Achievement of Target Gain Larger than Unity in an Inertial Fusion Experiment

On December 5, 2022, an indirect drive fusion implosion on the National Ignition Facility (NIF) achieved a target gain G_{target} of 1.5. This is the first laboratory demonstration of exceeding "scientific breakeven" (or G_{target}>1) where 2.05 MJ of 351 nm laser light produced 3.1 MJ of total fusion yield, a result which significantly exceeds the Lawson criterion for fusion ignition as reported in a previous NIF implosion [H. Abu-Shawareb et al. (Indirect Drive ICF Collaboration), Phys. Rev. Lett. 129, 075001 (2022)PRLTAO0031-900710.1103/PhysRevLett.129.075001]. This achievement is the culmination of more than five decades of research and gives proof that laboratory fusion, based on fundamental physics principles, is possible. This Letter reports on the target, laser, design, and experimental advancements that led to this result.

CTAD Task Force Paper: Neuropsychiatric Symptoms in AD: Clinical Trials Targeting Mild Behavioral Impairment: A Report from the International CTAD Task Force

The International CTAD Task Force (TF) addressed challenges related to designing clinical trials for agitation in dementia, presenting accomplishments from the two previous TFs on neuropsychiatric symptoms (NPS). In addition, this TF proposed a paradigm shift in NPS assessment and management, presenting Mild Behavioral Impairment (MBI) as a clinical syndrome. MBI is marked by later-life emergent and persistent NPS in dementia-free older persons (ranging from cognitively unimpaired to subjective cognitive decline to mild cognitive impairment), which facilitates earlier detection and better prognostication of Alzheimer's disease (AD). The TF has made the following recommendations for incorporation of NPS into AD preventative trials: (1) clinical trials targeting improvement in MBI symptoms should be undertaken; (2) treatment trials for MBI should be disease specific and confirm the diagnosis of participants using biomarkers; trials should include measures sensitive to cognitive changes in preclinical AD, which can serve as outcome measures, in addition to changes in biomarker levels; (3) as a first step, pharmacotherapeutic trials should address the full MBI complex as well as the specific symptoms/domains that constitute MBI; (4) clinical trials using problem-adaptation psychotherapy to target affective MBI should be considered; and (5) MBI should be considered in AD trials of disease modifying therapies. The well-validated and widely-used MBI Checklist (MBI-C) is an appropriate symptom rating scale for these studies, as it was developed specifically to identify and measure MBI in dementia-free persons. Other scales such as the Neuropsychiatric Inventory (NPI) may be used, although administration at two timepoints may be necessary to operationalize the MBI criterion of symptom persistence.

Organizational Social Relations and Social Embedding: A Pluralistic Review

To date there has been little systematic organization of the extensive literature on the processes and mechanisms shaping social relationships in and around organizations. In an analysis of 372 studies from this literature, we identified a broad spectrum of assumptions, priorities, and relational issues emerging from multiple disciplines and theoretical lenses. Three dominant perspectives surfaced in our study: economic, organizational, and interactionist. Each manifests distinctive ontologies of social relations, actors, relational processes, and modes of social embedding. The rich variety of relationships and causal patterns discovered characterizes more fully these perspectives, suggesting opportunities for further research within each, and a wider range of conceptual options to target relational paradigms toward different types of organizations, problems, and levels of analysis. It also brings to light the pluralistic nature of social relations in organizational contexts and the processes by which they become embedded.

