Search for the lepton number violating process * * This work is supported in part by National Key R&D Program of China under Contracts Nos. 2023YFA1606000, 2023YFA1606704; National Natural Science Foundation of China (NSFC) under Contracts Nos. 12035009, 11635010, 11935015, 11935016, 11935018, 12025502, 12035013, 12061131003, 12192260, 12192261, 12192262, 12192263, 12192264, 12192265, 12221005, 12225509, 12235017, 12361141819; the Chinese Academy of Sciences (CAS) Large-Scale Scientific Facility Program; CAS under Contract No. YSBR-101; 100 Talents Program of CAS; The Institute of Nuclear and Particle Physics (INPAC) and Shanghai Key Laboratory for Particle Physics and Cosmology; German Research Foundation DFG under Contract No. FOR5327; Istituto Nazionale di Fisica Nucleare, Italy; Knut and Alice Wallenberg Foundation under Contracts Nos. 2021.0174, 2021.0299; Ministry of Development of Turkey under Contract No. DPT2006K-120470; National Research Foundation of Korea under Contract No. NRF-2022R1A2C1092335; National Science and Technology fund of Mongolia; National Science Research and Innovation Fund (NSRF) via the Program Management Unit for Human Resources & Institutional Development, Research and Innovation of Thailand under Contract No. B50G670107; Polish National Science Centre under Contract No. 2024/53/B/ST2/00975; Swedish Research Council under Contract No. 2019.04595; U. S. Department of Energy under Contract No. DE-FG02-05ER41374

Based on events collected with the BESIII detector, we search for the lepton number violating decay for the first time. The upper limit on the branching fraction of this decay is set to at the 90% confidence level with a frequentist method. This is the first search for decays with a lepton number change by two, offering valuable insights into the underlying physical processes

General Will or Public Order? The Debate on Criminal Justice Policy in Early Colonial Himalaya, 1815–1816

When the British East India Company (EIC) conquered the West Himalaya region in the 1810s, it faced a critical challenge commonly encountered by colonial empires: determining the extent of intervention in intracommunity criminal matters among colonized subjects. This article examines the archived correspondence of colonial officials regarding this challenge and scrutinizes the various arguments made for and against intervention. It shows that the alterity of the subject population was strategically employed by both sides of the debate, who simultaneously promoted contradictory agendas: for those advocating intervention, alterity rendered involvement in criminal matters necessary and just, whereas those averse to intervention employed the very same notion to justify the opposite stance. This dual usage is explained by exposing the contemporary ideas about criminal justice that underlay each of these positions: that criminal law should represent the general will of society, and that it must be executed by a centralized power so as to maintain public order. While these two tenets are commonly perceived as supporting one another, the analysis reveals their decoupling in colonial settings. The debates of EIC officials thus demonstrate how the colonial setting distorts ideas foundational to modern criminal law systems, casting doubt over whether they were ever truly in harmony to begin with

A phase 1 experimental medicine study of anti-CD3 monoclonal antibody in rheumatoid arthritis

Introduction: An Fc-mutated chimeric aglycosyl anti-CD3 monoclonal antibody (mAb), otelixizumab, has been used successfully to treat renal transplant rejection and type 1 diabetes, with reduced toxicity compared with traditional anti-CD3 therapies such as OKT3. The aim of this study was to seek preliminary safety data for otelixizumab in rheumatoid arthritis (RA). Methods: A small Phase 1 experimental medicine study was performed in six participants with RA. The primary outcome measure was safety, with a focus on first-dose cytokine release reactions and extent of CD3+ lymphopenia. Cytokine release was quantified using ELISA, and lymphocyte subsets by flow cytometry. In vitro whole blood assays were used to interrogate the mechanisms underlying the first-dose cytokine release reaction. Clinical progress following therapy was monitored as an exploratory outcome. Results: All participants experienced a moderate first-dose cytokine release reaction. There was transient lymphopenia but no T-cell depletion, and a temporary CD8+ T-cell lymphocytosis occurred in all participants. In those who completed therapy, a sustained reduction in CRP following treatment was noted. In an in vitro whole blood assay, designed to mirror in vivo cytokine release, there was a trend for reduced cytokine production in seropositive RA compared with seronegative RA, psoriatic arthritis, or healthy controls. Conclusions: At the dosing regimen used, otelixizumab was associated with an unexpected and significant first-dose reaction in participants with RA

Impact of weight‐loss interventions on psoriasis severity: A systematic review and meta‐analysis

