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Review of: Terence Dooley, Burning the Big House: the story of the Irish country house in a time of war and revolution (New Haven and London: Yale University Press, 2022, xiv + 352 p., index)

Background/Aims Haemophagocytic lymphohistiocytosis (HLH) is a devastating condition caused by uncontrolled activation of the immune system. If left untreated, the condition leads to multi-organ failure and death. Even with treatment, recent UK data has shown a mortality rate of 50%. In 2019, a group of clinicians from University College London Hospital (UCLH) came together with the aim of improving outcomes for patients with HLH. The UCLH HLH multi-disciplinary meeting (MDM) has been running since that time and includes representation from rheumatology, haematology, infectious diseases, tropical medicine, virology, neurology, and critical care. Clinicians from any UK trust are invited to join and present patients. As part of a service evaluation project, we aimed to assess the scope of this meeting with regards to the number, demographics and primary diagnoses of patients discussed and the geographical location of the referring clinical team. Methods This is a retrospective descriptive analysis of all patients discussed at the UCLH HLH MDT from 2nd September 2020 to 20th July 2022. Data were obtained from electronic health records and analysed in Prism version 9.4.1. This work has been registered as a service evaluation project within the Division of Medical Specialities at UCLH. Results 93 patients were discussed. 38 were female. 55 were male. The median age was 38 years. Triggers for HLH were haematological malignancy (38.0%), infection (29.3%) rheumatological (14.1%) primary HLH (6.5%) and unknown (7.6%). In 4 patients, HLH was not felt to be the underlying diagnosis. 40 patients were managed as inpatients at UCLH, 37 of whom were transferred from other trusts. Geographical data were obtained on 81 patients. Patients were referred from all 9 regions of England: London (34), North East (1), North West (2), Yorkshire (2), East Midlands (1), West Midlands (3) South East (11), East of England (11), South West (11) as well as Wales (2), Scotland (2) and Ireland (1). Haemophagocytosis was confirmed on bone marrow biopsy in 66.7% of patients. Mortality data showed that 32 (34%) patients died following their diagnosis. Conclusion A multi-disciplinary approach is essential in the management of HLH. Our data show that patients with HLH are young, have a high mortality and broad range of pathology. The UCLH HLH MDT currently serves a wide geographical area across the UK and UCLH acts as a tertiary referral centre for patients with the condition. Disclosure N.S. Shah: None. M. Hutchinson: None. S. Clark: None. E. Sanchez: None. M. Brown: None. N. Stone: None. A.S. Carr: None. B. Carpenter: None. A. Laurence: None. S.H. Gohil: None. R.S. Tattersall: None. J.J. Manson: None. A. Jones: None.

Purpose To estimate the prevalence of current and past COVID-19 in Ohio adults. Methods We used stratified, probability-proportionate-to-size cluster sampling. During July 2020, we enrolled 727 randomly-sampled adult English- and Spanish-speaking participants through a household survey. Participants provided nasopharyngeal swabs and blood samples to detect current and past COVID-19. We used Bayesian latent class models with multilevel regression and poststratification to calculate the adjusted prevalence of current and past COVID-19. We accounted for the potential effects of non-ignorable non-response bias. Results The estimated statewide prevalence of current COVID-19 was 0.9% (95% credible interval: 0.1%-2.0%), corresponding to ∼85,000 prevalent infections (95% credible interval: 6,300-177,000) in Ohio adults during the study period. The estimated statewide prevalence of past COVID-19 was 1.3% (95% credible interval: 0.2%-2.7%), corresponding to ∼118,000 Ohio adults (95% credible interval: 22,000-240,000). Estimates did not change meaningfully due to non-response bias. Conclusions Total COVID-19 cases in Ohio in July 2020 were approximately 3.5 times as high as diagnosed cases. The lack of broad COVID-19 screening in the United States early in the pandemic resulted in a paucity of population-representative prevalence data, limiting the ability to measure the effects of statewide control efforts.

