Digital Commons Network^™

Strabismus And Amblyopia Disrupt Spatial Perception But Not The Fidelity Of Cortical Maps In Human Primary Visual Cortex, D. Schluppeck, D. Arnoldussen, Z. Hussain, J. Besle, S. T. Francis, P. V. Mcgraw

School of Psychology

Amblyopia is a common disorder of spatial vision and is frequently associated with the presence of anisometropia, strabismus, or both, during visual development. For highly visible stimuli, subjects with strabismic amblyopia often report marked spatial distortions, but the neural basis of this supra-threshold deficit is not well understood. Here, we used a combination of behavioural measurements and visual field mapping with high spatial-resolution functional magnetic resonance imaging (fMRI) at 7 T to assess perceptual distortions in 12 participants with strabismic amblyopia and 9 control subjects. We measured both behavioural and cortical visual field maps monocularly through each eye. Although amblyopic …

More Than Just A Magic Trick? Exploring An Audience's Supernatural Attributions For Magicians' Performances, Paul J. Silvia, Sara J. Crasson, Gil Greengross, Gustav Kuhn

School of Psychology

Performing magicians have long believed that some audience members attribute their magical effects to supernatural methods—to their use of “real magic”. In two samples of adults (n = 412 and 292), we explored personality traits and broader beliefs that might predict supernatural attributions for performance magic. Supernatural attributions were uncommon—many respondents wholly rejected the possibility that magicians' magic was sometimes real—but nevertheless highly variable. In Study 1, a greater belief that magic tricks at least sometimes involve supernatural powers was associated with relatively higher extraversion, higher neuroticism, and lower openness to experience. In Study 2, random forests suggested that supernatural …

Clinical Decision Making And Risk Appraisal Using Electronic Risk Assessment Tools For Cancer Diagnosis: A Qualitative Study Of Gp Experiences, Alex Burns, Emily Fletcher, Elizabeth Shephard, Raff Calitri, Mark Tarrant, Adrian Mercer, William Hamilton, Sarah Dean

School of Psychology

Background: Electronic risk assessment tools (eRATs) are intended to improve early primary care cancer diagnosis. eRATs, which interrupt a consultation to suggest a possibility of a cancer diagnosis, could impact clinical appraisal and the experience of the consultation. This study explores this issue using data collected within the context of the Electronic RIsk-assessment for CAncer (ERICA) trial. Aim: To explore views and experiences of GPs who used the ERICA eRATs, how the tools impacted their perception of risk and diagnostic thinking, and how this was communicated to patients. Design & setting: Qualitative interviews with GPs from English general practices undertaking …

How Decontextualised Risk Information Affects Clinicians’ Understanding Of Risk And Uncertainty In Primary Care Diagnosis: A Qualitative Study Of Clinical Vignettes, Alex Burns, Elizabeth Shephard, Raff Calitri, Adrian Mercer, Edmund Jack, Mark Tarrant, Sarah Dean

School of Psychology

Background: Decontextualised risk information (DRI) is any information pertaining to diagnosis, which is introduced into a clinical consultation, or a diagnostic thought process, without being requested by the clinician. It can be risk scores, computerised warnings, or laboratory tests or diagnostic imaging requests ordered by other clinicians. It is an increasing, and yet under-researched phenomena in UK primary care. Aim: To investigate how GPs integrate DRI into their clinical decision making and how might they communicate this to patients. Design & setting: Clinical vignettes of cases that involve DRI, designed to increase the diagnostic uncertainty of the case, were presented …

“Being Away From Everything”: Exploring The Importance Of Access To Nature For Individuals Living With Chronic Low Back Pain, Alexander Smith, Kayleigh Wyles, Patricia Schofield, Sam Hughes