Competitive Rationales: Beneath the Surface of Competitive Behavior

Competitive dynamics research has focused on studying whether rivals are able and likely to carry out competitive actions, typically by examining indirect reasons such as characteristics of the actions themselves, the firms involved, or the competitive context. We explore why rivals initiate a specific competitive action at a particular time and situation. Drawing from the philosophy of action literature, we introduce the concept of competitive rationales to examine the primary reasons that cause tactical actions. Given the rapid exchanges characterizing tactical competitive dynamics, we conducted an inductive, multicase study to explore the reasons behind over 800 discrete tactical decisions carried out by 9 professional basketball coaches during 15 basketball games. To garner insight, we develop a conceptual framework revealing their types and scope. Even during intense head-to-head rivalry, most rationales were not rivalrous but were instead organizational-to optimize resource use, strategic consistency, and reputation-or social-to manage relationships. Moreover, the three main types of rationales varied in scope, extending beyond immediate competitive situations and rivals to address longer term, strategic outcomes, and assorted stakeholders. Thus, our analysis reveals these rationales to be complex and potentially difficult for rivals to decipher. It also recasts each component of the dominant awareness-motivation-capability (AMC) model of rivalry, suggesting that awareness is challenged by subtle rationales, motivation drives not only action but also forbearance, and capability is both a requirement and product of action.

Lawson Criterion for Ignition Exceeded in an Inertial Fusion Experiment

For more than half a century, researchers around the world have been engaged in attempts to achieve fusion ignition as a proof of principle of various fusion concepts. Following the Lawson criterion, an ignited plasma is one where the fusion heating power is high enough to overcome all the physical processes that cool the fusion plasma, creating a positive thermodynamic feedback loop with rapidly increasing temperature. In inertially confined fusion, ignition is a state where the fusion plasma can begin "burn propagation" into surrounding cold fuel, enabling the possibility of high energy gain. While "scientific breakeven" (i.e., unity target gain) has not yet been achieved (here target gain is 0.72, 1.37 MJ of fusion for 1.92 MJ of laser energy), this Letter reports the first controlled fusion experiment, using laser indirect drive, on the National Ignition Facility to produce capsule gain (here 5.8) and reach ignition by nine different formulations of the Lawson criterion.

Which psychosocial interventions improve sex worker well-being? A systematic review of evidence from resource-rich countries

OBJECTIVE

To establish the state of the evidence base around psychosocial interventions that support well-being in sex workers in order to inform policy and practice within a resource-rich geographical context.

METHODS

Published and unpublished studies were identified through electronic databases (PsychINFO, CINHAL Plus, MEDLINE, EMBASE, The Cochrane Library and Open Grey), hand searching and contacting relevant organisations and experts in the field. Studies were included if they were conducted in high-income settings with sex workers or people engaging in exchange or transactional sex, and evaluated the effect of a psychosocial intervention with validated psychological or well-being measures or through qualitative evaluation.

RESULTS

A total of 19 202 studies were identified of which 10 studies met the eligibility criteria. The heterogeneity found dictated a narrative synthesis across studies. Overall, there was very little evidence of good quality to make clear evidence-based recommendations. Despite methodological limitations, the evidence as it stands suggests that peer health initiatives improve well-being in female street-based sex workers. Use of ecological momentary assessment (EMA), a diary-based method of collecting real-life behavioural data through the use of twice-daily questionnaires via a smartphone, increased self-esteem and behaviour change intentions.

CONCLUSIONS

Work with sex workers should be based on an evidence-based approach. Limitations to the existing evidence and the constraints of this work with vulnerable groups are recognised and discussed.

Paradoxical Resource Trajectories: When Strength Leads to Weakness and Weakness Leads to Strength

In proposing two evolutionary trajectories, we demonstrate some paradoxical aspects of strategic resources that contrast with current theorizing. First, we discuss how an abundance of resources can subject an organization to vulnerabilities, taking a firm from competitive strength to potential weakness. Second, we describe an opposite trajectory in which a lack of resources can lead to reactions engendering significant strengths. In both cases, the effects of resource abundance and poverty on executive perceptions and conduct, organizational arrangements, and strategic behavior can play important roles in trajectories of value creation and erosion.

