How delayed cord clamping saves newborn lives

Interest in the subject of umbilical cord clamping is long-standing. New evidence reveals that placental transfusion, facilitated by delayed cord clamping (DCC), reduces death and need for blood transfusions for preterm infants without evidence of harm. Even a brief delay in clamping the cord shows improved survival and well-being, but waiting at least two minutes is even better. We propose that three major benefits from DCC contribute to reduced mortality of preterm infants: (1) benefits from the components of blood; (2) assistance from the continued circulation of blood; and (3) the essential mechanical interactions that result from the enhanced volume of blood. The enhanced blood volume generates mechanical forces within the microcirculation that support the newborn’s metabolic and cardiovascular stability and secure short- and long-term organ health. Several unique processes prime preterm and term newborns to receive the full placental transfusion, not to be misinterpreted as extra blood or over-transfusion. Disrupting cord circulation before the newborn’s lung capillary bed has been fully recruited and the lungs can replace the placenta as a respiratory, gas-exchanging organ may be harmful. Early cord clamping also denies the newborn a full quota of iron-rich red blood cells as well as valuable stem cells for regeneration, repair, and seeding of a strong immune system. We propose that delayed cord clamping and intact-cord stabilization have the potential to save lives by protecting many neonates from hypovolemia, inflammation, and ischemia.</p

Shakespeare’s impersonations: Ariosto and the game of 'sorti' in Much Ado About Nothing

'Much Ado About Nothing', first published in 1600, is a play of dissimulation. Complex disguises, literal and emotional, persuade individuals into both declarations and disavowals of feelings. Claudio, in particular, is duped into humiliating his betrothed Hero by an elaborate trick in which she is made to seem unfaithful through a proxy performance of erotic arousal. It has long been assumed that a direct or indirect source for this major element in Shakespeare’s plot derives from Canto V of Ariosto’s Orlando Furioso, in which the servant Dalinda impersonates Ginevra on the balcony, to the most painful chagrin of Ginevra’s lover Ariodante. However, Shakespeare’s interest in dissimulation goes much further than this. Dissimulatio is the Latin rhetorical term in which the whole point is that the distinction between real and simulated feeling is often impossible to decipher, as Cicero and Quintilian discussed on several occasions. Moreover, the idea of impersonation merges with the developing discourse of personation on the stage: the ability of an actor to simulate the feelings of a different person, even without disguise. By ‘traveling through a textual labyrinth’, as Umberto Eco puts it, this essay investigates the presence of Ariosto’s Orlando Furioso among the complex sources of this Shakespearean play, whose comedic plot apropos of an unjustly accused character may reveal elements of tribute to Giordano Bruno’s ‘heroic’ pursuit of truth. In doing so, we aim to discern how Ariosto’s allegoric effects are diffused in Shakespeare’s play of betrayed emotions and epistemic quest.</p

Regulatory intermediaries in content moderation

The modern digital public sphere requires effective content moderation systems that balance the interests of states, technology companies, and the public. This article examines how two pieces of legislation establish regulatory intermediaries in an attempt to strike this balance: the EU’s Digital Services Act (DSA) with its out-of-court dispute settlement (ODS) bodies, and the proposed Brazilian Bill 2630/2020, which assigns supervisory responsibilities to CGI.br, a multi-stakeholder body. The analysis reveals that the design of regulatory intermediaries, including pre-existing structures like CGI.br, significantly impacts platform governance and user experiences. While the DSA’s ODS model offers a framework for independent and user-friendly dispute resolution, the non-binding nature of its decisions limits its effectiveness. Similarly, concerns remain regarding CGI.br’s limited financial and human resources, and its legal fragility, which could undermine its ability to fulfil the responsibilities the Bill assigns to it. By examining these models, the article offers insights for creating more effective participative online governance systems. It provides recommendations for the implementation of the DSA and informs ongoing legislative discussions in Brazil.</p

Expectations versus Reality: Achieving Impact from Social Work Practitioner Research in Challenging Circumstances

