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Whether they know it or not, many views of Chinese legal history continue to rely on the idea that Chinese law became thoroughly Confucian thousands of years ago and has since resisted all efforts to adjust that underlying philosophy. This “Confucianization” hypothesis represents a consequential misunderstanding: in the US, it adds fuel both to increasingly dangerous Sino-American hostilities and anti-Asian violence, while in China it underpins the government’s ethno-nationalist expansionism in Tibet, Xinjiang, and Hong Kong. This dissertation begins by examining the historical roots and some of the present-day effects of this view.A key assertion of the Confucianization hypothesis is that Chinese law was never significantly influenced by any of the “non-Chinese” groups who governed the territory administered today by the People’s Republic of China. In fact, supporters of this idea claim, Chinese culture in general and law in particular was so attractive to these outside groups that they adopted it almost wholesale. A prime example offered as evidence of this picture of largely untroubled cultural homogeneity is the Northern Wei 北魏 (386-535), a dynasty founded by a formerly nomadic group which conquered and then ruled China for a century and a half. In a speech several years ago, Chinese President Xi Jinping 習近平 singled out the Northern Wei and its adoption of Chinese practices as proof of the unique power and worth of Chinese culture.I challenge such claims by examining two major texts relating to Northern Wei law: the administrative and legal treatises in the History of Wei 魏書, a government-sponsored history written in the sixth century by Wei Shou 魏收 (506-572). Many of the most reductionist views of Chinese legal history draw on these texts, while many of the scholars focusing on the ethnic and cultural complexity of Northern Wei (contra the Confucianization hypothesis) have turned away from the History of Wei, leaving it primarily to those with the most polemical ends. I argue that these texts actually reflect a diversity of theory and practice far beyond what is generally recognized, and that the origins of important features of imperial Chinese law and administration can be found in the synthesis of approaches these treatises record. By focusing on that diversity, this dissertation hopes to revive interest in works that offer the potential to further complicate some of the simplistic but still-influential attitudes to both the Northern Wei and to Chinese history as a whole.

Most studies of crime reporting examine decisions to report to the police in community settings. While informative, this focus leaves a gap in identifying the correlates of official reporting behaviors among incarcerated individuals. This is noteworthy considering the passage of the Prison Rape Elimination Act mandating states collect and report data on sexual assaults in confinement facilities. To address these concerns, this study provides one of the first multivariable examinations of decisions to officially report sexual assaults to correctional staff. This study also examines the correlates of official reporting across perpetrator type (another incarcerated individual or correctional staff member) and the correlates for not reporting a sexual assault (embarrassment, fear of reprisal, and belief no investigation will take place). The findings indicate most sexual assaults are not reported, and few in-prison experiences or incident characteristics explain the decision to officially report or the reasons for not reporting.

Communication is a fundamental step in the process of political representation, and an influential stream of research hypothesizes that male and female politicians talk to their constituents in very different ways. To build the broad dataset necessary for this analysis, we harness the massive trove of communication by American politicians through Twitter. We adopt a supervised learning approach that begins with the hand coding of over 10,000 tweets and then use these to train machine learning algorithms to categorize the full corpus of over three million tweets sent by the lower house state legislators who were serving in the summer of 2017. Our results provide insights into politicians’ behavior and the consequence of women’s underrepresentation on what voters learn about legislative activity.

Innovative solutions are needed for the treatment of bacterial infections, and a range of antibacterial molecules have been explored as alternatives to antibiotics. A different approach is to investigate the immune system of the host for new ways of making the antibacterial defence more efficient. However, the immune system has a dual role as protector and cause of disease: in addition to being protective, increasing evidence shows that innate immune responses can become excessive and cause acute symptoms and tissue pathology during infection. This role of innate immunity in disease suggests that the immune system should be targeted therapeutically, to inhibit over-reactivity. The ultimate goal is to develop therapies that selectively attenuate destructive immune response cascades, while augmenting the protective antimicrobial defence but such treatment options have remained underexplored, owing to the molecular proximity of the protective and destructive effects of the immune response. The concept of innate immunomodulation therapy has been developed successfully in urinary tract infections, based on detailed studies of innate immune activation and disease pathogenesis. Effective, disease-specific, immunomodulatory strategies have been developed by targeting specific immune response regulators including key transcription factors. In acute pyelonephritis, targeting interferon regulatory factor 7 using small interfering RNA or treatment with antimicrobial peptide cathelicidin was protective and, in acute cystitis, targeting overactive effector molecules such as IL-1β, MMP7, COX2, cAMP and the pain-sensing receptor NK1R has been successful in vivo. Furthermore, other UTI treatment strategies, such as inhibiting bacterial adhesion and vaccination, have also shown promise.

