In Defence of the Hearing? : Emerging Geographies of Publicness, Materiality, Access and Communication in Court Hearings

The shift towards dispute resolution taking place outside traditional legal arenas is fundamentally changing the relationship between space and law, presenting legal geography with pressing new research opportunities. This paper explores how the emerging geographies of publicness, materiality, access to justice and communication shed light on the consequences of alternative and online dispute resolution. Crucially, these consequences raise urgent interdisciplinary questions for geography and law. We set out these questions and suggest that legal geography will be best placed to address them by working through some of the practical, applied ramifications of its concepts and perspectives

GX 339-4: the distance, state transitions, hysteresis and spectral correlations

We study X-ray and variability and distance of GX 339-4. We derive d>7 kpc, based on recent determination of the binary parameters. We study data from the Ginga/ASM, the CGRO/BATSE, and the RXTE/ASM, PCA and HEXTE. From 1987 to 2004, GX 339-4 underwent 15 outbursts and went through all known states of black-hole binaries. We also present the PCA data from the initial stage of the 2004 outburst. We then study colour-colour and colour-flux correlations. In the hard state, there is a strong anticorrelation between the 1.5-5 and 3-12 keV spectral slopes, which we explain by thermal Comptonization of disc photons. There is also a softening of the spectrum above 3 keV with the increasing flux that becomes stronger with increasing energy up to 200 keV. This indicates an anticorrelation between the electron temperature and luminosity, explained by hot accretion models. In addition, we see a variable broad-band slope with a pivot at 200 keV. We confirm the presence of pronounced hysteresis, with the hard-to-soft state transitions occurring at much higher (and variable) luminosities than the soft-to-hard transitions. We fit the ASM data with a model consisting of an outer accretion disc and a hot inner flow. State transitions are associated then with variations in the disc truncation radius, which we fit as 6GM/c^2 in the soft state and several times that in the hard state. The disappearence of the inner disc takes place at a lower accretion rate than its initial appearance due to the dependence of the transitions on the source history. We provide further evidence against the X-ray emission in the hard state being nonthermal synchrotron, and explain the observed radio-X-ray correlation by the jet power being correlated with the accretion power.Comment: MNRAS, in press (a substantially revised version, including new data from the Feb. 2004 outburst of GX 339-4

International genome-wide meta-analysis identifies new primary biliary cirrhosis risk loci and targetable pathogenic pathways.

Primary biliary cirrhosis (PBC) is a classical autoimmune liver disease for which effective immunomodulatory therapy is lacking. Here we perform meta-analyses of discovery data sets from genome-wide association studies of European subjects (n=2,764 cases and 10,475 controls) followed by validation genotyping in an independent cohort (n=3,716 cases and 4,261 controls). We discover and validate six previously unknown risk loci for PBC (Pcombined<5 × 10(-8)) and used pathway analysis to identify JAK-STAT/IL12/IL27 signalling and cytokine-cytokine pathways, for which relevant therapies exist

The genetic architecture of the human cerebral cortex

The cerebral cortex underlies our complex cognitive capabilities, yet little is known about the specific genetic loci that influence human cortical structure. To identify genetic variants that affect cortical structure, we conducted a genome-wide association meta-analysis of brain magnetic resonance imaging data from 51,665 individuals. We analyzed the surface area and average thickness of the whole cortex and 34 regions with known functional specializations. We identified 199 significant loci and found significant enrichment for loci influencing total surface area within regulatory elements that are active during prenatal cortical development, supporting the radial unit hypothesis. Loci that affect regional surface area cluster near genes in Wnt signaling pathways, which influence progenitor expansion and areal identity. Variation in cortical structure is genetically correlated with cognitive function, Parkinson's disease, insomnia, depression, neuroticism, and attention deficit hyperactivity disorder

Rehabilitation versus surgical reconstruction for non-acute anterior cruciate ligament injury (ACL SNNAP): a pragmatic randomised controlled trial

BackgroundAnterior cruciate ligament (ACL) rupture is a common debilitating injury that can cause instability of the knee. We aimed to investigate the best management strategy between reconstructive surgery and non-surgical treatment for patients with a non-acute ACL injury and persistent symptoms of instability.MethodsWe did a pragmatic, multicentre, superiority, randomised controlled trial in 29 secondary care National Health Service orthopaedic units in the UK. Patients with symptomatic knee problems (instability) consistent with an ACL injury were eligible. We excluded patients with meniscal pathology with characteristics that indicate immediate surgery. Patients were randomly assigned (1:1) by computer to either surgery (reconstruction) or rehabilitation (physiotherapy but with subsequent reconstruction permitted if instability persisted after treatment), stratified by site and baseline Knee Injury and Osteoarthritis Outcome Score—4 domain version (KOOS4). This management design represented normal practice. The primary outcome was KOOS4 at 18 months after randomisation. The principal analyses were intention-to-treat based, with KOOS4 results analysed using linear regression. This trial is registered with ISRCTN, ISRCTN10110685, and ClinicalTrials.gov, NCT02980367.FindingsBetween Feb 1, 2017, and April 12, 2020, we recruited 316 patients. 156 (49%) participants were randomly assigned to the surgical reconstruction group and 160 (51%) to the rehabilitation group. Mean KOOS4 at 18 months was 73·0 (SD 18·3) in the surgical group and 64·6 (21·6) in the rehabilitation group. The adjusted mean difference was 7·9 (95% CI 2·5–13·2; p=0·0053) in favour of surgical management. 65 (41%) of 160 patients allocated to rehabilitation underwent subsequent surgery according to protocol within 18 months. 43 (28%) of 156 patients allocated to surgery did not receive their allocated treatment. We found no differences between groups in the proportion of intervention-related complications.InterpretationSurgical reconstruction as a management strategy for patients with non-acute ACL injury with persistent symptoms of instability was clinically superior and more cost-effective in comparison with rehabilitation management

Society of Behavioral Medicine (SBM) position statement: SBM supports increased efforts to integrate community health workers into the patient-centered medical home

Integrating community health workers (CHWs) into health care systems has been associated with enhanced patient experience, improved population health, and reduced costs and unnecessary utilization of resources. Under the Affordable Care Act (ACA), care provided by CHWs is eligible for reimbursement. However, optimal integration of CHWs into health care requires purposeful implementation. This health policy brief is focused on the benefits of integrating CHWs specifically into the patient-centered medical home (PCMH). CHWs in the PCMH can serve as primary providers of culturally relevant information and advocacy, assist providers in understanding the influence of patients\u27 environment on disease management, and enhance motivation for self-care management among patients with chronic diseases. Despite the important role of CHWs, there are some barriers to integration into existing systems of care. The Society of Behavioral Medicine (SBM) recommends overcoming these barriers by establishing standards that ensure a skilled CHW workforce, clearly defining roles for CHWs, and expanding the scope of reimbursable prevention and primary care services to include those provided by CHWs

Insights into pancreatic β cell energy metabolism using rodent β cell models

Abstract Background: Mitochondrial diabetes is primarily caused by β-cell failure, a cell type whose unique properties are important in pathogenesis. Methods: By reducing glucose, we induced energetic stress in two rodent β-cell models to assess effects on cellular function. Results: Culturing rat insulin-secreting INS-1 cells in low glucose conditions caused a rapid reduction in whole cell respiration, associated with elevated mitochondrial reactive oxygen species production, and an altered glucose-stimulated insulin secretion profile. Prolonged exposure to reduced glucose directly impaired mitochondrial function and reduced autophagy. Conclusions: Insulinoma cell lines have a very different bioenergetic profile to many other cell lines and provide a useful model of mechanisms affecting β-cell mitochondrial function