The Splitting of the Self: Catherine’s Crisis of Identity in \u3ci\u3eWuthering Heights\u3c/i\u3e

Winner of the 2022-2023 Robert T. Wilson Award for Scholarly Writin

Towards a transparent, credible, evidence-based decision-making process of new drug listing on the Hong Kong Hospital Authority Drug Formulary: challenges and suggestions

The aim of this article is to describe the process, evaluation criteria, and possible outcomes of decision-making for new drugs listed in the Hong Kong Hospital Authority Drug Formulary in comparison to the health technology assessment (HTA) policy overseas. Details of decision-making processes including the new drug listing submission, Drug Advisory Committee (DAC) meeting, and procedures prior to and following the meeting, were extracted from the official Hong Kong Hospital Authority drug formulary management website and manual. Publicly-available information related to the new drug decision-making process for five HTA agencies [the National Institute of Health and Care Excellence (NICE), the Scottish Medicines Consortium (SMC), the Australia Pharmaceutical Benefits Advisory Committee (PBAC), the Canadian Agency for Drugs and Technologies in Health (CADTH), and the New Zealand Pharmaceutical Management Agency (PHARMAC)] were reviewed and retrieved from official documents from public domains. The DAC is in charge of systemically and critically appraising new drugs before they are listed on the formulary, reviewing submitted applications, and making the decision to list the drug based on scientific evidence to which safety, efficacy, and cost-effectiveness are the primary considerations. When compared with other HTA agencies, transparency of the decision-making process of the DAC, the relevance of clinical and health economic evidence, and the lack of health economic and methodological input of submissions are the major challenges to the new-drug listing policy in Hong Kong. Despite these challenges, this review provides suggestions for the establishment of a more transparent, credible, and evidence-based decision-making process in the Hong Kong Hospital Authority Drug Formulary. Proposals for improvement in the listing of new drugs in the formulary should be a priority of healthcare reforms

Letter to Philander Chase

Lady Sparrow looks forward to having Bishop Chase for dinner and having him stay the night.https://digital.kenyon.edu/chase_letters/2040/thumbnail.jp

Understanding the Internet Pitchfork Mob: Internal Revolutionary Activity in Self-Regulated Online Communities

Research into organised online protest typically focuses on how digital activism empowers social movements. But what if an online community is rebelling against its platform owners? This study seeks to identify the trajectory of internally focused revolutionary activity in self-regulated online communities. Based on an analysis of three cases (Reddit, 2015; Mozilla, 2014, and Skyrim, 2015) it identifies six stages of revolution: incident, reaction, mobilization, action, negotiation, and a return to ‘normality’ with a new power equilibrium. For each stage, key events, relations between the community and platform managers, and the ways in which power is enacted through online means, are identified. This preliminary model for online community revolution offers potential for further work that has diagnostic, predictive and ameliorative value. Relations with online communities are of significant value in an era in which many platform-related business models are reliant on voluntary contributions of self-regulating online communities

Membrane supports designed for Pd membranes

Unique properties such as high permeance and a theoretically infinite selectivity to hydrogen gas exhibited by Palladium (Pd)-based membranes have caused thin Palladium films to emerge as an attractive method to separate and purify hydrogen from syngas. Pd-based membrane costs are a considerable economic hindrance to transforming this technology into a commonly applied gas separation technology, hence, the cost of these membranes needs to be reduced significantly. Cost reduction can be achieved by utilising composite membranes, composed of a thin dense layer of a Pd alloy deposited onto a porous support structure. While significant research has focused on Pd-based top layer optimisation, the physical properties of each sublayer have all but been ignored. In order to address challenges such as stability and durability of membranes, membrane production and operation costs more effectively, the current work aims to look at each layer as an integral part of the membrane system instead of unlinked individual layers. The end product of Pd-based membrane development should exhibit the following characteristics; a) defect-free continuous films, without protruding defects which would negatively affect the quality of the collected permeate gas, b) mechanically and chemically stable films, to hinder the formation of defects during the lifetime of the membrane under operating conditions, c) the film should have minimum thickness required in order to obtain a) and b) as excessive thickness will have a detrimental impact on H2 permeance and material cost. Please click Additional Files below to see the full abstract

Original Encounter with Antigen Determines Antigen-Presenting Cell Imprinting of the Quality of the Immune Response in Mice

BACKGROUND:Obtaining a certain multi-functionality of cellular immunity for the control of infectious diseases is a burning question in immunology and in vaccine design. Early events, including antigen shuttling to secondary lymphoid organs and recruitment of innate immune cells for adaptive immune response, determine host responsiveness to antigens. However, the sequence of these events and their impact on the quality of the immune response remain to be elucidated. Here, we chose to study Modified Vaccinia virus Ankara (MVA) which is now replacing live Smallpox vaccines and is proposed as an attenuated vector for vaccination strategies against infectious diseases. METHODOLOGY/PRINCIPAL FINDINGS:We analyzed in vivo mechanisms triggered following intradermal (i.d.) and intramuscular (i.m.) Modified Vaccinia virus Ankara (MVA) administration. We demonstrated significant differences in the antigen shuttling to lymphoid organs by macrophages (MPhis), myeloid dendritic cells (DCs), and neutrophils (PMNs). MVA i.d. administration resulted in better antigen distribution and more sustained antigen-presenting cells (APCs) recruitment into draining lymph nodes than with i.m. administration. These APCs, which comprise both DCs and MPhis, were differentially involved in T cell priming and shaped remarkably the quality of cytokine-producing virus-specific T cells according to the entry route of MVA. CONCLUSIONS/SIGNIFICANCE:This study improves our understanding of the mechanisms of antigen delivery and their consequences on the quality of immune responses and provides new insights for vaccine development