This reflective article examines the claim that social work practitioner research is more likely to lead to impact. We reflect on the impact that we achieved as part of a social work practitioner research within an acute hospital in the South-East of England. First, we explore the literature on social work practitioner research and impact. Second, we outline our original research project. Third, we examine the individual, organisational and cultural impact we believe we achieved before reflecting on how our views and motivation towards impact changed throughout the research journey. Fourth, we discuss the barriers to achieve our original impact aspirations and reflect on the factors influencing our energy and motivation to achieve impact. Finally, we reflect on the factors that enabled us to achieve impact.</p

Support for young people who are distressed by hearing voices: protocol for an uncontrolled feasibility evaluation of a psychological intervention package delivered within secondary schools (the ECHOES study)

Background: Hearing voices is a common experience for young people and can cause significant distress. There are no evidence-based psychological interventions for distressing voices in young people, although a focus on coping strategies has been suggested as a useful approach. We have developed and evaluated a brief 1:1 coping intervention for young people who hear distressing voices. This intervention has been successfully piloted within Child and Adolescent Mental Health Services (CAMHS), together with a psychoeducational workshop for parents. The 1:1 intervention and the workshop will be combined into an intervention package and offered within schools to maximise accessibility. Methods: This study will be an uncontrolled feasibility evaluation addressing the following questions: is the intervention package acceptable to young people, those who support them, and staff and practitioners within secondary schools? What is the optimum content, structure, and duration for the intervention package? Is delivery of the intervention package feasible for the practitioners and what are their requirements for training and supervision? What tools can be used to evaluate the impact of the intervention package? The study will be guided by the MRC Framework for the development of complex interventions and consist of an iterative process over four phases: phase 1—adaptation of the intervention package with young people, parents, and school staff; phase 2—delivery of the intervention package through Mental Health Support Teams to students, supporters who have been nominated by the students and school staff; phase 3—analysis of quantitative and qualitative data collected from participants and practitioners; phase 4—further adaptation of the intervention package with young people, parents and school staff. Discussion: If the findings from the study suggest that a future trial is warranted, a feasibility Randomised Controlled Trial will be designed to establish the parameters for a definitive trial. Trial registration: Current Controlled Trials ISRCTN registration number: 16395888. Registered on 11 January 2024. 10.1186/ISRCTN16395888.</p

Exploring the literacy learning journeys of deaf professional adults in Mexico

This PhD thesis critically examines the literacy acquisition and educational experiences of Deaf adults in both formal and informal educational settings, drawing insights from eight Deaf professionals and twelve hearing practitioners living in one Mexican region. It addresses a significant gap in research on Deaf education by focusing on the unique historical, cultural, and linguistic factors shaping the educational landscape in Mexico.Previous literature critiques the dominance of oralist teaching methods that prioritise spoken over sign language, hindering Deaf individuals’ literacy acquisition. This thesis challenges these biases by redefining Deaf literacy to include multimodal approaches, such as sign languages and visual communication, grounded in Deaf people’s lived experiences.The research is innovative in its application of three theoretical frameworks to the Mexican context: Critical Realism, Capabilities Theory, and Deaf-LatCrit. Together, they aid a comprehensive exploration of the intersectional challenges faced by Deaf individuals. They support a nuanced exploration of the interplay between structural barriers, individual agency, systemic oppression, and cultural identity, yielding valuable insights into the dynamics of empowerment and inclusion in Deaf education.The study utilised two complementary methods to investigate the experiences and challenges of Deaf individuals in Mexico’s education system. The first component employed narrative life history research in Mexican Sign Language (LSM) with Deaf professionals, uncovering deep insights into their personal and educational trajectories. It highlighted how they interpret their experiences, navigate systemic challenges, and leverage agency to overcome barriers, while emphasising the influence of family dynamics and poverty within a socio-economic context shaped by cultural and linguistic obstacles.The second component involved semi-structured interviews with hearing practitioners experienced in teaching literacy to Deaf students. These interviews provided a detailed understanding of inclusive education in Mexico, identifying systemic difficulties educators face in addressing the needs of Deaf learners. By integrating findings from both components, the study illuminated pervasive barriers to inclusive education, including limited resources, inadequate educational options, and ineffective teaching practices, offering a holistic understanding of the structural inequities hindering educational equity for Deaf individuals.The analysis demonstrates that entrenched audism, ethnocentrism and insufficient policy implementation significantly impede the educational progress of Deaf individuals in Mexico. These challenges are further exacerbated by the insufficiency of culturally appropriate teaching methods and inadequate support for multilingual education incorporating Mexican Sign Language. Despite these systemic obstacles, Deaf professionals demonstrate remarkable resilience and agency, forging their own paths to literacy. They employ innovative strategies, such as fostering support networks within the Deaf community, advocating for systemic reforms, and leveraging their cultural and linguistic assets to advance professionally and personally.</p