Review of Sarah Goldsmith, Masculinity and danger on the eighteenth-century Grand Tour (London: University of London Press, Institute of Historical Research, 2020, xiii + 272 p., index).

A double-walled tetrahedral metal-organic cage assembled in solution from silver(I), 2-formyl-1,8-naphthyridine, halide, and a threefold-symmetric triamine. The AgI4X clusters at its vertices bring together six naphthyridine-imine moieties, leading to a structure in which eight tritopic ligands bridge four clusters in an (AgI4X)4L8 arrangement. Four ligands form an inner set of tetrahedron walls that are surrounded by the outer four. The cage has significant interior volume, and was observed to bind anionic guests. The structure also possesses external binding clefts, located at the edges of the cage, which bound small aromatic guests. Furthermore, the halide ions bound to the silver clusters were observed to exchange in a well-defined hierarchy, thus enabling modulation of the cavity volume. The principles here uncovered may allow for the generation of increasingly more sophisticated cages with silver-cluster vertex architectures, with post-assembly tuning of the interior cavity volume enabling targeted binding behavior.

The metal additive manufacturing (AM) industry is actively developing instruments and strategies to enable higher productivity, optimal build quality, and controllable as-built microstructure. One of the beam controlling techniques, laser oscillation has shown potential in all these aspects in laser welding; however, few attempts have been made to understand the underling physics of the oscillating keyholes/melt pools which are the prerequisites for the these strategies to become a useful tool for laser-based AM processes. To address this gap, we utilized a synchrotron-based X-ray operando technique to image the dynamic keyhole oscillation in Ti-6Al-4V using a miniature laser powder bed fusion setup. We found good agreement between the experimental observations and simulations performed with a validated Lattice Boltzmann multi-physics model. The study revealed the continuous and periodic fluctuations in the characteristic keyhole parameters that are unique to the oscillating laser beam processing and responsible for the chevron pattern formation at solidification. Despite the intrinsic longer-range fluctuation, the oscillating technique displayed potential for reducing keyhole instability, mitigating porosity formation, and altering surface topology. The results provide important insights about the dynamics of the oscillating keyholes which are valuable guidelines for the future development and application of this technique.

Book review

Cancer is one of the leading causes of death worldwide, affecting millions of people every year. While chemotherapy remains one of the most common cancer treatments in the world, the severe side effects of chemotherapy drugs impose serious concerns to cancer patients. In many cases, the chemotherapy can be localized to maximize the drug effects; however, the drug systemic circulation induces undesirable side effects. Here, we have developed a highly efficient cellulose-based nanoadsorbent that can capture more than 6000 mg of doxorubicin (DOX), one of the most widely used chemotherapy drugs, per gram of the adsorbent at physiological conditions. Such drug capture capacity is more than 3200% higher than other nanoadsorbents, such as DNA-based platforms. We show how anionic hairy cellulose nanocrystals, also known as electrosterically stabilized nanocrystalline cellulose (ENCC), bind to positively charged drugs in human serum and capture DOX immediately without imposing any cytotoxicity and hemolytic effects. We elucidate how ENCC provides a remarkable platform for biodetoxification at varying pH, ionic strength, ion type, and protein concentration. The outcome of this research may pave the way for developing the next generation in vitro and in vivo drug capture additives and devices.

In this paper, we study the Convolutional Neural Network (CNN) applications in medical image processing during the battle against Coronavirus Disease 2019 (COVID- 19). Specifically, three CNN implementations are examined: CNN-LSTM, COVID-Net, and DeTraC. These three methods have been shown to offer promising implications for the future of CNN technology in the medical field. This survey explores how these technologies have improved upon their predecessors. Qualitative and quantitative analyses have strongly suggested that these methods perform significantly better than the commensurate technologies. After analyzing these CNN implementations, it is reasonable to conclude that this technology has a place in the future of the medical field, which can be used by professionals to gain insight into new diseases and to help in diagnosing infections using medical imaging.