Background The safety, effectiveness, and cost-effectiveness of molnupiravir, an oral antiviral medication for SARS-CoV-2, has not been established in vaccinated patients in the community at increased risk of morbidity and mortality from COVID-19. We aimed to establish whether the addition of molnupiravir to usual care reduced hospital admissions and deaths associated with COVID-19 in this population. Methods PANORAMIC was a UK-based, national, multicentre, open-label, multigroup, prospective, platform adaptive randomised controlled trial. Eligible participants were aged 50 years or older—or aged 18 years or older with relevant comorbidities—and had been unwell with confirmed COVID-19 for 5 days or fewer in the community. Participants were randomly assigned (1:1) to receive 800 mg molnupiravir twice daily for 5 days plus usual care or usual care only. A secure, web-based system (Spinnaker) was used for randomisation, which was stratified by age (vs ≥50 years) and vaccination status (yes vs no). COVID-19 outcomes were tracked via a self-completed online daily diary for 28 days after randomisation. The primary outcome was all-cause hospitalisation or death within 28 days of randomisation, which was analysed using Bayesian models in all eligible participants who were randomly assigned. This trial is registered with ISRCTN, number 30448031. Findings Between Dec 8, 2021, and April 27, 2022, 26 411 participants were randomly assigned, 12 821 to molnupiravir plus usual care, 12 962 to usual care alone, and 628 to other treatment groups (which will be reported separately). 12 529 participants from the molnupiravir plus usual care group, and 12 525 from the usual care group were included in the primary analysis population. The mean age of the population was 56·6 years (SD 12·6), and 24 290 (94%) of 25 708 participants had had at least three doses of a SARS-CoV-2 vaccine. Hospitalisations or deaths were recorded in 105 (1%) of 12 529 participants in the molnupiravir plus usual care group versus 98 (1%) of 12 525 in the usual care group (adjusted odds ratio 1·06 [95% Bayesian credible interval 0·81–1·41]; probability of superiority 0·33). There was no evidence of treatment interaction between subgroups. Serious adverse events were recorded for 50 (0·4%) of 12 774 participants in the molnupiravir plus usual care group and for 45 (0·3%) of 12 934 in the usual care group. None of these events were judged to be related to molnupiravir. Interpretation Molnupiravir did not reduce the frequency of COVID-19-associated hospitalisations or death among high-risk vaccinated adults in the community. Funding UK National Institute for Health and Care Research

We examine compensation as a tool to encourage the thoughtful use of audit experimentation. If researchers had to compensate subjects or communities, they would be more likely to avoid excessively large studies and to only conduct high-value studies. We build on Desposato and propose that when conducting an audit study, (1) researchers donate time or money to the communities potentially affected by the study, (2) researchers preregister this donation, and (3) researchers provide evidence of the donation they made in publication and presentation.

Summary Background Botulinum toxin (BT-A) chemodenervation has been proved to significantly improve the physical and psychological well-being of patients suffering from facial synkinesis. Despite this, a cohort of patients has persistent tightness and discomfort around the angle of the jaw, which may be caused by synkinesis within the posterior belly of digastric (PBD) muscle. This study was designed to evaluate the benefits of ultrasound-guided BT-A injections into the PBD. Methods Thirty-three patients with recalcitrant tightness and discomfort around the angle of the jaw, despite maximal facial therapy and platysmal chemodenervation were selected for inclusion. Patients underwent ultrasound-guided BT-A injection into the ipsilateral PBD muscle (skin puncture site 1 cm inferior and posterior to the angle of mandible). Outcomes consisted of the Facial Disability Index (FDI), Synkinesis Assessment Questionnaire (SAQ), and a visual analogue scale (VAS) designed to assess tightness and pain around the PBD when moving the jaw, swallowing, and masticating. Questionnaires were completed two weeks before and postinjection. Statistical analysis was performed using a paired t-test. Results Nineteen patients completed the post-treatment outcome questionnaire. A statistically significant improvement was noted in the physical and social function aspects of the FDI and all aspects of the patient-reported VAS scores apart from tightness and pain on jaw retrusion and swallowing. There was no significant difference in the SAQ. Conclusion This study has demonstrated the patient-perceived benefit of ultrasound-targeted BT-A chemodenervation of PBD. This represents a low-risk treatment option that can be easily added to the repertoire of treatments offered to patients with post paralysis facial synkinesis.

