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Since 2014, Chinese courts have placed tens of millions of court judgments online. We analyze the promise and pitfalls of using this new data source, highlighting takeaways for readers facing similar issues using other collections of legal texts. Drawing on 1,058,986 documents from Henan Province, we identify problems with missing data and call on scholars to treat variation in court disclosure rates as an urgent research question. We also outline strategies for learning from a corpus that is vast and incomplete. Using a topic model of administrative litigation in Henan, we complicate conventional wisdom that administrative lawsuits are an extension of contentious politics that give Chinese citizens an opportunity to challenge the state. Instead, we find a high prevalence of administrative cases that reflect an underlying dispute between two private parties, suggesting that administrative lawsuits are often an attempt to enlist help from the state in resolving an underlying civil dispute.
Ice streams are warmed by shear strain, both vertical shear near the bed and lateral shear at the margins. Warm ice deforms more easily, establishing a positive feedback loop in an ice stream where fast flow leads to warm ice and then to even faster flow. Here, we use radar attenuation measurements to show that the Siple Coast ice streams are colder than previously thought, which we hypothesize is due to along-flow advection of cold ice from upstream. We interpret the attenuation results within the context of previous ice-temperature measurements from nearby sites where hot-water boreholes were drilled. These in-situ temperatures are notably colder than model predictions, both in the ice streams and in an ice-stream shear margin. We then model ice temperature using a 1.5-dimensional numerical model which includes a parameterization for along-flow advection. Compared to analytical solutions, we find depth-averaged temperatures that are colder by 0.7°C in the Bindschadler Ice Stream, 2.7°C in the Kamb Ice Stream and 6.2–8.2°C in the Dragon Shear Margin of Whillans Ice Stream, closer to the borehole measurements at all locations. Modelled cooling corresponds to shear-margin thermal strengthening by 3–3.5 times compared to the warm-ice case, which must be compensated by some other weakening mechanism such as material damage or ice-crystal fabric anisotropy.
We study the endothermic reaction and flow of a granular solid reactant, where energy for the reaction is provided by a counter-current flow of hot gases through the porous reactant bed. Research into reacting flows typically focusses on exothermic combustion processes. However, endothermic processes are common in the metallurgy industry, including the production of cement, silicon and rutile titanium dioxide. Several common features are observed in experimental and numerical studies of these processes, including critical temperatures of the reactant at which the chemical reaction begins, and regions of the reactor with uniform reactant temperature. Motivated specifically by the processes in a silicon furnace, we analyse a model of endothermic, reacting counter-current flow using the method of matched asymptotic expansions. Assuming the Péclet number in the solid is large, we explore the full range of values for the dimensionless inter-phase heat-transfer rate, finding six distinguished limits. In all limits, we find a diffusive boundary layer in which there is a fast chemical reaction rate due to the high temperatures, analogous to exothermic flame fronts. Outside this region, the counter-current flow is crucial to the chemical processes. For intermediate values of the heat-transfer rate, we find the same qualitative properties as those observed across the metallurgy industry, and we quantify the dependence of these properties on the flow rate and heat-transfer rate. In the limit of large heat-transfer coefficient, we derive the single-temperature limit, in which the solution structure is dependent on the direction of net heat flux through the domain.
Hallucinations occur in the absence of sensory stimulation and result in vivid perceptual experiences of nonexistent events that manifest across a range of sensory modalities. Approaches from the field of experimental and cognitive psychology have leveraged the idea that associative learning experiences can evoke conditioning-induced hallucinations in both animals and humans. In this review, we describe classical and contemporary findings and highlight the variables eliciting these experiences. We also provide an overview of the neurobiological mechanisms, along with the associative and computational factors that may explain hallucinations that are generated by representation-mediated conditioning phenomena. Through the integration of animal and human research, significant advances into the psychobiology of hallucinations are possible, which may ultimately translate to more effective clinical applications.
To determine whether a clinician-directed acute respiratory tract infection (ARI) intervention was associated with improved antibiotic prescribing and patient outcomes across a large US healthcare system.
Multicenter retrospective quasi-experimental analysis of outpatient visits with a diagnosis of uncomplicated ARI over a 7-year period.
Outpatients with ARI diagnoses: sinusitis, pharyngitis, bronchitis, and unspecified upper respiratory tract infection (URI-NOS). Outpatients with concurrent infection or select comorbid conditions were excluded.
Audit and feedback with peer comparison of antibiotic prescribing rates and academic detailing of clinicians with frequent ARI visits. Antimicrobial stewards and academic detailing personnel delivered the intervention; facility and clinician participation were voluntary.