School of Psychology

Chronic low back pain is a persistent and debilitating condition, and therapeutic outcomes in the long term are generally poor. There is growing evidence to support the ineffectiveness of ‘one-size-fits-all’ pharmacological approaches to pain management. To that end, alternative non-pharmacological therapies such as green social prescribing and time spent in nature are gaining popularity. But it is imperative to understand to what extent these potential interventions are viable by gaining a deeper insight into the lived experiences of the chronic low back pain community. The present qualitative cross-sectional study employed ten semi-structured interviews (9 women, M age = 50.1, M …

Secretive Sheriffs: Opacity And Variation In California's Jail Responses To Covid-19, Hadar Aviram, Aparna Komarla

Faculty Scholarship

Agnotology is the study of culturally induced ignorance or doubt, particularly the publication of inaccurate or misleading scientific data. In this Article, we draw attention to a disturbing site of agnotology: healthcare in California jails. Often obscured because of the attention to state prisons, jails were sites of opacity and misinformation, largely because of sheriffs’ refusal to collaborate with data collection efforts—both coordinated by the state and solicited through non-profits.

Building on the data collection effort of the Covid In-Custody Project and on public advocacy efforts of the #StopSanQuentinOutbreak coalition and its off-shoots, we show the chasm between data on …

Trumpian Impoundments In Historical Perspective, Zachary S. Price

Faculty Scholarship

During the election campaign and the first 100 days of his second term, President Donald Trump and key figures in his administration took actions and made statements suggesting that they believe the President holds a constitutional power to "impound," or decline to spend, appropriated funds. They also suggested that they believe the executive branch is better suited than Congress to represent the common good in federal spending. Although both these arguments have historical antecedents, both are deeply flawed, and courts should reject them in an appropriate case. Rather than continue its trajectory toward executive governance, the United States should adhere …

The Supreme Court And Public Opinion, Scott Dodson

Faculty Scholarship

Alexander Hamilton famously called the Supreme Court the “least dangerous branch” because it was reliant on Congress for funding and the President for enforcement. To manage its relationship with the political branches in a way that affords the Court both independence from them and the necessary assistance from them, the Court must cultivate the affection of the electorate. Several doctrinal tools facilitate that cultivation, and, historically, the Court has used those tools effectively to maintain relatively high public-approval rates. But over the last decade, those rates have fallen significantly to historic lows. This paper interrogates why that is. Tracing the …

Transcultural Courts, Scott Dodson

Faculty Scholarship

Although countries commonly divide their judicial systems along geographic and subject-matter divisions, the idea of creating specialized courts based on culture has not taken root. Instead, courts are generally transcultural. Functionally, the lack of culture-specific courts is surprising because cultural diversity within a population often creates legally significant distinctions. Focusing primarily on the U.S. judicial system, but incorporating attributes of other judicial systems where appropriate, this paper offers three explanations for why courts tend to eschew cultural specializations in favor of transculturality. It also hazards some opportunities for experimenting with cultural specializations in discrete areas of the law that most …

Personal Jurisdiction And The Fifth Amendment, Scott Dodson

Faculty Scholarship

The Supreme Court has avoided clarifying the relationship between federal-court personal jurisdiction, congressional statutes, and the Fifth Amendment. Until June 2025, that is. In that month, the Court decided two important cases involving constraints on a federal court's exercise of personal jurisdiction outside of Rule 4(k)(1)(A), which typically ties federal-court personal jurisdiction to state-court personal jurisdiction. This brief essay explains and analyzes those cases, situating them in the Court's larger agenda for personal jurisdiction. It also discusses some open questions raised by the decisions and the role that personal jurisdiction in the United States may now play on the global …

Personal Jurisdiction And Federalism, Scott Dodson

Faculty Scholarship

Personal jurisdiction has long professed to safeguard interstate federalism through the principle that good fences make good neighbors. Although this goal sits uncomfortably with the idea of personal jurisdiction as an individual right under the Due Process Clause, recent decisions from the Supreme Court have reinvigorated the federalism aspect of personal jurisdiction, offering a new opportunity to appraise its value and efficacy. This Article does so and concludes that personal jurisdiction fails to protect interstate federalism. States and private parties, it turns out, have too much authorization to expand state-court personal jurisdiction beyond state borders using the doctrine of consent …