Maintaining good wellbeing in older age is seen to have a positive effect on health, including cognitive and physiological functioning. This paper explores experiences of wellbeing in a particular older adult community: those who have served in the military. It aims to identify the specific challenges that ex-service personnel may have, reporting findings from a qualitative study focused on how older veterans told stories of military service and what these stories revealed about wellbeing. We used a qualitative approach; data are drawn from 30 individual interviews, and from engagement with veterans in workshops. Analysis was conducted using a data-driven constant comparison approach. Three themes are presented: how loneliness affects older adult veterans; how they draw on fictive kinship; and the role of military visual culture. Although participants had diverse experiences of military service, they felt that being a veteran connected them to a community that went beyond association with specific experiences. Using narratives of military experience to connect, both in telling stories and by stories being listened to, was vital. As veterans, older adults were able to access each other as a resource for listening and sharing. However, it was also exclusionary: civilians, because they lacked military service experience, could not empathise and be used as a resource.

Earth’s field nuclear magnetic resonance (EFNMR) spectroscopy offers students a unique opportunity to consolidate their understanding of NMR spectroscopic theory through hands-on practice with a simple spectrometer. A comprehensive, 6 h experiment is presented for the introduction of low-field NMR techniques, covering spectroscopy, relaxivity, and imaging experiments in the Earth’s magnetic field. This multifaceted practical session explores the concepts of free induction decay, pulse sequences, field homogeneity, relaxation times, J-coupling, and magnetic resonance imaging (MRI), which are reinforced through a series of experiments carried out within an undergraduate teaching laboratory. Students are required to alter parameters as they see fit in order to obtain data, ensuring their understanding of the theory behind NMR spectroscopy. The challenges overcome for the implementation of EFNMR spectroscopy in a modern undergraduate laboratory are also discussed, and detailed instructions are included for spectrometer setup.

Large diameter (&gt, 100 mm) planar Na-&beta, &Prime, Al2O3 solid electrolytes (BASE) with thickness from 1.0 to 1.5 mm have been prepared. Na-&beta, Al2O3 was processed as a slurry and cast to give several meters of tape. One hundred and forty mm diameter discs were punched from the tape, stacked, and laminated with a large hydraulic press. Binder burnout and sintering were performed in 150 mm diameter MgO spinel encapsulations to mitigate the loss of Na2O vapor. Conductivity and flexural strength were measured on smaller Na-&beta, Al2O3 samples produced via the same tape casting process followed by sintering and gave results consistent with BASE materials produced by uniaxial pressing of powders. Planar BASE membranes enable new cell designs, which are predicted to have higher power densities and better stacking efficiency compared to currently manufactured tubular cells.

The availability of new medications has improved exercise capacity, enhanced quality of life, and extended time to clinical worsening in patients with pulmonary arterial hypertension (PAH). For many of these medications, careful individualized dose titration is required to maximize therapeutic effectiveness while minimizing side effects. In addition, specific routes of administration, including intravenous (IV), subcutaneous (SC), and inhaled administration may present additional challenges for patients and healthcare providers. These challenges include the possibility of catheter-related infections (IV), infusion site pain (SC), and adherence to frequent dosing schedules (inhaled). Temporary discontinuations may require re-titration and, in some cases, may even be life threatening. Here, based on our clinical experience, we provide our recommendations for dose titration schemes for PAH medications that require individualized dosing in adult patients, including agents acting on the endothelin-1 pathway (bosentan and ambrisentan), the prostacyclin pathway (epoprostenol, treprostinil, and selexipag), and the nitric oxide pathway (tadalafil and the soluble guanylate cyclase stimulator riociguat). A case study that illustrates the application of best practices for PAH medication dose titration in a real-world setting is presented. Good two-way communication between specialty pharmacies and other healthcare providers promotes optimal medication usage and patient health. Experience has shown that slow, cautious up-titration is generally associated with better long-term outcomes. In all cases, patient education, frequent monitoring and careful management of side effects, and treatment adherence are critical.

