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We consider a class of external potentials on the complex plane C for which the coincidence set to the obstacle problem contains a Jordan curve in the exterior of the droplet. We refer to this curve as a spectral outpost. We study the corresponding Coulomb gas at β=2[jls-end-space/].Generalizing recent work in the radially symmetric case, we prove that the number of particles which fall near the s
Objectives: Infectious diseases are often associated with decline in quality of life. The aim of this study is to analyze the relationship between personal history of communicable, i.e., infectious and parasitic diseases and self-rated health. Study design: Secondary analysis of a large dataset multi-country observational study. Methods: We used a four-pronged analysis approach to investigate whet
BackgroundAdvanced Trauma Life Support® (ATLS®) is the most widely adopted form of trauma life support training worldwide, but there is no high-quality evidence that it can improve patient outcomes. The aim of this trial is to compare the effects of ATLS® training with standard care on outcomes in adult trauma patients.MethodsADVANCE TRAUMA is a batched stepped-wedge cluster randomised controlled
Despite significant advances in knowledge and the development of guidelines, the management of hypoplastic left heart syndrome (HLHS) remains highly variable. A structured questionnaire was circulated across European Association of Paediatric & Congenital Cardiology (AEPC) affiliated centres. The aims were to evaluate standards in pre-operative assessment, types of surgery, follow-up and medic
Background: There is limited data on the organisation of paediatric echocardiography laboratories in Europe. Methods: A structured and approved questionnaire was circulated across all 95 Association for European Paediatric and Congenital Cardiology affiliated centres. The aims were to evaluate: (1) facilities in paediatric echocardiography laboratories across Europe, (2) accredited laboratories, (
Limited data exist on the implementation of current fetal cardiology training and practice guidelines, how trainees are assessed, and how trained fetal cardiologists maintain their skills among countries affiliated with the Association of European Paediatric and Congenital Cardiology (AEPC). A structured questionnaire was sent to fetal cardiologists or national delegates from 44 centers in 33 Euro
AIMS: The COVID-19 pandemic had substantial impacts on mortality and morbidity, even after the rollout of vaccinations. These impacts however, varied considerably across regions. We examined regional disparities in COVID-19 mortality and hospitalizations among older people in Sweden from January 2021 to August 2023 and assessed the role of vaccination coverage in shaping these disparities.METHODS:
The congenital heart disease (CHD) population has seen substantial growth due to advancements in paediatric cardiac care, cardiothoracic surgery, anaesthesia, and intensive care. Although improved surgical interventions have enhanced survival rates for even the most severe defects, such as hypoplastic left heart syndrome, most CHD patients remain palliated rather than cured, requiring lifelong exp
Background Trauma is the leading cause of quality-related mortality in low- and middle-income countries, with an estimated two million preventable deaths each year. Although trauma quality improvement programmes have been utilised in high-income countries for more than three decades, there is no high-level evidence of their effect on patient outcomes. We aimed to assess whether implementing a cont
Background:Trauma patients present with heterogeneous injury patterns that are challenging to represent in statistical models. Traditional approaches either use high-dimensional one-hot encoding, resulting in sparse features, or aggregate injuries into summary scores that lose patient-specific detail.Objective:This study developed data-driven ICD-10 embeddings for trauma injuries and evaluated the
The effects of quality improvement interventions in healthcare are mixed, and the mechanisms through which they mediate their effect remain poorly understood. Quality improvement methods often rest on implicit assumptions of predictability, linear causality, and standardisation. Health systems are increasingly recognised as complex adaptive systems, where outcomes emerge through adaptation, self-o
octurnal lepidopteran pollinators face pesticide exposure risks in agricultural landscapes, yet lack adequate risk assessment frameworks compared to diurnal species. We present a formal model description for Noctua pronuba within the Animal Landscape and Man Simulation System (ALMaSS), providing the first comprehensive agent-based framework for assessing the impacts of pesticides on nocturnal mothNocturnal lepidopteran pollinators face pesticide exposure risks in agricultural landscapes, yet lack adequate risk assessment frameworks compared to diurnal species. We present a formal model description for Noctua pronuba within the Animal Landscape and Man Simulation System (ALMaSS), providing the first comprehensive agent-based framework for assessing the impacts of pesticides on nocturnal mot
Horizontal gene transfer by conjugative plasmids plays a critical role in the evolution of antibiotic resistance. Interactions between bacteria and other organisms can affect the persistence and spread of conjugative plasmids. Here we show that protozoan predation increased the persistence and spread of the antibiotic resistance plasmid RP4 in populations of the opportunist bacterial pathogen Serr
Mobile genetic elements such as conjugative plasmids are responsible for antibiotic resistance phenotypes in many bacterial pathogens. The ability to conjugate, the presence of antibiotics, and ecological interactions all have a notable role in the persistence of plasmids in bacterial populations. Here, we set out to investigate the contribution of these factors when the conjugation network was di
The increasing prevalence of antimicrobial-resistant bacterial infections has ushered in a major global public health crisis. Judicious or restricted antimicrobial use in animal agriculture, aiming to confine the use for the treatment of infections, is the most commonly proposed solution to reduce selection pressure for resistant bacterial strains and resistance genes. However, a multifaceted solu
Experimental microbial ecology and evolution have yielded foundational insights into ecological and evolutionary processes using simple microcosm setups and phenotypic assays with one- or two-species model systems. The fields are now increasingly incorporating more complex systems and exploration of the molecular basis of observations. For this purpose, simplified, manageable and well-defined mult
Low concentrations of antibiotics have numerous effects on bacteria. However, it is unknown whether ecological factors such as trophic interactions and spatial structuring influence the effects of low concentrations of antibiotics on multispecies microbial communities. Here, we address this question by investigating the effects of low antibiotic concentration on community composition and horizonta
Recognizing when and how rapid evolution drives ecological change is fundamental for our understanding of almost all ecological and evolutionary processes such as community assembly, genetic diversification and the stability of communities and ecosystems. Generally, rapid evolutionary change is driven through selection on genetic variation and is affected by evolutionary constraints, such as trade
A tumour grows when the total division (birth) rate of its cells exceeds their total mortality (death) rate. The capability for uncontrolled growth within the host tissue is acquired via the accumulation of driver mutations which enable the tumour to progress through various hallmarks of cancer. We present a mathematical model of the penultimate stage in such a progression. We assume the tumour ha