The coercive nature of prisons is a longstanding topic of academic inquiry. Although correctional staff help incarcerated individuals adjust to prison by enforcing prison rules and providing guidan...

Psychopathy is an important forensic mental health construct. Despite this importance, the research base of psychopathy among individuals convicted of capital murder is limited. Archival data were collected from a sample of 636 persons convicted of capital murder and sentenced to death in the State of California. Psychopathy was assessed using the Psychopathy Checklist - Revised (PCL-R) instrument. Data on criminal careers and other behavioral disorders were also extracted. The sample mean PCL-R total score was 23.31 (SD = 9.92) and one-third of individuals in this sample were considered clinically psychopathic with PCL-R total scores of 30 or greater. Factor analytic examination yielded support for four facets: affective, interpersonal, lifestyle, and antisocial. Criterion validity findings revealed positive correlations of psychopathy scores with Antisocial Personality Disorder (ρ = 0.72), Conduct Disorder (ρ = 0.46), sexual sadism (ρ = 0.24), Oppositional Defiant Disorder (ρ = 0.20), ADHD (ρ = 0.15), arrest charges (r = 0.56), prison sentences (r = 0.53), and age of arrest onset (r = -0.57). Individuals convicted of capital murder and sentenced to death reflect heterogeneity in psychopathy with some individuals exhibiting pronounced psychopathic features.

The lack of samples for generating standardized DNA datasets for setting up a sequencing pipeline or benchmarking the performance of different algorithms limits the implementation and uptake of cancer genomics. Here, we describe reference call sets obtained from paired tumor–normal genomic DNA (gDNA) samples derived from a breast cancer cell line—which is highly heterogeneous, with an aneuploid genome, and enriched in somatic alterations—and a matched lymphoblastoid cell line. We partially validated both somatic mutations and germline variants in these call sets via whole-exome sequencing (WES) with different sequencing platforms and targeted sequencing with >2,000-fold coverage, spanning 82% of genomic regions with high confidence. Although the gDNA reference samples are not representative of primary cancer cells from a clinical sample, when setting up a sequencing pipeline, they not only minimize potential biases from technologies, assays and informatics but also provide a unique resource for benchmarking ‘tumor-only’ or ‘matched tumor–normal’ analyses.

Aims National guidelines instruct clinical decision making around post-polypectomy surveillance. The current polyp surveillance guidelines were jointly published by the British Society of Gastroenterologists (BSG), the Association of Coloproctology of Great Britain and Ireland (ACPGBI) and Public Health England (PHE) in 2019, updating the 2010 surveillance guidelines. Adherence to polyp surveillance guidelines is historically poor, both in the UK and globally. This audit set out to establish the adherence rate of clinicians to the 2019 polyp surveillance guidelines in a district general hospital and to compare this to the adherence rate to the 2010 surveillance guidelines. Methods We aimed to collect 300 patients who had been treated under the 2010 or 2019 polyp surveillance guidelines. After exclusion criteria were applied we collected 152 and 133 patients who had respectively been treated under the 2010 and 2019 guidelines. Each patient record was analysed and it was determined by our team whether the chosen polyp surveillance was adherent to the respective guidelines or not. Results Of 152 patients treated under the 2010 guidelines, 41.4% (63) of patients were adherent. Of 133 patients treated under the 2019 guidelines, 66.2% (88) of patients were adherent. This represents a score difference of 24.7% (95% confidence interval of 13.5% to 35.9%, p Conclusions Our results show that following the introduction of the 2019 guidelines, adherence to polyp surveillance guidelines increased. Increased adherence to guidelines has significant implications for improving patient safety, financial savings and protecting endoscopy capacity.