Are Socially Responsible Firms Associated with Socially Responsible Citizens? A Study of Social Distancing During the Covid-19 Pandemic

The literature on the interplay between geographic communities and organizations has largely ignored the role of individual residents. In adopting a meso-perspective, we examine a potentially vital relationship between corporate conduct and pro-social behavior demanding sacrifice from individuals. Drawing on Weber (Economy and society: an outline of interpretive sociology. University of California Press, Berkeley, 1978 (Translation of Wirtschaft und Gesellschaft, Grundriss der verstehenden Soziologie, 1922)), we theorize that organizations in a community legitimize personal social conduct in three ways-by serving as role models, imparting norms and values, and routinizing forms of interaction. We study the relationship between corporate social responsibility (CSR) behavior by local firms and the social distancing (SD) of citizens in US counties during the Covid-19 pandemic, a core ethical outcome. We argue and find that the residents of communities in which firms exhibit higher levels of CSR engaged in more SD during the Covid-19 pandemic. This was true when firms were (a) long-established, (b) isomorphic in their CSR, and (c) major employers and vendors. Moreover, CSR relating to the treatment of employees as well as positive and negative extremes in CSR bore especially strong relationships with SD. Implications are drawn for the study of business ethics, as modeled by CSR, as a force for ethical personal behavior and public health in communities.

Vaccine acceptability, uptake and completion amongst men who have sex with men: A systematic review, meta-analysis and theoretical framework

BACKGROUND

Due to an increased risk of sexually transmitted infections (STIs), gay, bisexual and other men who have sex with men (MSM) have been recommended to receive vaccinations against human papillomavirus, meningitis C and hepatitis A/B. This review aimed to compare the rates of vaccine acceptability, uptake and completion, and to identify determinants of vaccine outcomes specific to MSM to inform a theoretical framework.

METHODS

In January 2020 four databases were explored to identify vaccination behaviours and associated factors among MSM. A narrative systematic review and meta-analysis were performed. Data were synthesised for theoretical modelling.

RESULTS

Seventy-eight studies, mostly from the USA, were included. The average vaccine acceptability was 63% (median = 72%, range: 30%-97%), vaccine uptake 45% (median = 42%, range: 5%-100%) and vaccine completion 47% (median = 45%, range: 12%-89%). Six categories of factors associated with vaccination acceptability, uptake and completion were conceptualised: Individual (e.g., demographic and psychosocial); Interpersonal (e.g., peer education); Healthcare provider (e.g., vaccine recommendation); Organisational and practice setting (e.g., routine collection of patient sexual orientation information that is integrated into a clinical decision support system); Community environment (e.g., targeted health promotion campaigns); and National, state and local policy environment (e.g., public health guidelines targeting MSM).

CONCLUSION

Despite overall high levels of acceptability, uptake and completion rates were below targets predicted by cost-effectiveness modelling across all recommended vaccines. These parameters may need to be adjusted for more precise estimations of cost-effectiveness. Addressing the multiple levels of determinants, as outlined in our theoretical framework, will help guide interventions to increase vaccine completion among MSM.

Targeted Extension Programming for New and Beginning Beef Cattle Producers Through a Multi-night Lecture Series

An introductory level-based educational program was developed for stakeholders interested in learning more about the basics of beef cattle management systems in Alabama. The Beef Systems Short Course was designed to 1) introduce concepts related to best management practices in beef operations to producers and 2) to create awareness among producers about educational services offered through Alabama Extension. Ten Beef Systems Short Courses were offered in fall 2019 and winter 2020 throughout Alabama. There were 136 participants enrolled in the program statewide. Eight topics were taught over a four-night time period (2 topics per meeting; 45 mins each). Topics included: Forages; Nutrition; Herd Health; Reproduction; Animal Identification, Genetics, and Records; Environmental Stewardship; Economics; Meat Science. A post-program survey was conducted to evaluate 1) potential change in knowledge and intent to adopt beef cattle management practices (n = 130 responses). Seventy percent of the producers in the program had less than 10 years of experience in the beef business, and the majority of these were part-time farmers (55%). Overall, producers were highly satisfied with the program with an overall rating of 4.7 out of 5 (Likert-type scale) across program topics, and 81% of participants planned to begin the adoption one or more of the management practices shared at the program in the next 12 months. The top three practices producers planned to implement included 1) establishing a calving season, 2) proper identification of livestock, and 3) improved forage management strategies. Participants reported significant knowledge gain across topics presented ranging from a 45 to 76% increase in understanding of practices. Notably, 55% of the participants reported that this was their first time attending an Extension program, demonstrating a great level of effectiveness in this program reaching new clientele. 100% of the participants indicated that they planned to attend Extension programs and use available online decision-making resources in their operations in the future. The total economic impact of the program was $525,450, with an estimated return on investment of 6:1.