Minimax Under Pressure: The Case Of Tennis, Ben Depoorter, Simon Jantschgi, Ivan Lendl, Miha Mlakar, Heinrich N. Nax

Faculty Scholarship

A series of articles has tested von Neumann’s minimax theory against behavioral evidence based on field data from professional sports. The evidence has been viewed and collectively cited as positive evidence that elite athletes in their familiar sports contexts mix well and behave in line with minimax. In this paper, based on open state-of-the-art tennis data and analytics, we shall uncover new and significant evidence against minimax at the very top of the game, where previously, such results had not been obtained. The kinds of behavioral deviations from minimax that we find become apparent, because we enrich the test strategy …

Navigating The Growing Prospects And Growing Pains Of Managed Aquifer Recharge, Dave Owen, Helen Dahlke, Andrew Fisher, Ellen Bruno, Michael Kiparsky

Faculty Scholarship

Increasing water demands and declining groundwater levels have led to rising interest in managed aquifer recharge. That interest is growing in the United States—the focus of this article—and elsewhere. Increasing interest makes sense; managed aquifer recharge can reduce water-supply challenges and provide environmental benefits, sometimes with lower costs than alternative water-management approaches. But managed aquifer recharge also faces growing pains, which will make it difficult for projects to scale up and may limit the benefits provided by those projects that do go forward. Some of the problems arise from the challenges of finding physically suitable locations for managed aquifer recharge; …

Legislatively Erased: The Failure Of Privacy Legislation To Protect People Connected To The Criminal Legal System, Kate Weisburd, Chaz Arnett

Faculty Scholarship

No abstract provided.

Imperfect Access: Structural Barriers And External Threats To Preventive Care, Dorit Rubenstein Reiss, Richard H. Hughes Iv

Faculty Scholarship

Access to healthcare in the United States is often partial and inequitable. This is due in large part to a highly fragmented public-private system of providing health insurance coverage to its citizens. Yet, through incremental policy developments, the United States provides more comprehensive preventive care coverage across both public and private sources of coverage than in other areas of healthcare. Moreover, it has developed safety net programs intended to gap-fill access for those without insurance coverage. This is not surprising; like other countries, the United States realize that in addition to being just and equitable, broader access to prevention has …

The Current Clinical Practice And Experiences In Buccal Midazolam Prescribing In Community For Status Epilepticus Termination In The United Kingdom: The Rescue Epilepsy Medication And Training (Remit) Study, Rohit Shankar

Peninsula Medical School

Background: Epilepsy is one of the commonest neurological conditions worldwide and confers a significant mortality risk, partly driven by status epilepticus (SE). Terminating SE is the goal of pharmaceutical rescue therapies. This survey evaluates UK-based healthcare professionals’ clinical practice and experience in community-based rescue therapy prescribing. Methods: A cross-sectional, 21 item questionnaire composed of Likert-style and free-text based questions was administered online. It was distributed through a non-discriminative snow-balling methodology to members of the Epilepsy Specialist Nurses’ Association (ESNA) and the British International League Against Epilepsy (ILAE). Quantitative analysis used Chi-squared, Fishers’ exact and Mann-Whitney tests. Qualitative data were analysed …

Mortality Prediction After Major Surgery In A Mixed Population Through Machine Learning: A Multi-Objective Symbolic Regression Approach, Pietro Arina, Davide Ferrari, Nicholas Tetlow, Amy Dewar, Robert Stephens, Daniel Martin, Ramani Moonesinghe, Vasa Curcin, Mervyn Singer, John Whittle, Evangelos B Mazomenos

Peninsula Medical School

INTRODUCTION: Understanding 1-year mortality following major surgery offers valuable insights into patient outcomes and the quality of peri-operative care. Few models exist that predict 1-year mortality accurately. This study aimed to develop a predictive model for 1-year mortality in patients undergoing complex non-cardiac surgery using a novel machine-learning technique called multi-objective symbolic regression.