Background: Psoriasis affects at least 60 million people worldwide, and 80% also live with overweight or obesity. Excess weight increases susceptibility to psoriasis and is associated with more severe disease. Objective: To evaluate the impact of weight‐loss interventions on psoriasis severity (Psoriasis Area and Severity Index [PASI], PASI50, PASI75, PASI100 [50%/75%/100% reduction in baseline PASI, respectively]) and quality of life (Dermatology Life Quality Index [DLQI]). Methods: We systematically searched five databases and two trial registries (inception to 03/09/2025). Outcomes were informed by patient focus‐group discussions. Randomized controlled trials (RCTs) in adults with psoriasis, comparing any weight‐loss intervention versus usual care or a lower‐intensity weight‐loss intervention, were included. Studies had to report a change in weight and ≥1 psoriasis severity or quality‐of‐life measure. Random effects meta‐analyses were used. Results: Thirteen RCTs (1145 participants) with 14 comparisons were included. Eleven interventions advised dietary changes, of which four included physical activity. Three used weight‐loss medications. Across 14 comparisons (n = 1145, mean difference (MD) in weight change: −6.7 kg), weight‐loss interventions produced a greater reduction in PASI versus control: MD −2.5 (95%CI: −3.8 to −1.1, I2 = 85.2%). We found a significant effect of weight‐loss interventions on the likelihood of achieving PASI75 (RR = 1.6, 95%CI: 1.1–2.2, I2 = 22.6% [based on six comparisons, n = 681, MD in weight change: −7.3 kg]). There was no statistically significant effect of the interventions on the likelihood of achieving PASI50 (RR = 1.5, 95%CI: 0.9–2.4, I2 = 72.8% [based on four comparisons, n = 509, MD in weight change: −4.0 kg]) or PASI100 (RR = 1.6, 95%CI: 0.3–9.7, I2 = 0.0% [based on two comparisons, n = 334, MD in weight change: −5.2 kg]), but both analyses were limited by few studies. Across seven comparisons (n = 364; MD in weight change −7.8 kg), weight‐loss interventions were associated with a significant improvement in DLQI compared to control: MD −5.0 (95%CI: −9.7 to −0.3, I2 = 96.0%). Conclusion: High‐certainty evidence suggests weight‐loss interventions can improve psoriasis severity and quality of life, and should be considered as part of routine treatment

Current gynaecological management of women and girls with bleeding disorders in the United Kingdom: A UKHCDO haemophilia treatment centre survey and evaluation of real‐world clinical practice for the British Journal of Haematology

Summary: Girls and women with bleeding disorders (GWBD) comprise more than half of all registered patients with bleeding disorders in the UK National Haemophilia Database. The gynaecological care of GWBD, until recently, has not been prioritised despite high health burdens, where four of every five patients experience heavy menstrual bleeding (HMB). We report the results of a national survey exploring gynaecological health‐care services offered across haemophilia centres in the United Kingdom, with a focus on HMB. We combine these results with a retrospective cohort analysis of individual patient care records, across a 3‐year period. Of 65 haemophilia centres, 41 responded, covering 90% of the UK GWBD population. Six hundred and ninety‐seven individual patient care records were included, from 13 centres. Our results show that immediate clinical care offered to GWBD experiencing HMB is adequate, despite infrastructure deficiencies (such as lack of joint‐gynaecology input and few centres having named clinical leads for GWBD). We recommend several areas for immediate prioritisation within haemophilia centres which will improve the equity of care for GWBD. These include direct access to gynaecological services; universal testing of iron status; and more broadly, a shift towards clinical practices that recognise and address the impact HMB has on patients' psycho‐social, sexual and overall quality of life

Navigating the Multiplexity of Africa’s Digital Partnerships amidst Global Rivalry

Digital development has progressively become a public policy priority for many African governments and occupies an increasingly important place in the continent’s relations with its strategic partners. Despite challenging local contexts and constrained budgets, several African governments are maneuvering to achieve ambitious national priorities in relation to digital transformation. At the local level, private sector actors and national governments are adopting a range of techniques to engage and negotiate different digital collaborations in order to fulfill their objectives despite global geopolitical tensions in the digital sphere, especially between the US and China. As in several other parts of the world, digital rivalries or geopolitics are manifested in Africa by competing partners making rival offers to digitize African economies. Yet the landscape of Africa’s digital partners is marked by the absence of hegemony by a single or a small set of countries or actors. Instead, Africa’s digital partners include a large variety of actors, among which are large and small nations, international and regional organizations, private corporations, and non-state actors. By using multiplexity (instead of multipolarity) as a conceptual framework, this article aims to describe and analyze the dynamic ways in which African governments organize their digital partnerships in a context of global power rivalry and how, despite the persistence of various dependencies, the pluralization of choice allows for the exercise of agency