The diagnostic odyssey: our family's story

Danny is the father of two boys with MEPAN syndrome and a member of Global Genes' RARE Foundation Alliance Leadership Council.

Facial action units, activity and time spent with dam are effective measures of pain in response to mulesing of Merino lambs

Repeatable measures of pain in ruminants following husbandry procedures are required to validate responses to pain relief. This study tested the hypotheses that facial action units, activity and time spent with dam can be used to assess the efficacy of pain relief in lambs following mulesing. Merino lambs (n = 120) were allocated to one of six treatments implemented at mulesing: (1) lambs that were not mulesed or lambs that were mulesed and administered (2) no pain relief, (3) meloxicam 15 min before mulesing, (4) Tri-Solfen®, (5) a combination of meloxicam 15 min before mulesing and Tri-Solfen after mulesing and (6) meloxicam at mulesing. Facial action units detected a difference in pain between mulesed and non-mulesed lambs at 1 and 5 h post-mulesing (P = 0.005 and <0.001) but not at 26 h post-mulesing. Lambs that were not mulesed were more active and spent more time with their dams than mulesed lambs (P < 0.001). No differences were observed between lambs that were mulesed with or without pain relief. Therefore, facial action units, activity of the lamb and time spent with dam can detect pain in response to mulesing in Merino lambs but cannot detect any changes associated with pain relief.

Understanding how corporations both drive & use neoliberalism to block progress in public health

This paper examines the role of corporations in the creation and utilisation of think tanks, lobby ventures and front groups, both nationally and internationally. It examines how these were implicated in the introduction of neoliberalism in the 1970s/80s. It briefly tells the story of the development of the Mont Pelerin Society and how its acolytes 'littered the world' with free market think tanks which then did battle in the struggle to introduce neoliberalism. It examines how this led to the 'disembedding' (Polanyi 1944) of political and economic elites from society via the rise and maturation of a wide range of intermediary institutions and organisations including three main kinds of groups: National and transnational policy planning groups; Think tanks and think tank networks; lobbying and public relations consultancies. This part of the paper concludes by examining the role of those industrial sectors that have had the most significant Public Health footprint in the neoliberal revolution, in each of the three kinds of groups mentioned above.

The paper then turns to the concrete advantages that these ongoing changes gave specific corporate actors with negative public health effects

Intraluminal Carotid Artery Thrombus in COVID-19: Another Danger of Cytokine Storm?

Coronavirus disease 2019 (COVID-19) is associated with a severe inflammatory response. Inflammation affects atherosclerotic plaque vulnerability and promotes a thrombogenic environment. We report a series of 6 patients with COVID-19 with acute ischemic stroke due to intraluminal carotid artery thrombus presenting during an 8-day period. Six patients were included (5 men) with a mean age of 65.8 years (range, 55-78 years). COVID-19 was diagnosed by detection of Severe Acute Respiratory Syndrome coronavirus 2 in 5 patients and was presumed due to typical clinical and imaging findings in 1 patient. All patients had vascular risk factors including diabetes (83%), hyperlipidemia (100%), and smoking (17%). Four patients presented with large infarcts with initial NIHSS scores of 24-30. During their hospitalization, all patients had elevated D-dimer and C-reactive protein levels, 5 patients had elevated lactate dehydrogenase and ferritin levels, 3 had elevated interleukin-6 levels, and 2 had elevated troponin levels. Inflammation related to COVID-19 may result in rupture of vulnerable atherosclerotic plaques, resulting in thrombosis and acute ischemic stroke.

