Happy, Healthy and Well Project Report: May 1, 2009 - August 2010

This report was prepared by the Muskie School for the Maine Office of Adults with Cognitive and Physical Disabilities as specified in the Cooperative Agreement between OACPD and the Muskie School. This Project Report describes the activities related to the implementation of the Happy Healthy and Well Initiative (HHW) in the past year as well as a brief overview of the development of the project. Additionally, recommended next steps are included

Effect of angiotensin-converting enzyme inhibitor and angiotensin receptor blocker initiation on organ support-free days in patients hospitalized with COVID-19

IMPORTANCE Overactivation of the renin-angiotensin system (RAS) may contribute to poor clinical outcomes in patients with COVID-19. Objective To determine whether angiotensin-converting enzyme (ACE) inhibitor or angiotensin receptor blocker (ARB) initiation improves outcomes in patients hospitalized for COVID-19. DESIGN, SETTING, AND PARTICIPANTS In an ongoing, adaptive platform randomized clinical trial, 721 critically ill and 58 non–critically ill hospitalized adults were randomized to receive an RAS inhibitor or control between March 16, 2021, and February 25, 2022, at 69 sites in 7 countries (final follow-up on June 1, 2022). INTERVENTIONS Patients were randomized to receive open-label initiation of an ACE inhibitor (n = 257), ARB (n = 248), ARB in combination with DMX-200 (a chemokine receptor-2 inhibitor; n = 10), or no RAS inhibitor (control; n = 264) for up to 10 days. MAIN OUTCOMES AND MEASURES The primary outcome was organ support–free days, a composite of hospital survival and days alive without cardiovascular or respiratory organ support through 21 days. The primary analysis was a bayesian cumulative logistic model. Odds ratios (ORs) greater than 1 represent improved outcomes. RESULTS On February 25, 2022, enrollment was discontinued due to safety concerns. Among 679 critically ill patients with available primary outcome data, the median age was 56 years and 239 participants (35.2%) were women. Median (IQR) organ support–free days among critically ill patients was 10 (–1 to 16) in the ACE inhibitor group (n = 231), 8 (–1 to 17) in the ARB group (n = 217), and 12 (0 to 17) in the control group (n = 231) (median adjusted odds ratios of 0.77 [95% bayesian credible interval, 0.58-1.06] for improvement for ACE inhibitor and 0.76 [95% credible interval, 0.56-1.05] for ARB compared with control). The posterior probabilities that ACE inhibitors and ARBs worsened organ support–free days compared with control were 94.9% and 95.4%, respectively. Hospital survival occurred in 166 of 231 critically ill participants (71.9%) in the ACE inhibitor group, 152 of 217 (70.0%) in the ARB group, and 182 of 231 (78.8%) in the control group (posterior probabilities that ACE inhibitor and ARB worsened hospital survival compared with control were 95.3% and 98.1%, respectively). CONCLUSIONS AND RELEVANCE In this trial, among critically ill adults with COVID-19, initiation of an ACE inhibitor or ARB did not improve, and likely worsened, clinical outcomes. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT0273570

To what extent has the European Endowment for Democracy facilitated the growth of an ecosystem of independent media organisations in Lebanon? (2017-2023)

This thesis investigates the relationship between the ecosystem of independent media organisations in Lebanon, and their relationship to the European Union, specifically the European Endowment for Democracy. The analysis follows a trajectory starting from Beirut all the way back to Brussels, the lens of focus widening as it reaches its conclusion. It does so through first focusing on the case study of Megaphone News and whether it can be considered a Non Profit Media Organisation as proposed by economist, Julia Cagé. Then it takes testimonies from seven respondents across a number of these organisations to consider whether their approach and strategies align with the theory of participative journalism. Finally it uses thematic clusters to broaden discussion to consider the European Endowment’s role in the development of Lebanon’s independent media.  It concludes that European involvement in this context is fundamentally limited and impact by interests other than democracy assistance. It shows that neither theories can accommodate the interdependence and collaboration between organisations. It shows that the work of these independent media organisations has influenced the development of the European Endowment in a relationship that can be characterised as symbiotic and contradictory to the founding principles of this European Union institution. Both theories do not fully accommodate for the difficulties of operation in a collapsing economy and an unrepresentative political elite. The fluidity and innovation of these organisations in difficult conditions generate insights about how the theories and the relationship with Europe may be improved to facilitate continuation of development. The European Endowment is crucial in facilitating the growth of independent media in Lebanon, but those organisations have also shifted perspective of the Endowment in return. The content of this facilitation reveals internal limitations to democracy assistance efforts.