Velleman, MacIntyre, and others have argued for the compositional view that lives can be other than equally good for the person who lives them even though they contain all and only the same moments, and that this is explained by their narrative structure. I argue instead for explanation by self-realization, partly by interpreting Siegfried Sassoon’s exemplary life-narrative. I decide between the two explanations by distinguishing the various features of the radial concept of narrative, and showing, for each, either that self-realization is just as good an account, or that we should prefer the self-realization account, of the composition it is supposed to explain. I conclude that, if the shape of a life matters, it matters because some shapes are self-realizations, not because they are narratives.

Introduction Severe COVID-19 disease is associated with a hyperinflammatory, pro-thrombotic state and a high mortality. A thrombotic phenotype rather than a coagulopathy is suggested and we undertook plasma exchange to determine its effects on organ function and thrombo-inflammatory markers. Methods Plasma exchange was carried out in seven critically ill adults with severe COVID-19 respiratory failure (PaO2:FiO2 ratio 800 IU/L and D dimer>1000 µg/L (or doubling from baseline). Patients received a daily single volume 3 litre plasma exchange for a minimum of five days. No other immunomodulatory medications were initiated during this period. Effects on organ function, thrombo-inflammatory markers and complications were monitored. Seven patients matched for age and baseline biochemistry were a comparator group. Results Coagulation screening revealed no evidence of coagulopathy. However, von Willebrand Factor (VWF) activity, antigen and VWF antigen:ADAMTS13 ratio, Factor VIII and D-dimers were all elevated. Following five days of plasma exchange, plasma levels of all the above, and ferritin levels, were significantly reduced (p Conclusion Plasma exchange was associated with an improvement in oxygenation, decreased incidence of AKI, normalisation of lymphocytes and reduction in circulating thrombo-inflammatory markers including D-Dimer and VWF Ag:ADAMTS13 ratio. Disclosures Thomas: Ablynx: Honoraria, Other: Advisory Board; Bayer: Honoraria, Speakers Bureau; Sanofi: Honoraria, Other: Advisory Board. Scully:Takeda: Consultancy, Speakers Bureau; Alexion: Consultancy, Speakers Bureau; Sanofi: Consultancy, Speakers Bureau; Shire/Takeda: Other: Advisory Board, Research Funding, Speakers Bureau; Novartis: Other: Advisory Board, Speakers Bureau; Takeda: Speakers Bureau; Ablynx/Sanofi: Consultancy, Other: Advisory Board, Speakers Bureau.

Autobiography is a distinctive and valuable kind of reasoning towards ethical knowledge. But how can autobiography be ethical reasoning? I distinguish four ways in which autobiography can be merely involved in reasoning: as clue to authorial intentions; as container for conventional reasoning; as historical data; and as thought experiment. I then show how autobiography can itself be reasoning by investigating its generic form. Autobiographies are particular, enabling vivid display of and education in value-suffused perception. They are diachronic, enabling critique by ironic contrast. And they are compositional, enabling sense-making by placing in a temporal structure. But these features don’t distinguish autobiographies from novels. Should we therefore accept a deflationary account of a fourth generic feature of autobiographies, that they are self-reflective? I instead pursue a more ambitious account of self-reflection and the distinctively autobiographical reasoning it enables, involving a realism constraint, a reflexive explanation constraint, and unique address to first-person problems of the self. I conclude with an interpretation of an example work of autobiographical reasoning, Siegfried Sassoon’s Memoirs of George Sherston, against the idea that self-owning is necessary to the good human life.