METHODS: A single-institution database of patients undergoing major elective surgery with previous cardiopulmonary exercise testing was divided into three datasets: pre-operative clinical data; cardiorespiratory and physiological data; and combined. A multi-objective symbolic regression model was developed and compared against existing models. Model performance was evaluated using the …

The Added Value Of Narrow Band Imaging In Sinonasal Tumour Resection And Surveillance: Our Experience, Yazan Kanaan, Ra'ed Al-Ashqar, Hisham Khalil, Konstantinos Geronatsios, Marios Stavrakas

Peninsula Medical School

BACKGROUND & PURPOSE: Narrow Band Imaging (NBI), developed by Olympus Medical Systems, has played a role in diagnosing digestive tract lesions and cancers, diagnosing and characterizing bladder cancers during cystoscopy and in the diagnosis and management of Head and Neck cancers. We aim to explore the potential use of NBI in the diagnosis, management, and follow-up of sinonasal tumours.

METHODS: We present a series of cases treated at our institution, where NBI played a crucial role in the diagnosis, surgical management, intraoperative decision-making, and follow-up. The cases include a patient with sinonasal lymphoma, 2 patients with sinonosal malignant melanoma and …

Patterns Of Intra-Cluster Correlation Coefficients In School-Based Cluster Randomised Controlled Trials Of Interventions For Improving Social-Emotional Functioning Outcomes In Pupils: A Secondary Data Analysis Of Five Uk-Based Studies, Kitty Parker, Michael Nunns, Zhi Min Xiao, Tamsin Ford, Paul Stallard, Willem Kuyken, Nick Axford, Obioha C. Ukoumunne

Peninsula Medical School

Background: The cluster randomised trial (CRT) design is increasingly used to evaluate the impact of school-based interventions for improving social-emotional functioning outcomes in pupils. Good knowledge is required on plausible values of the intra-cluster correlation coefficient (ICC) of the outcome to calculate the required sample size in such studies. Using data from five school-based CRTs in the UK, we estimate, and describe patterns in, ICCs for social-emotional functioning outcomes. Methods: Mixed effects linear regression models were fitted to estimate the ICC and variance components. Estimates for baseline data were obtained by fitting “null” models that had no predictor variables; estimates …

Evidence For Alcohol-Mediated Hemolysis And Erythrophagocytosis, Chaowen Zheng, Siyuan Li, Johannes Mueller, Cheng Chen, Huanran Lyu, Guandou Yuan, Ane Zamalloa, Lissette Adofina, Parthi Srinivasan, Krishna Menon, Nigel Heaton, Stephan Immenschuh, Ines Silva, Vanessa Rausch, Seddik Hammad, Steven Dooley, Shilpa Chokshi, Antonio Riva, Songqing He, Sebastian Mueller

Peninsula Medical School

Alcohol-related liver disease (ALD) is the most common liver disease worldwide; however, its underlying molecular mechanisms remain poorly understood. Here, we identify ethanol-mediated hemolysis and erythrophagocytosis as major contributors to ALD pathogenesis using both in vitro and in vivo models, as well as surrogate markers such as heme oxygenase-1 (HO-1) and CD163, a scavenger receptor for hemoglobin-haptoglobin complexes. A key initial observation was the direct optical evidence of serum hemolysis in heavy drinkers, which diminished after one week of alcohol withdrawal. In parallel, soluble CD163 (sCD163) levels declined during alcohol detoxification correlating with liver damage and fibrosis stages. Moreover, red …

Epidemiology Of Thrombotic Thrombocytopenia Syndrome 2011 To 2022: English Sentinel Network Cohort Studies, José M. Ordóñez-Mena, Debasish Kar, Xuejuan Fan, Filipa Ferreira, Sneha N. Anand, Deborah Layton, David Clifton, Mark Joy, Anshul Thakur, Anu Alessi, Andrew Lee, Lisa Mather, Simon De Lusignan

