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Against the status quo, this article argues for the right to renounce state citizenship while remaining a resident. To motivate this argument, it presents a dilemma: if long-term residents can choose not to naturalize, why cannot citizens renounce their status without leaving? This article rejects one way out of this dilemma—making citizenship mandatory for long-term residents—and proceeds to make the positive case for the right to renounce citizenship. It argues for the value of citizenship renunciation as an expressive political act, distinct from territorial exit, which allows individuals to sever political ties while maintaining social membership. This form of political exit enables citizens to express their detachment from the state without the costs of emigration. This article explores the implications of this proposal for democratic consent, legitimate authority, and collective citizen responsibility for state action, arguing that a right to renounce without emigration enhances autonomy and democratic legitimacy.
This research note introduces a new publicly available dataset identifying which federal candidates are out as LGBTQ2S+. The dataset comprises 4,201 candidates who ran in 2015, 2019 and 2021 for the five parties that won seats in the House of Commons. In this research note, we describe the replicable procedure we followed to identify out LGBTQ2S+ candidates, which involved systematic individual candidate searches. This procedure identified 176 LGBTQ2S+ candidates in total, which is more than in previous datasets. We illustrate how the data can be used by documenting how LGBTQ2S+ candidates changed over time relative to straight cisgender candidates. This dataset will allow researchers to examine a range of questions about LGBTQ2S+ representation as well as conduct intersectional analyses.
Central venous catheter use is not standardised in paediatric cardiology, yet it is associated with additional morbidity. We aimed to characterise variation in central venous catheter use and complications across paediatric acute care cardiology units.
Methods:
This retrospective, multi-centre, and registry-based study examined all unique acute care cardiology encounters from February 2019 through September 2021 in the Paediatric Acute Care Cardiology Collaborative registry. Descriptive and comparative statistics were assessed for differences based on central venous catheter use. Multivariate logistic regression identified factors associated with increased line duration and use frequency.
Results:
About 35,379 encounters from 24 institutions were assessed. About one in five encounters had at least one central venous catheter (n = 7,524, 21.3%). Neonates and post-operative cardiothoracic surgery patients were more likely to have central venous catheters than not (28.9% of neonates with, versus 11.4% without; 58.4% of post-operative patients with, versus 35.7% without; p < 0.001). Most patients after STAT 4 procedures retained central venous access for over half of the acute care cardiology stay. Institutions with overall “low” central venous catheter utilisation rates (<20%) also used central venous access most often on STAT 4 patients (p < 0.0001). Complication rates for venous thrombus and central line-associated bloodstream infection were low (1.9% and 0.2%).
Conclusion:
There is variable utilisation of central venous catheters across participating acute care cardiology units, though overall they are common vascular access modalities. Acute care cardiology units use central venous catheters more often in neonates, those after cardiac surgery, and in their higher-risk patients (i.e. after STAT 4 procedures).
Two years on from the implementation of the Assisted Decision-Making (Capacity) Act (ADMCA) 2015, significant legal uncertainty persists in Ireland’s acute hospitals for the care of people who lack capacity to consent to treatment. Consultation-liaison psychiatrists must navigate a legal landscape where clear lacunae have emerged in the regulation of frequently encountered clinical scenarios. We identify three of these – eating disorders requiring refeeding, refusal of life-saving treatment, and unsafe discharges – where neither the ADMCA nor the Mental Health Act 2001 provide legal authority to intervene. In such cases, the Inherent Jurisdiction of the High Court has become the default mechanism for authorising treatment or deprivation of liberty, raising serious concerns about proportionality, clinical delays and uncertainty, cost, and consistency. We also consider a fourth category of patients who require immediate life-saving treatment, and the legal status of Advance Healthcare Directives in this context. Many of the patients who fall into these categories will have an established or suspected mental illness requiring the clinical input of a consultation-liaison psychiatry team.
We contrast Ireland’s evolving capacity legislation with developments in England and Wales. Reflecting on these comparisons, we consider the proposed Protection of Liberty Safeguards may provide some clarification but also contain potential risks of becoming unwieldy and bureaucratic and still fail to provide a workable statutory basis for authorising medical treatment in acute hospital settings. A proportionate, patient-centred, and clinically usable legal framework remains urgently needed.