High temperature Na2O vapor conversion of α-Al2O3 with different concentrations of yttria stabilized zirconia (YSZ) was used to produce Na-β″-Al2O3 solid electrolyte (BASE) materials. The influence of different ratios of yttria (YSZ-3 and YSZ-8) on conversion and material properties (ionic conductivity and flexural strength) was also investigated. Extent of conversion to Na-β″-Al2O3 was calculated by semi-quantitative XRD phase analysis. Al2O3 composites with 20% or less YSZ were incompletely converted to Na-β″-Al2O3 after 2 h at 1450 °C. Al2O3 composites with 30–40% YSZ-3 appear fully converted by XRD but have lower conductivity and higher strength compared to conventionally sintered Na-β″-Al2O3 composites with the same concentration of YSZ-3. SEM of the materials indicated differences in morphology and grain size. XRD of Al2O3 composites with YSZ-8 showed significantly lower conversion than those with YSZ-3. This is attributed to the larger grain size of YSZ-8, which limits the homogeneity of composites with Al2O3 and thus does not assist in oxygen diffusion as well as YSZ-3. Although the vapor converted BASE materials tended to have lower conductivities at 300 °C, they have lower activation energies (0.20 eV) compared to conventionally sintered Na-β″-Al2O3 composites (0.30 eV) and comparatively higher conductivity at ambient temperature. Vapor converted BASE materials also have better mechanical properties, which should allow fabrication of thinner electrodes.

In this article, we propose a new class of priors for Bayesian inference with multiple Gaussian graphical models. We introduce fully Bayesian treatments of two popular procedures, the group graphical lasso and the fused graphical lasso, and extend them to a continuous spike-and-slab framework to allow self-adaptive shrinkage and model selection simultaneously. We develop an EM algorithm that performs fast and dynamic explorations of posterior modes. Our approach selects sparse models efficiently with substantially smaller bias than would be induced by alternative regularization procedures. The performance of the proposed methods are demonstrated through simulation and two real data examples.

Ionic liquid (IL) monomers are receiving increased attention due to their versatile range of application, especially in the electrochemical and electromechanical fields. Within this study, imidazole-based ILs containing a polymerizable methacrylate (MA) group were synthesized to examine their influence on the viscosity and reactivity of typical (meth)acrylates. The IL-MAs were prepared from 1-butylimidazole and bromo methacrylates with different spacer lengths (C2–C6). The best results with respect to physicochemical properties and double bond conversions could be obtained for ILs with C3 and C6 spacers. Bulk polymerizations exhibited unusually high reactivity and double-bond conversion compared with typical mono-methacrylates. Addition of 10 wt% IL-MA to reactive diluents like hexane-1,6-diol diacrylate caused only minor reduction in reaction rate but increased final double bond conversion compared with the pure diacrylate.

Additive manufacturing (AM) alias 3D printing translates computer-aided design (CAD) virtual 3D models into physical objects. By digital slicing of CAD, 3D scan, or tomography data, AM builds objects layer by layer without the need for molds or machining. AM enables decentralized fabrication of customized objects on demand by exploiting digital information storage and retrieval via the Internet. The ongoing transition from rapid prototyping to rapid manufacturing prompts new challenges for mechanical engineers and materials scientists alike. Because polymers are by far the most utilized class of materials for AM, this Review focuses on polymer processing and the development of polymers and advanced polymer systems specifically for AM. AM techniques covered include vat photopolymerization (stereolithography), powder bed fusion (SLS), material and binder jetting (inkjet and aerosol 3D printing), sheet lamination (LOM), extrusion (FDM, 3D dispensing, 3D fiber deposition, and 3D plotting), and 3D bioprinting. The range of polymers used in AM encompasses thermoplastics, thermosets, elastomers, hydrogels, functional polymers, polymer blends, composites, and biological systems. Aspects of polymer design, additives, and processing parameters as they relate to enhancing build speed and improving accuracy, functionality, surface finish, stability, mechanical properties, and porosity are addressed. Selected applications demonstrate how polymer-based AM is being exploited in lightweight engineering, architecture, food processing, optics, energy technology, dentistry, drug delivery, and personalized medicine. Unparalleled by metals and ceramics, polymer-based AM plays a key role in the emerging AM of advanced multifunctional and multimaterial systems including living biological systems as well as life-like synthetic systems.

Anarchists are commonly assumed to hold deeply optimistic views about human nature, and to be nostalgic for ‘primitive’ (as opposed to ‘civilised’) societies. I shall argue here not only that these assumptions are false but also that it is worthwhile revealing them as such, both as a means of recovering some interesting thought from misrepresentation, and because a more precise account of primitivism is useful in other contexts.