‘Disciples of Aesclepius’: glimpses into lives of the ‘Gentlemen of the Faculty’ of medicine in Brighton, England 1800–1809

Here we present newspaper accounts from the Sussex Advertiser to consider hitherto largely unknown Brighton doctors active between 1800 and 1809. This body of physicians, surgeons and apothecaries comprised Brighton's ‘Gentlemen of the [medical] Faculty’, whom the newspaper also dubbed the ‘Disciples of Aesclepius’. Members are considered under three broad categories. First, are Brighton-based clinicians (Mr Barratt, Mr Bond, Charles Bankhead, Thomas Guy, John Hall, John Newton, Benjamin Scutt and Sir Matthew Tierney). Second are London clinicians, probably in attendance to the Prince of Wales (John Hunter and Thomas Keate), More widely, two dentists (Dr Durlacher and Mr Bew) and two Royal Navy surgeons (Robert Chambers and Thomas Thong) also recorded at Brighton are considered. Other aspects of medical life are described: recruiting an apprentice, anatomy training at Joshua Brooke's London museum, midwifery, a description of a surgeon's bag and the last reference to the Royal Sussex Jennerian Society (which disappears from the newspaper record in 1807). Clinical cases described include: resuscitation from near-drowning, post-mortem examinations, death from the ‘gravel and stone’ and accounts of suicide. The primary sources presented in this paper offer rare glimpses into medical life in Brighton at the very start of the nineteenth century.</p

Place-based reproductive justice and resistance: Human rights and abortion mobilities in the Post-Dobbs era

This article integrates human rights and abortion mobilities frameworks to demonstrate the ramifications of abortion restrictions and highlights historic and emergent forms reproductive justice and resistance. It engages with and critiques narrow conceptualizations of reproductive rights and biopolitics and considers the complex ways that abortion legislation becomes embodied in the post-Dobbs era. Mobility is explored across three frames—repression, privilege, and resistance—to highlight the interconnections between reproductive (in)justice and place-based resistance. Situating the analysis within human rights scholarship and reproductive justice and mobilities scholarship, the article outlines the continuities and current configurations of place-based reproductive (in)justice across three interconnected axes. The first axis traces the embodied ramifications of anti-abortion laws for marginalized individuals and communities; the second axis explores the complex personal, political, and economic costs of travelling to access abortion care; and the third axis reflects on historic and current forms of community-based resistance and care. Read together, these axes challenge binary assumptions of agency or subjugation and instead reveal how embodied experiences of abortion restrictions for marginalized individuals and groups also run alongside radical forms of community care to resist these restrictions and address broader forms of lived intersectional inequalities.</p

A journey through quantum technology

Technology aims to utilise physics to invent things that improve our lives. Our current information technology era is the result of quantum mechanics and the concept of wave-particle duality. Many revolutionary technologies, such as the laser, MRI and integrated circuits were developed from this first quantum revolution. This paper provides a brief summary of these key quantum technologies and investigates some of the ongoing research that may spark a second quantum revolution.</p

Resonant Fully Dielectric Metasurfaces for Ultrafast Terahertz Pulse Generation

In the framework of optical frequency conversion, metasurfaces have elevated the potential for effective interfacial nonlinear coefficients through various modes of field localization. For the generation of pulsed ultrafast terahertz (THz) signals, metasurfaces present a viable alternative in the domain of surface-scalable sources driven by low-power oscillators (using nJ pulses). However, recent innovations have predominantly relied on surface plasmons (metals) and, more broadly, on excitations within non-transparency windows-conditions that typically impose limitations on applications and the choice of platforms. Here, we demonstrate the utilization of a fully-dielectric, fully transparent semiconductor that exploits surface-nano-structure-mediated resonances alongside its inherent quadratic nonlinear response. Our system exhibits a remarkable 40-fold efficiency enhancement in comparison to the non-decorated substrate.</p