This article explores the challenge of financially advantaged spouses concealing assets within corporate structures during divorce proceedings, using the English legal framework as a reference point for potential reforms in Ghana. Although Ghana has made significant strides in ensuring the equitable distribution of marital property, these efforts may be insufficient if the concealment of personal or marital assets within corporate entities is not adequately addressed. The study focuses on the English legal distinction between piercing and lifting the corporate veil. It highlights that while piercing the corporate veil is a stringent measure used sparingly and typically in cases of fraud or evasion, lifting the veil is more pertinent in matrimonial disputes for revealing the actual control and ownership of assets. The article advocates for a clearer and more systematic application of the veil-lifting principles in Ghanaian law to expose hidden marital and personal assets effectively. By adopting these principles, Ghana can strengthen its legal framework to ensure a more equitable distribution of marital assets and achieve fairer outcomes in divorce proceedings.
We report a rare case of coronary sinus ostium atresia diagnosed due to impaired cardiac function caused by Marshall vein stenosis, which occurred during surgical treatment. Transcatheter perforation of the coronary sinus ostium and stenting of the Marshall vein stenosis improved ventricular function, enabling subsequent surgical enlargement. This staged strategy minimised surgical risks and demonstrated a reliable and effective treatment for such challenging conditions.
Let $(\Sigma , g)$ be a closed Riemann surface, and let u be a weak solution to the equation
$$\begin{align*}- \Delta_g u = \mu, \end{align*}$$
where $\mu $ is a signed Radon measure. We aim to establish $L^p$ estimates for the gradient of u that are independent of the choice of the metric g. This is particularly relevant when the complex structure approaches the boundary of the moduli space. To this end, we consider the metric $g' = e^{2u} g$ as a metric of bounded integral curvature. This metric satisfies a so-called quadratic area bound condition, which allows us to derive gradient estimates for $g'$ in local conformal coordinates. From these estimates, we obtain the desired estimates for the gradient of u.
Coronary to pulmonary artery fistula is a rare malformation that can be detected incidentally because most cases are asymptomatic. Here, we present multiple micro coronary to pulmonary artery fistulas in a Fontan physiology adult patient, which leaded dyspnoea due to elevated pulmonary artery pressure and were successfully closed with vascular plugs from the pulmonary side.
Research on water wave metamaterials based on local resonance has advanced rapidly. However, their application to floating structures for controlling surface gravity waves remains underexplored. In this work, we introduce the floating metaplate, a periodic array of resonators on a floating plate that leverages locally resonant bandgaps to effectively manipulate surface gravity waves. We employ the eigenfunction matching method combined with Bloch’s theorem to solve the wave–structure interaction problem and obtain the band structure of the floating metaplate. An effective model based on averaging is developed, which agrees well with the results of numerical simulation, elucidating the mechanism of bandgap formation. Both frequency- and time-domain simulations demonstrate the floating metaplate’s strong wave attenuation capabilities. Furthermore, by incorporating a gradient in the resonant frequencies of the resonators, we achieve the rainbow trapping effect, where waves of different frequencies are reflected at distinct locations. This enables the design of a broadband wave reflector with a tuneable operation frequency range. Our findings may lead to promising applications in coastal protection, wave energy harvesting and the design of resilient offshore renewable energy systems.
Here we consider the hypergraph Turán problem in uniformly dense hypergraphs as was suggested by Erdős and Sós. Given a $3$-graph $F$, the uniform Turán density $\pi _{\boldsymbol{\therefore }}(F)$ of $F$ is defined as the supremum over all $d\in [0,1]$ for which there is an $F$-free uniformly $d$-dense $3$-graph, where uniformly $d$-dense means that every linearly sized subhypergraph has density at least $d$. Recently, Glebov, Král’, and Volec and, independently, Reiher, Rödl, and Schacht proved that $\pi _{\boldsymbol{\therefore }}(K_4^{(3)-})=\frac {1}{4}$, solving a conjecture by Erdős and Sós. Despite substantial attention, the uniform Turán density is still only known for very few hypergraphs. In particular, the problem due to Erdős and Sós to determine $\pi _{\boldsymbol{\therefore }}(K_4^{(3)})$ remains wide open.