Background Stunting is prevalent by the age of 6 months in the indigenous population of the Western Highlands of Guatemala. Aim The objective of this study was to determine the time course and predictors of linear growth failure and weight-for-age in early infancy. Study design and subjects One hundred and forty eight term newborns had measurements of length and weight in their homes, repeated at 3 and 6 months. Maternal measurements were also obtained. Results Mean ± SD length-for-age Z-score (LAZ) declined from newborn − 1.0 ± 1.01 to − 2.20 ± 1.05 and − 2.26 ± 1.01 at 3 and 6 months respectively. Stunting rates for newborn, 3 and 6 months were 47%, 53% and 56% respectively. A multiple regression model (R 2 = 0.64) demonstrated that the major predictor of LAZ at 3 months was newborn LAZ with the other predictors being newborn weight-for-age Z-score (WAZ), gender and maternal education ∗ maternal age interaction. Because WAZ remained essentially constant and LAZ declined during the same period, weight-for-length Z-score (WLZ) increased from − 0.44 to + 1.28 from birth to 3 months. The more severe the linear growth failure, the greater WAZ was in proportion to the LAZ. Conclusion The primary conclusion is that impaired fetal linear growth is the major predictor of early infant linear growth failure indicating that prevention needs to start with maternal interventions.

What does David Hume do with the dialogue form in Dialogues Concerning Natural Religion? I pursue this question in the context of a partial taxonomy of uses for dialogue in philosophy in general, and distinguish uses out of playfulness; for self-concealment; to tame opponents; for self-effacement; for causal operation; for self-discovery; and for dramatising a political ideal. I argue for Hume’s use of the last two, and investigate the expressions of selfhood and politics which these uses reveal in Dialogues Concerning Natural Religion: the self is multiple; sociable pleasure in company is more important than winning arguments or gaining knowledge. These performative readings of Dialogues reveal Hume as aiming to transform our individual and collective self-understanding and action, and propose a more political engagement with his thought generally.

This thesis focuses on subnational corruption law enforcement in a new democracy: Indonesia. It seeks to understand temporal and spatial variation in corruption prosecutions in the post-Suharto era, and answer three core research questions: Why has the number of corruption cases steadily increased over the past twenty years? Why is there significant subnational variation in the investigation and prosecution of corruption? And why are some cases of local corruption investigated and prosecuted while others are ignored? The argument developed in the thesis consists of three inter-linked components: that corruption generates complex collective action problems for law enforcement; that ostensibly public law enforcement regimes in Indonesia are informally privatised public law enforcement regimes; and that, in the context of these hybrid regimes, the availability of resources and the formation of coalitions is critical to understanding when individuals and groups mobilise corruption laws at the subnational level. The project uses a mixed methods research strategy—combining qualitative case studies, formal game theoretic modelling, and quantitative regression analysis—to develop and provide evidence for the argument. The research strategy required twelve months of fieldwork in Indonesia. In total over one hundred interviews in Jakarta and Central Java were conducted, and a unique dataset of local corruption cases was coded for two additional provinces. The thesis's argument and methodological approach has implications for literature that spans the field of law and politics: the political economy of prosecution, theories of legal mobilisation, socio-legal studies, and studies of politics and power in contemporary Indonesia.

This paper addresses questions of friendship and political community by investigating a particular complex case, comradeship in the life of the soldier. Close attention to soldiers’ accounts of their own lives, successes and failures shows that the relationship of friendship to comradeship, and of both to the success of the soldier’s individual and communal life, is complex and tense. I focus on autobiographical accounts of basic training in order to describe, and to explore the tensions between, two positions: (1) Becoming a soldier is a corrupting loss of individuality and moral sensitivity, and friendship is resistance to it. (2) Becoming a soldier is one form of flourishing, and comradeship—the soldier’s distinctive form of friendship—is one of its constitutive virtues. I draw particularly on George Orwell’s account of basic training and fighting in the Spanish Civil War, and on Tim O’Brien’s account of basic training and fighting in Vietnam.