To what extent has the European Endowment for Democracy facilitated the growth of an ecosystem of independent media organisations in Lebanon? (2017-2023)

This thesis investigates the relationship between the ecosystem of independent media organisations in Lebanon, and their relationship to the European Union, specifically the European Endowment for Democracy. The analysis follows a trajectory starting from Beirut all the way back to Brussels, the lens of focus widening as it reaches its conclusion. It does so through first focusing on the case study of Megaphone News and whether it can be considered a Non Profit Media Organisation as proposed by economist, Julia Cagé. Then it takes testimonies from seven respondents across a number of these organisations to consider whether their approach and strategies align with the theory of participative journalism. Finally it uses thematic clusters to broaden discussion to consider the European Endowment’s role in the development of Lebanon’s independent media.  It concludes that European involvement in this context is fundamentally limited and impact by interests other than democracy assistance. It shows that neither theories can accommodate the interdependence and collaboration between organisations. It shows that the work of these independent media organisations has influenced the development of the European Endowment in a relationship that can be characterised as symbiotic and contradictory to the founding principles of this European Union institution. Both theories do not fully accommodate for the difficulties of operation in a collapsing economy and an unrepresentative political elite. The fluidity and innovation of these organisations in difficult conditions generate insights about how the theories and the relationship with Europe may be improved to facilitate continuation of development. The European Endowment is crucial in facilitating the growth of independent media in Lebanon, but those organisations have also shifted perspective of the Endowment in return. The content of this facilitation reveals internal limitations to democracy assistance efforts.

Breaking trade-offs between translucency and diffusion in particle-doped films

Particle-doped thin films that are translucent and diffusive have applications in cosmetics, coatings, and display technologies, but finding material combinations that produce these effects simultaneously is challenging: formulations tend to be either transparent or opaque. Using a combination of Mie scattering calculations and spectral transmission measurements on monodisperse colloidal suspensions, we demonstrate that the two characteristic optical properties of the films, total transmittance and haze, scale with the effective backscattering and forward scattering cross sections, both of which are properties of single particles. These scalings enable an efficient computational search for combinations of particle sizes, concentrations, and refractive indices that break the trade-off between translucency and diffusion. The optimum particle sizes and concentrations obey power-law dependences on the refractive index difference, a result of the interference condition for resonances in the scattering cross sections. The power laws serve as design equations for formulating particle-doped thin films.Physic

Nanoscale NMR spectroscopy and imaging of multiple nuclear species

Nuclear magnetic resonance (NMR) spectroscopy and magnetic resonance imaging (MRI) provide non-invasive information about multiple nuclear species in bulk matter, with wide-ranging applications from basic physics and chemistry to biomedical imaging1. However, the spatial resolution of conventional NMR and MRI is limited2 to several micrometres even at large magnetic fields (>1 T), which is inadequate for many frontier scientific applications such as single-molecule NMR spectroscopy and in vivo MRI of individual biological cells. A promising approach for nanoscale NMR and MRI exploits optical measurements of nitrogen–vacancy (NV) colour centres in diamond, which provide a combination of magnetic field sensitivity and nanoscale spatial resolution unmatched by any existing technology, while operating under ambient conditions in a robust, solid-state system3, 4, 5. Recently, single, shallow NV centres were used to demonstrate NMR of nanoscale ensembles of proton spins, consisting of a statistical polarization equivalent to ∼100–1,000 spins in uniform samples covering the surface of a bulk diamond chip6, 7. Here, we realize nanoscale NMR spectroscopy and MRI of multiple nuclear species (1H, 19F, 31P) in non-uniform (spatially structured) samples under ambient conditions and at moderate magnetic fields (∼20 mT) using two complementary sensor modalities.Physic