Recent advances in deep learning-based markerless pose estimation have dramatically improved the scale and ease with which body landmarks can be tracked in studies of animal behavior. However, pose estimation for animals in a laboratory setting still faces some specific challenges. Researchers typically need to manually generate new training data for each experimental setup and visual environment, limiting the generalizability of this approach. With each network being trained from scratch, different investigators track distinct anatomical landmarks and analyze the resulting kinematic data in idiosyncratic ways. Moreover, much of the movement data is discarded: only a few sparse landmarks are typically labeled, due to the inherent scale and accuracy limits of manual annotation. To address these issues, we developed an approach, which we term GlowTrack, for generating large training datasets that overcome the relatively modest limits of manual labeling, enabling deep learning models that generalize across experimental contexts. The key innovations are: a) an automated, high-throughput approach for generating hidden labels free of human error using fluorescent markers; b) a multi-camera, multi-light setup for generating large amounts of training data under diverse visual conditions; and c) a technique for massively parallel tracking of hundreds of landmarks simultaneously using computer vision feature matching algorithms, providing dense coverage for kinematic analysis at a resolution not currently available. These advances yield versatile deep learning models that are trained at scale, laying the foundation for standardized behavioral pipelines and more complete scrutiny of animal movements.

Telomeres are regions of repetitive nucleotide sequences capping the ends of eukaryotic chromosomes that protect against deterioration, and whose lengths can be correlated with age and adverse health risk factors. Yet, given their length and repetitive nature, telomeric regions are not easily reconstructed from short-read sequencing, thus making telomere sequencing, mapping, and variant resolution challenging problems. Recently, long-read sequencing, with read lengths measuring in hundreds of kilobase pairs, has made it possible to routinely read into telomeric regions and inspect their sequence structure. Here, we describe a framework for extracting telomeric reads from whole-genome single-molecule sequencing experiments, including de novo identification of telomere repeat motifs and repeat types, and also describe their sequence variation. We find that long, complex telomeric stretches and repeats can be accurately captured with long-read sequencing, observe extensive sequence heterogeneity of human telomeres, discover and localize noncanonical telomere sequence motifs (both previously reported, as well as novel), and validate them in short-read sequence data. These data reveal extensive intra- and inter-population diversity of repeats in telomeric haplotypes, reveal higher paternal inheritance of telomeric variants, and represent the first motif composition maps of multi-kilobase-pair human telomeric haplotypes across three distinct ancestries (Ashkenazi, Chinese, and Utah), which can aid in future studies of genetic variation, aging, and genome biology.

BackgroundIncreasing the GP workforce will not necessarily level up healthcare provision: instead increasing GP training numbers could worsen health inequity and inequalities. This is especially true if there are fewer opportunities to learn, train and build confidence in under-served, socioeconomically deprived areas.AimTo investigate the representation of socioeconomic deprivation in postgraduate GP training practices in Northern Ireland (NI).Design and SettingSocioeconomic deprivation indices and scores of GP practices in Northern Ireland were calculated.MethodsWe compared the socioeconomic deprivation indices and scores of GP postgraduate training practices against general practice in NI by examining the representation of practices whose patients live in areas of blanket deprivation, higher deprivation and higher affluence.ResultsOf 319 practices in NI, 171 (54%) were registered as postgraduate training practices with a mean deprivation score of 3.02 (95% CI 2.91–3.12) compared with non-training practices’ higher mean deprivation score of 3.2 (95% CI 3.01–3.33),P-value ConclusionPostgraduate training practices had a statistically significant lower deprivation score and did not fully reflect the socioeconomic make-up of wider NI general practice. The results, however, are more favourable than in other areas of the UK and better than undergraduate teaching opportunities in general practice. Health inequalities will worsen if the representation of general practice training in areas of greater social economic deprivation is not increased.