Peninsula Medical School

Background and Objective: Thrombotic thrombocytopenia syndrome (TTS) is a rare condition following vaccination with adenovirus-vectored coronavirus disease 2019 (COVID-19) vaccines. This retrospective analysis of England primary care data aimed to estimate TTS event rates before, during, and after the COVID-19 pandemic, and following AZD1222 (ChAdOx1-nCoV-19) vaccination. Methods: Primary care data on TTS events were collected using the Oxford-Royal College of General Practitioners Research and Surveillance Centre sentinel network. TTS events were defined as thromboembolism with coincident (± 7 days) thrombocytopenia events using Systematized Nomenclature of Medicine clinical terms (the current Brighton Collaboration definition could not be used in the study …

How Epilepsy Risks Might Be Introduced And Discussed In Clinical Consultations, Rohit Shankar

Peninsula Medical School

AbstractAdverse impacts of epilepsy (e.g., injury, depression, and Sudden Unexpected Death from Epilepsy (SUDEP) can be mitigated by factors that patients may control, such as medication adherence, improved sleep and diet, reduced alcohol and taking care around pregnancy. New guidelines state that risk should be discussed at the time of diagnosis but some clinicians express concern about not wanting to raise anxiety.ObjectiveTo explicate practices by which epilepsy expert clinicians broach discussions of risk in specialist epilepsy clinics.Methods24 recordings of initial telephone appointments at specialist clinics where epilepsy is diagnosed from two specialist outpatient epilepsy services in England were subjected to …

Il-1 Signal Inhibition In Alcohol-Related Hepatitis: A Randomized, Double-Blind, Placebo-Controlled Trial Of Canakinumab, Nikhil Vergis, Vishal Patel, Karolina Bogdanowicz, Justyna Czyzewska-Khan, Rosemary Keshinro, Francesca Fiorentino, Emily Day, Paul Middleton, Stephen Atkinson, Thomas Tranah, Mary Cross, Daphne Babalis, Neil Foster, Emma Lord, Alberto Quaglia, Josephine Lloyd, Robert Goldin, William Rosenberg, Richard Parker, Paul Richardson, Steven Masson, Gavin Whitehouse, Cyril Sieberhagan, David Patch, Nikolai Naoumov, Ashwin Dhanda, Ewan Forrest, Mark Thursz

Peninsula Medical School

Background and Aims: Short-term mortality in alcohol-related hepatitis (AH) is high, and no current therapy results in durable benefit. A role for interleukin (IL)-1β has been demonstrated in the pathogenesis of alcohol-induced steatohepatitis. This study explored the safety and efficacy of canakinumab (CAN), a monoclonal antibody targeting IL-1β, in the treatment of patients with AH. Methods: Participants with biopsy-confirmed AH and discriminant function ≥32 but Model for End-Stage Liver Disease ≤27 were randomly allocated 1:1 to receive either CAN 3 mg/kg or placebo (PBO). Liver biopsies were taken before and 28 days after treatment. The primary endpoint was the overall …

Impact Of Social Deprivation Upon The Preoperative Pathway And Early Surgical Outcomes After Pancreatoduodenectomy For Pdac And Non-Pdac Periampullary Cancer In England: The Surg-Panc-Uk Study, Surg-Panc-Uk Study Group On Behalf Of Augis, Thomas W Thorne, Siobhan C Mckay, Samir Pathak, Richard Wilkin, Jenifer Barrie, John Moir, Keith J Roberts, Somaiah Aroori

Peninsula Medical School

BACKGROUND: Socioeconomic deprivation is linked to poorer outcomes in many cancers, however the impact of social deprivation on survival in resectable pancreatic and other peri-ampullary cancers appears mixed. Moreover, no studies consider the impact of social deprivation on diagnostic pathway length.

METHODS: A retrospective observational cohort study of adults with suspected periampullary cancer undergoing pancreaticoduodenectomy in England. Following surgery, patients were stratified by cancer type (PDAC, duodenal cancer, cholangiocarcinoma and ampullary cancer) and the impact of social deprivation (IMD deprivation quintiles) upon short-term survival and diagnostic pathway length analysed.