Publisher's Note: Direct Lifetime Measurements of the Excited States in ^{72}Ni [Phys. Rev. Lett. 116, 122502 (2016)]

This corrects the article DOI: 10.1103/PhysRevLett.116.122502.

The effects of advanced maternal age on T-cell subsets at the maternal-fetal interface prior to term labor and in the offspring: a mouse study

Women who conceive at 35 years of age or older, commonly known as advanced maternal age, have a higher risk of facing parturition complications and their children have an increased risk of developing diseases later in life. However, the immunological mechanisms underlying these pathological processes have yet to be established. To fill this gap in knowledge, using a murine model and immunophenotyping, we determined the effect of advanced maternal age on the main cellular branch of adaptive immunity, T cells, at the maternal-fetal interface and in the offspring. We report that advanced maternal age impaired the process of labor at term, inducing dystocia and delaying the timing of delivery. Advanced maternal age diminished the number of specific proinflammatory T-cell subsets [T helper type 1 (Th1): CD4⁺ IFN-γ⁺ , CD8⁺ IFN-γ⁺ and Th9: CD4⁺ IL-9⁺ ], as well as CD4⁺ regulatory T cells (CD4⁺ CD25⁺ FoxP3⁺ T cells), at the maternal-fetal interface prior to term labor. Advanced maternal age also altered fetal growth and survival of the offspring in early life. In addition, infants born to advanced-age mothers had alterations in the T-cell repertoire but not in CD71⁺ erythroid cells (CD3^- CD71⁺ TER119⁺ cells). This study provides insight into the immune alterations observed at the maternal-fetal interface of advanced-age mothers and their offspring.

Publishing Bad News: A Meandering Journey

I present some lessons from an unanticipated research and publishing journey. They demonstrate that research can become a highly unpredictable process whose mission fails, yielding instead, after struggle and reorientation, some useful surprises. Whereas the less controversial surprises may be welcomed by academics, the more discordant ones may resist publication – but draw significant interest from practitioners.

Meta-analysis of the influence of lifestyle changes for preoperative weight loss on surgical outcomes

Background

The aim was to investigate whether preoperative weight loss results in improved clinical outcomes in surgical patients with clinically significant obesity.

Methods

This was a systematic review and aggregate data meta-analysis of RCTs and cohort studies. PubMed, MEDLINE, Embase and CINAHL Plus databases were searched from inception to February 2018. Eligibility criteria were: studies assessing the effect of weight loss interventions (low-energy diets with or without an exercise component) on clinical outcomes in patients undergoing any surgical procedure. Data on 30-day or all-cause in-hospital mortality were extracted and synthesized in meta-analyses. Postoperative thromboembolic complications, duration of surgery, infection and duration of hospital stay were also assessed.

Results

A total of 6060 patients in four RCTs and 12 cohort studies, all from European and North American centres, were identified. Most were in the field of bariatric surgery and all had some methodological limitations. The pooled effect estimate suggested that preoperative weight loss programmes were effective, leading to significant weight reduction compared with controls: mean difference –7·42 (95 per cent c.i. –10·09 to –4·74) kg (P &lt; 0·001). Preoperative weight loss interventions were not associated with a reduction in perioperative mortality (odds ratio 1·41, 95 per cent c.i. 0·24 to 8·40; I2 = 0 per cent, P = 0·66) but the event rate was low. The weight loss groups had shorter hospital stay (by 27 per cent). No differences were found for morbidity.