INTRODUCTION Fifty years since Dr Tudor-Hart’s publication of the ‘Inverse Care Law’, all-cause mortality rates and COVID-19 mortality rates are higher in more deprived areas. Part of the solution is to increase access and availability to healthcare in underserved and deprived areas. This paper examined how socio-economically representative the undergraduate general practice placements are in Northern Ireland (NI).METHODS A quantitative study of general practices involved in undergraduate medical placements through Queen’s University Belfast, comparing practice lists by deprivation indices, examining both blanket deprivation and deprivation quintile trends for teaching and non-teaching practices.RESULTS Deprivation data for 135 teaching practices were compared against the 323 NI practices. Teaching practices had fewer patients living in the most deprived quintiles compared with non-teaching practices. Fewer practices with blanket deprivation were involved in undergraduate medical education, 32% compared with 42% without blanket deprivation. Practices in areas of blanket deprivation were under-represented as teaching practices, 10%, compared to 14% of NI general practices that met this criterion.CONCLUSION Practices with blanket deprivation were under-represented as teaching practices. Exposure to general practice in deprived areas is an essential step to improving future workforce recruitment and ultimately to closing the health inequalities gap. Ensuring practices in high-need areas are proportionately represented in undergraduate placements is one way to direct action in addressing the ‘Inverse Care Law’. This study is limited to NI and further work is required to compare institutions across the UK and Ireland.

Legislators who know their constituents' opinions are more likely to be successful in providing substantive representation on issues of the day. However, previous work suggests that state legislators and candidates commonly misestimate their constituents' preferences. Some of that work also finds that candidates and current incumbents in highly professionalized legislatures are less likely to misestimate constituent opinion. We investigate why this professionalism advantage exists. We use a Blinder–Oaxaca decomposition to determine how much of the professionalism advantage can be attributed to three sources: attracting knowledgeable candidates, fostering legislator knowledge in office, and retaining incumbents. We apply the decomposition to data on candidates' perceptions of public opinion from the 2014 National Candidate Survey. Fostering knowledge in office and retaining incumbents are not responsible for the professionalism advantage. We find evidence that the professionalism advantage occurs because higher professionalism legislatures attract more knowledgeable nonincumbent candidates.

PURPOSE The direct brow lift is a simple and popular technique, particularly in patients with brow ptosis secondary to facial palsy. It provides a high degree of control in determining the degree of brow elevation and shape achieved. However, it is arguably the least debated in terms of addressing some of its sequelae, namely the risks of a visible or indrawn scar and forehead paraesthesia. In this article, we report outcomes using four alternative principles to those outlined in current published literature. METHODS All patients undergoing a primary direct brow lift for brow ptosis secondary to facial palsy between January 2015 and December 2019 under a single surgeon (R.M.) were included in the study. The technical refinements of the procedure included a W-plasty type stealth skin incision, counter-bevelling of the upper and lower incision lines, skin excision in the subcutaneous plane only with minimal excision of fat and browpexy to the frontal periosteum through small linear puncture incisions in the frontalis. RESULTS A total of 23 patients undergoing 24 direct brow lifts were included in the study. The mean follow-up was 1.3 years (range 0.5-3 years). No patients reported postoperative forehead paraesthesia or brow alopecia. One patient required a further temporal browlift 15 months later. Brow height was rated excellent (0-1.5 mm difference) in 71% of brows and good (1.6-4.9 mm difference) in 14% of brows. The average Manchester scar scale was 8.6/28. CONCLUSION The technical modifications presented substantially reduce the rates of postoperative paraesthesia, whilst achieving satisfactory aesthetic outcomes.

Understanding the pathophysiology of SARS-CoV-2 infection is critical for therapeutic and public health strategies. Viral-host interactions can guide discovery of disease regulators, and protein structure function analysis points to several immune pathways, including complement and coagulation, as targets of coronaviruses. To determine whether conditions associated with dysregulated complement or coagulation systems impact disease, we performed a retrospective observational study and found that history of macular degeneration (a proxy for complement-activation disorders) and history of coagulation disorders (thrombocytopenia, thrombosis and hemorrhage) are risk factors for SARS-CoV-2-associated morbidity and mortality-effects that are independent of age, sex or history of smoking. Transcriptional profiling of nasopharyngeal swabs demonstrated that in addition to type-I interferon and interleukin-6-dependent inflammatory responses, infection results in robust engagement of the complement and coagulation pathways. Finally, in a candidate-driven genetic association study of severe SARS-CoV-2 disease, we identified putative complement and coagulation-associated loci including missense, eQTL and sQTL variants of critical complement and coagulation regulators. In addition to providing evidence that complement function modulates SARS-CoV-2 infection outcome, the data point to putative transcriptional genetic markers of susceptibility. The results highlight the value of using a multimodal analytical approach to reveal determinants and predictors of immunity, susceptibility and clinical outcome associated with infection.