In this work, we determine the uniform Turán density of the $3$-graph on five vertices that is obtained from $K_4^{(3)-}$ by adding an additional vertex whose link forms a matching on the vertices of $K_4^{(3)-}$. Further, we point to two natural intermediate problems on the way to determining $\pi _{\boldsymbol{\therefore }}(K_4^{(3)})$, and solve the first of these.
This research shows that droughts are robustly associated with city-level unrest in Europe over the years 900 to 1800 ce. This relationship is non-linear, with disproportionately greater increases in the probability of a conflict among droughts in the upper tail of the severity distribution. Elected city governments are relatively immune to drought-induced conflict, while those based on representation by burghers or guilds are not. These results suggest that local governments are key to maintaining social stability during economic shocks, and are most successful when they have a greater degree of democratic legitimacy.
The 58th Annual Scientific Conference of the Nutrition Society of New Zealand, held in Christchurch in 2024, brought together 187 delegates under the theme ‘Kotahitanga: Bridging Research, Industry and Practice’. This theme reflected the society’s commitment to uniting diverse sectors to address key nutrition challenges across the life course. Kotahitanga refers to unity and collective action. Topics included nutrition in ageing and chronic disease, infant and toddler nutrition, gut health, sustainable food systems and food safety. Presentations on sarcopenia and Parkinson’s disease emphasised the need for greater awareness and tailored nutrition strategies for older adults. The Muriel Bell Lecture celebrated the legacy of New Zealand’s first State Nutritionist and called for continued leadership in evidence-based nutrition and encouraged nutritionists to communicate research to the public. A panel on science communication offered practical strategies for engaging the public and countering misinformation. The conference reinforced the importance of collaboration, advocacy and practical application in advancing nutrition.
Single ventricle pulmonary arteriovenous malformations are poorly understood and variably assessed in published literature. To improve our understanding of single ventricle pulmonary arteriovenous malformations and facilitate multi-centre studies, it will be necessary to have uniform clinical practice patterns among paediatric heart institutions.
Objectives:
The aim of this study was to assess paediatric interventional cardiologists’ clinical perspectives and practice patterns for diagnosing single ventricle pulmonary arteriovenous malformations.
Methods:
We surveyed paediatric interventional cardiologists using the Congenital Cardiovascular Interventional Consortium listserv. A single survey was distributed electronically with two subsequent reminder emails. Voluntary participants completed the anonymous survey electronically via RedCap.
Results:
Among 253 Congenital Cardiovascular Interventional Consortium members, a total of 55 (21.7%) paediatric cardiology interventional attending physicians completed the survey. There was near unanimity (98%) that pulmonary arteriovenous malformations develop due to lack of hepatic vein blood flow to the lungs; however, there was wide variation among practice patterns. A minority (20%) of respondents perform bubble contrast echocardiograms (bubble studies) more than half the time pre-Fontan, whereas many (31%) almost never (< 5% of cases) perform bubble studies pre-Fontan. Most respondents reported that they did not perform bubble studies because results do not impact clinical decision making pre-Fontan (56%) or post-Fontan (60%). Many respondents (49%) do not have a typical volume of agitated saline that they inject for bubble studies.
Conclusions:
Clinical practice patterns vary widely among paediatric cardiology interventionalists. A standardised clinical approach, new diagnostic tools, or both are needed to standardise our field’s approach to diagnosing, studying, and treating single ventricle pulmonary arteriovenous malformations.
In 2022, a Tunisian citizen was arrested in Oslo when he tried to sell 30 Carthaginian bronze coins to a local antiques dealer. The dealer had previously alerted the police after receiving an email inquiry asking him whether he was interested in buying a ‘large number’ of Punic coins from an alleged underwater find, presumably a hoard, off the coast of Tunisia. The University of Oslo’s Museum of Cultural History, which cooperates with law-enforcement agencies and the authorities in cases involving illicit cultural artefacts, assisted with the identification of the coins. Eventually, the latter were returned to Tunisia, and Norwegian prosecutors dropped the charges against the Tunisian national. This article discusses the relevant legal framework of the case and the process that unfolded from the time when an attempt was made to sell the coins until they were returned to their country of origin. The broader numismatic implications of this find are also examined.
This single-center retrospective analysis evaluated the yield of blood cultures in patients with febrile neutropenia during a supply shortage. The detection rate of true bacteremia was observed to increase with the number of sets obtained, although this increase was not statistically significant. Findings support limiting repeat cultures within 48 hours.