We calculated the probability to receive antibiotics for an ARI before and after implementation. Secondary outcomes included probability for a return clinic visits or infection-related hospitalization, before and after implementation. Intervention effects were assessed with logistic generalized estimating equation models. Facility participation was tracked, and results were stratified by quartile of facility intervention intensity.
We reviewed 1,003,509 and 323,023 uncomplicated ARI visits before and after the implementation of the intervention, respectively. The probability to receive antibiotics for ARI decreased after implementation (odds ratio [OR], 0.82; 95% confidence interval [CI], 0.78–0.86). Facilities with the highest quartile of intervention intensity demonstrated larger reductions in antibiotic prescribing (OR, 0.69; 95% CI, 0.59–0.80) compared to nonparticipating facilities (OR, 0.89; 95% CI, 0.73–1.09). Return visits (OR, 1.00; 95% CI, 0.94–1.07) and infection-related hospitalizations (OR, 1.21; 95% CI, 0.92–1.59) were not different before and after implementation within facilities that performed intensive implementation.
Implementation of a nationwide ARI management intervention (ie, audit and feedback with academic detailing) was associated with improved ARI management in an intervention intensity–dependent manner. No impact on ARI-related clinical outcomes was observed.
Consumers, public officials, and even managers of health care and insurance are unhappy about care quality, access, and costs. This book shows that is because efforts to do something about these problems often rely on hope or conjecture, not rigorous evidence of effectiveness. In this book, experts in the field separate the speculative from the proven with regard to how care is rendered, how patients can be in control, how providers should be paid, and how disparities can be reduced – and they also identify the issues for which evidence is currently missing. It provides an antidote to frustration and a clear-eyed guide for forward progress, helping health care and insurance innovators make better decisions on deciding whether to go ahead now based on current evidence, to seek and wait for additional evidence, or to move on to different ideas. It will be useful to practitioners in hospital systems, medical groups, and insurance organizations and can also be used in executive and MBA teaching.
OBJECTIVES/GOALS: Heart failure (HF) is a clinical condition that notably affects the lives of patients in rural areas. The partnering of a rural satellite hospital with an urban academic medical center may provide geographically underrepresented populations with HF an opportunity to access controlled clinical trials (CCTs). METHODS/STUDY POPULATION: We report our experience in screening, consenting and enrolling subjects at the VCU Health Community Memorial Hospital (VCU-CMH) in rural South Hill, Virginia, that is part of the larger VCU Health network, with the lead institution being VCU Health Medical College of Virginia Hospitals (VCU-MCV), Richmond, VA. Subjects were enrolled in a clinical trial sponsored by the National Institutes of Health (ClinicalTrials.gov: NCT03797001) and assigned to treatment with an anti-inflammatory drug for HF or placebo. We used the electronic health record and remote guidance and oversight from the VCU-MCV resources using a closed-loop communication network to work with local resources at the facility to perform screening, consenting and enrollment. RESULTS/ANTICIPATED RESULTS: One hundred subjects with recently decompensated HF were screened between January 2019 and August 2021, of these 61 are enrolled to date: 52 (85 %) at VCU-MCV and 9 (15%) at VCU-CMH. Of the subjects enrolled at VCU-CMH, 33% were female, 77% Black, with a mean age of 52ï‚±10 years. DISCUSSION/SIGNIFICANCE: The use of a combination of virtual/remote monitoring and guidance of local resources in this trial provides an opportunity for decentralization and access of CCTs for potential novel treatment of HF to underrepresented individuals from rural areas.
Emphasizing the predictive success and practical utility of psychological science is an admirable goal but it will require a substantive shift in how we design research. Applied research often assumes that findings are transferable to all practices, insensitive to variation between implementations. We describe efforts to quantify and close this practice-to-practice gap in education research.
Silicon is produced in submerged arc furnaces which are heated by electric currents passing through the furnace. It is important to understand the distribution of heating within the furnace in order to accurately model the silicon production process, yet many existing studies neglect aspects of this current flow. In the present paper, we formulate a model that couples the electrical current to thermal, material flow and chemical processes in the furnace. We then exploit disparate timescales to homogenise the model over the timescale of the alternating current, deriving averaged equations for the slow evolution of the system. Our numerical simulations predict a minimum applied current that is required in order to obtain steady-state solutions of the homogenised model and show that for high enough applied currents, two spatially heterogeneous steady-state solutions exist, with distinct crater sizes. We show that the system evolves to the steady state with a larger crater radius and explain this behaviour in terms of the overall power balance typically found within a furnace. We find that the industrial practice of stoking furnaces increases the overall rate of material consumption in the furnace, thereby improving the efficiency of silicon production.