Prison murder is the most severe form of institutional violence but its exceedingly low prevalence has limited prior research. Recent studies of prison murders make clear that serious, violent, and chronic career criminals are most likely to perpetrate inmate murders with equivocal evidence of the role of prior homicide offending on prison murder. Using retrospective administrative data from 1,005 prisoners selected from the southwestern United States, the current study examined whether homicide offending in the community is itself an importation factor that is useful for understanding prison murder and thus can be used to understand continuity in homicidal offending from the community to confinement context. Rare events logistic regression models found that individuals sentenced for first-degree murder are more likely to perpetrate prison murder. A separate rare events logistic regression model with any type of homicide commitment offense as a predictor provided similar findings suggesting these effects are robust to model specification. Given its gravity and fundamental threat to prison safety and security, we encourage data collection and additional research on prison murder and the inmates that perpetrate it.

Despite considerable change in inmate rights over the past several decades, researchers, practitioners, and policymakers know little about the current state of prisoner litigation. The purpose of t...

Background Lake Hillier is a hypersaline lake known for its distinctive bright pink color. The cause of this phenomenon in other hypersaline sites has been attributed to halophiles, Dunaliella, and Salinibacter, however, a systematic analysis of the microbial communities, their functional features, and the prevalence of pigment-producing-metabolisms has not been previously studied.Our results are evidence that Lake Hillier is composed of a diverse set of microorganisms including archaea, bacteria, algae, and viruses. Our data indicate a core microbiome in Lake Hillier composed of multiple pigment-producer microbes, many of which are cataloged as polyextremophiles. Additionally, we estimated the diversity of metabolic pathways in the lake and determined that many of these are related to pigment production. We reconstructed complete or partial genomes for 21 discrete bacteria (N = 14) and archaea (N = 7), only 2 of which could be taxonomically annotated to previously observed species.Our findings provide the first metagenomic study to decipher the source of the pink color of Australia’s Lake Hillier. The study of this pink hypersaline environment is evidence of a microbial consortium of pigment producers, a repertoire of polyextremophiles, a core microbiome and potentially novel species.

The COVID-19 pandemic has had a profound, detrimental effect on economies and societies worldwide. Where the pandemic has been controlled, extremely high rates of diagnostic testing for the SARS-CoV-2 virus have proven critical, enabling isolation of cases and contact tracing. Recently, diagnostic testing has been supplemented with wastewater measures to evaluate the degree to which communities have infections. Whereas much testing has been done through traditional, centralized, clinical, or environmental laboratory methods, point-of-care testing has proven successful in reducing time to result. As the pandemic progresses and becomes more broadly distributed, further decentralization of diagnostic testing will be helpful to mitigate its spread. This will be particularly both challenging and critical in settings with limited resources due to lack of medical infrastructure and expertise as well as requirements to return results quickly. In this article, we validate the tiny isothermal nucleic acid quantification system (TINY) and a novel loop-mediated isothermal amplification (LAMP)–based assay for the point-of-care diagnosis of SARS-CoV-2 infection in humans and also for in-the-field, point-of-collection surveillance of wastewater. The TINY system is portable and designed for use in settings with limited resources. It can be powered by electrical, solar, or thermal energy and is robust against interruptions in services. These applied testing examples demonstrate that this novel detection platform is a simpler procedure than reverse-transcription quantitative polymerase chain reaction, and moreover, this TINY instrument and LAMP assay combination has the potential to effectively provide both point-of-care diagnosis of individuals and point-of-collection environmental surveillance using wastewater.