Conclusion

This limited preoperative weight loss has advantages but may not alter the postoperative morbidity or mortality risk.

Accuracy and reproducibility of fetal-fraction measurement using relative quantitation at polymorphic loci with microarray

OBJECTIVES

Various methods of fetal-fraction measurement have been employed in conjunction with different approaches to cell-free DNA testing for fetal aneuploidy. In this study, we determined the accuracy and reproducibility of fetal-fraction measurement using polymorphic assays that are incorporated into the test design as part of the Harmony® prenatal test and evaluated whether the single nucleotide polymorphisms selected for and used in these assays can be applied broadly to all patient populations.

METHODS

Clinical maternal plasma samples were assayed using a custom microarray with Digital ANalysis of Selected Regions (DANSR) assays designed to cover non-polymorphic targets on chromosomes of interest for aneuploidy assessment (13, 18, 21, X and Y) and polymorphic targets for fetal-fraction assessment. In a consecutive series of 47 512 maternal plasma samples, fetal-fraction measurements based on polymorphic assays were compared with those from Y-sequence quantitation. Reproducibility was examined between first- and second-tube measurements for the same patient sample in 734 cases. The fraction of informative loci was calculated for 13 988 samples.

RESULTS

There was a strong correlation between fetal fractions determined using the polymorphic assays and using Y-chromosome sequence quantitation (r = 0.97). Fetal-fraction measurement between the first and second tubes was highly reproducible (r = 0.98). The fraction of informative loci observed in a clinical series was consistent with predictions based on assay design.

CONCLUSIONS

The method based on relative quantitation at polymorphic loci on a microarray is accurate and reproducible for fetal-fraction estimation and is equally informative across global populations. This study provides a useful benchmark for ensuring the reliability and accuracy of fetal-fraction measurement. © 2018 Roche Sequencing Solutions. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology.

Oxidative Stress and Cardiovascular Risk in Type 1 Diabetes Mellitus: Insights From the DCCT/EDIC Study

Background

Hyperglycemia leading to increased oxidative stress is implicated in the increased risk for the development of macrovascular and microvascular complications in patients with type 1 diabetes mellitus.

Methods and Results

A random subcohort of 349 participants was selected from the DCCT / EDIC (Diabetes Control and Complications Trial/Epidemiology of Diabetes Interventions and Complications) cohort. This included 320 controls and 29 cardiovascular disease cases that were augmented with 98 additional known cases to yield a case cohort of 447 participants (320 controls, 127 cases). Biosamples from DCCT baseline, year 1, and closeout of DCCT , and 1 to 2 years post‐ DCCT ( EDIC years 1 and 2) were measured for markers of oxidative stress, including plasma myeloperoxidase, paraoxonase activity, urinary F 2α isoprostanes, and its metabolite, 2,3 dinor‐8 iso prostaglandin F 2α . Following adjustment for glycated hemoblobin and weighting the observations inversely proportional to the sampling selection probabilities, higher paraoxonase activity, reflective of antioxidant activity, and 2,3 dinor‐8 iso prostaglandin F 2α , an oxidative marker, were significantly associated with lower risk of cardiovascular disease (−4.5% risk for 10% higher paraoxonase, P <0.003; −5.3% risk for 10% higher 2,3 dinor‐8 iso prostaglandin F 2α , P =0.0092). In contrast, the oxidative markers myeloperoxidase and F 2α isoprostanes were not significantly associated with cardiovascular disease after adjustment for glycated hemoblobin. There were no significant differences between DCCT intensive and conventional treatment groups in the change in all biomarkers across time segments.

Conclusions

Heightened antioxidant activity (rather than diminished oxidative stress markers) is associated with lower cardiovascular disease risk in type 1 diabetes mellitus, but these biomarkers did not change over time with intensification of glycemic control.

Clinical Trial Registration

URL : https://www.clinicaltrials.gov . Unique identifiers: NCT 00360815 and NCT 00360893.