Benchtop comparison of seven ureteroscopes: evaluating physical properties and deflection with flexible and navigable suction access sheaths

Objectives: To evaluate the physical properties of seven ureteroscopes (URSs) and compare the maximal angle of deflection (MAD) when used with flexible and navigable suction access sheaths (FANSs) of varying sizes. Materials and Methods: Seven commercial URSs (ranging from 6.3 to 9.5 F in size) were evaluated for outer diameter, irrigation flow rate, image resolution, colour reproduction and MAD. MAD was measured under three conditions: standalone URS deflection without the FANS; standard deflection of the FANS while positioned at the URS tip; and advanced FANS deflection, with the URS fully deflected beyond the FANS, and the FANS advanced. For each URS type, standalone deflection was repeated five times, and FANS deflections were repeated four times to calculate an average. FANS sizes of 10/12 F, 11/13 F and 12/14 F (ClearPetra) were tested. Results: The HugeMed URS had the smallest scope diameter (6.3 F) and the lowest flow (20 mL/min), while the Endoso URS had the highest flow (32 mL/min). All the URSs had similar resolutions except the MacroLux, Seegen and Endoso URSs, which were noticeably superior in this respect. Colour reproduction was best with the MacroLux and Endoso URSs. Without a FANS, the standalone mean MAD across all URS types was 293°. Standard deflection with FANS significantly decreased the MAD (up to a 49% reduction), whereas advanced deflection maintained the MAD (up to 269°). Larger FANS, especially the 12/14‐F size, tended to reduce deflection. The MacroLux URS maintained the highest MAD across all FANS sizes, followed by the Seegen and Urotech devices. Conclusion: Ureteroscope deflection significantly varied by model. Use of a FANS reduced deflection angles, especially with larger sheaths. However, advancing the FANS over a deflected scope preserved deflection angles. Overall, the MacroLux URS showed the best deflection with FANS, whereas the Seegen, Endoso and Urotech URSs showed a balance between flow rate, optics and deflection. These findings could inform clinicians in their selection of a URS for endourology procedures

Socioeconomic inequality and access to emergency care: understanding the pathways to the emergency department in the UK

OBJECTIVE: To examine how socioeconomic deprivation influences referral pathways to emergency departments (EDs) and to assess how these pathways affect subsequent hospital outcomes. DESIGN: Retrospective observational study. SETTING: Emergency department of a large teaching hospital in the East of England, providing secondary and tertiary care. PARTICIPANTS: 482 787 ED attendances by patients aged 16 years and over, recorded between January 2019 and December 2023. Patients were assigned Index of Multiple Deprivation (IMD) deciles based on residential postcode. MAIN OUTCOME MEASURES: Referral source (general practitioner (GP), National Health Service (NHS) 111, ambulance, self-referral, other), total ED time, 4-hour breach, hospital admission and unplanned return within 72 hours. RESULTS: Substantial socioeconomic inequalities were observed in referral pathways. Patients from the most deprived areas were significantly less likely to be referred by a GP (4.7%) than those from the least deprived areas (14.7%) and more likely to arrive via ambulance (32% vs 24%). These differences persisted after adjusting for demographic, clinical and contextual variables. Ambulance referrals showed the longest ED stays, ranging from 347 to 351 min across IMD deciles (overall 95% CI 343 to 363) and the highest probability of 4-hour breaches (51%; 95% CI 50% to 53%). Self-referrals had the greatest rates of unplanned returns within 7 days (up to 7.1%; 95% CI 5.5% to 8.7%). In contrast, NHS 111 and GP referrals were associated with shorter stays, lower breach rates and fewer reattendances. Minimal variation in outcomes was observed across deprivation levels once referral source was accounted for. CONCLUSIONS: Inequalities in how patients access emergency care, particularly reduced GP and NHS 111 referrals among more deprived groups, appear to underpin disparities in ED outcomes. Referral source captures important clinical and system-level factors that influence patient experience and resource use. Interventions to improve equitable access to structured referral pathways, particularly in more deprived areas, may enhance both the efficiency and fairness of emergency care delivery. Further research using national data is needed to assess broader policy implications and economic costs associated with differential access