; NRI 41.7%, ORME 31.6 for males), malaise and fatigue (NRI 14.5%, ORME 4.6 for females; NRI 11.5%, ORME 7.9 for males), and post-viral and related fatigue syndromes (NRI 10.1%, ORME 21.1 for females; NRI 6.4%, ORME 28.4 for males). Conclusions: Machine learning can predict PASC based on previous diagnoses and medications. Use of this AI method could support diagnostics of PASC in primary care and provide insight into PASC etiology
Femtosecond charge and spin dynamics in a Co50Pt50 alloy
No full textThe use of advanced x-ray sources plays a key role in the study of dynamic processes in magnetically ordered materials. The progress in x-ray free-electron lasers enables the direct and simultaneous observation of the femtosecond evolution of electron and spin systems through transient x-ray absorption spectroscopy and x-ray magnetic circular dichroism, respectively. Such experiments allow us to resolve the response seen in the population of the spin-split valence states upon optical excitation. Here, we utilize circularly polarized ultrashort soft x-ray pulses from the new helical afterburner undulator at the free-electron laser FLASH in Hamburg to study the femtosecond dynamics of a laser-excited CoPt alloy at the Co L3-edge absorption. Despite employing a weaker electronic excitation level, we find a comparable demagnetization for the Co 3d-states in CoPt compared to previous measurements on CoPd. This is attributed to the distinctly different spin–orbit coupling between 3d and 4d vs 3d and 5d elements in the corresponding alloys and multilayers
Blockchain Narratives : Cyber-Romanticism and the Digital Enlightenment
No full textThere is a growing recognition that the stories surrounding technology; so called ‘narratives’, have a strong influence on our inception of reality, for example, on how societies imagine the future, or how organisations position themselves in relation to technological change. Technologies do not simply emerge and diffuse, claims the narrative literature, but are made meaningful through stories, symbols, and contested ideas about what they are, have been, or could become. While blockchain is often described in technical terms through promises of its disruptive potential, less attention has been paid to the stories themselves; how they shape its technological trajectory, and how stories about blockchain’s capabilities orient and guide our thinking in certain contexts. Current literature tends to treat blockchain either as a neutral infrastructure or as a disruptive force within established paradigms, with much of it positioning blockchain uncritically as a utopian solution to contemporary challenges. Consequently, this thesis aims to explore how different narratives shape the way blockchain is understood, and how these narratives reciprocally shape our experiences with this amorphous technology. Drawing on the philosophy of technology, sociomateriality, and narrative theories, a qualitative, interpretive methodology is used to conceptualise and explore the implications of two dominant narratives; that of Cyber-Romanticism, and the Digital Enlightenment. As critical lenses, these narratives are subsequently applied to the papers that are included within this thesis, in order to help understand the implications of blockchain use across the dimensions of Autonomy of Money, Corruption, Sustainability, and Digital Asset Ownership. Findings suggest that blockchain is not one technology, but many competing visions wrapped into a single term. Rather than settling into a stable trajectory, it remains a site of ongoing negotiation and meaning-making, with important implications for how technological change is understood; not as a linear process driven solely by technical features or market forces, but as a contested and imaginative social practice. Consequently, this thesis contributes to a deeper understanding of how emerging technologies such as blockchain are indirectly narrated into being, and it invites scholars and practitioners alike to reflect on the power of stories, not only to describe the, past, present, and future, but also to actively shape it
Fibromyalgia patients have altered lipid concentrations associated with disease symptom severity and anti-satellite glial cell IgG antibodies
No full textAutoimmunity and immunoglobulin G (IgG) autoantibodies may contribute to pain in a subset of fibromyalgia (FM) patients. Previously, IgG from FM patients was found to induce pain-like behavior in mice and bind to satellite glial cells (anti-SGC IgG). The anti-SGC IgG levels were also associated with more severe symptomatology. Lipid metabolism in FM subjects is altered with lysophosphatidylcholines (LPCs) acting as pain mediators. The relationship between autoantibodies, lipid metabolism, and FM symptomatology remains unclear. Serum lipidomics with liquid chromatography mass spectrometry, anti-SGC IgG levels, and clinical measures were examined in 35 female FM subjects and 33 age- and body mass index-balanced healthy controls (HC). Fibromyalgia subjects with higher anti-SGC IgG levels experienced more intense pain than those with lower levels. Sixty-three lipids were significantly altered between FM subjects and HC or between FM subjects with severe (FM severe) and mild symptoms (FM mild). Compared to HC, FM subjects had lower concentrations of lipid species belonging to the classes LPC (n = 10), lysophosphatidylethanolamine (n = 7), phosphatidylcholine (n = 4), and triglyceride (n = 5), but higher concentrations of diglyceride (n = 3). Additionally, FM severe had higher LPC 19:0, 22:0, and 24:1 and lower sphingomyelin (n = 9) concentrations compared to FM mild. Positive associations were seen for LPC 22:0 and 24:1 with pain intensity and anti-SGC IgG levels in FM subjects. Taken together, these results suggest an association between altered lipid metabolism and autoimmune mechanisms in FM