RESULTS: 648 patients from England with social deprivation data were identified, …

Discussing Poverty Within Primary Care Consultations: Implications For Mental Health Support, F. Thomas, K. Wyatt, K. Berzins, I. Lee, J. Horrell, A. Mcloughlin

Peninsula Medical School

No abstract provided.

A Mapping Review Of Studies Exploring The Barriers And Facilitators To A Dementia Diagnosis Through An Intersectionality Lens, Ben Hicks, Katherine Wheatley, Emma Porter, Nicolas Farina, Sube Banerjee

Peninsula Medical School

BackgroundPromoting a ‘timely’ diagnosis is a global policy directive.AimsThis review adopts an intersectional approach, visually mapping the existing literature to highlight gaps in the evidence base on barriers and facilitators to dementia diagnosis.MethodA systematic approach was undertaken, following the PRISMA guidelines, updating previous reviews. The literature search was conducted on PubMed, PsycINFO, CINAHL Complete and Scopus. In line with mapping review methodology, we report the current state of the literature by describing the number of studies that outline barriers and facilitators to seeking help for a dementia diagnosis, split by social categorisation.ResultsOn the 7 June 2024, a total of 45 …

From Hospital Discharge To Long-Term Care: Unmet Rehabilitation Needs In Cauda Equina Syndrome Patients From A National Uk Cohort, Uces Collaborators, British Neurosurgical Trainee Research Collaborative, Holly Roy, Krithika Anil, Jack Read, Marcus J. Drake, Ingrid Hoeritzauer, Julie Woodfield

Peninsula Medical School

Objectives: Although long term disability may be a consequence of cauda equina syndrome (CES), the evidence base for the effect of rehabilitation or different rehabilitation strategies is lacking. Our aim was to understand long term neurological deficits (understood as rehabilitation needs) and current rehabilitation provision for patients with CES. Methods: We retrospectively analysed data from a large UK wide cohort of CES patients presenting between 1st June 2018 and 31st May 2019. Rehabilitation referrals and attendance were described, and symptoms at discharge and one year were identified as potential targets for rehabilitation. Results: Physiotherapy was the most common inpatient rehabilitation …

An Immanent Postfoundational Methodology For Researching The Violent Trans-Sections Of Ableism, Classism And Sexism, Elizabeth Done, Cara Baer

School of Law, Humanities and Social Sciences

This paper charts the unfolding of a small-scale qualitative study, presented at institutional ethical approval stage as drawing on posthumanist theorising and seeking to (re)configure the concept of intersectionality, and focusing on the lived experience of postgraduate students of lower socio-economic status with disabilities. The self-selected sample comprised six women, three of whom volunteered accounts of sexual violence that complicated their experiences of dis-ability and class, and highlighted the complexity of their lived experience of intersectionality. We describe a research process in which interviewing became intra-viewing, lived experience came to be understood through Deleuzian and Deleuzo-guattarian concepts and intersectionality became …

Shedding Light To The Rights To Light In England And Wales: The Need For Reform, Goodtime Okara

School of Law, Humanities and Social Sciences

The right to light is unarguably a right that could hinder the development of the servient land. Owing to the possibility of granting a mandatory injunction when breached, this right could lead to extra costs and delays in the efficient development of the servient land by real property developers, even when the dominant tenement does not wish to enjoy the right. Hence, this paper critically reflects on rights to light in England and Wales to determine the impact of this right on the servient land. It explores the direction of travel across the Courts – by briefly examining rights to …

Transatlantic Solidarity In The Shadow Of The Russian–Ukrainian War: A Neorealist Explanation, Lorenzo Cladi

School of Law, Humanities and Social Sciences

The threat posed by Russia, which was exposed most clearly following the invasion of Ukraine in February 2022, provided the impetus to strengthen solidarity among the transatlantic allies. Notable consequences included a renewed sense of purpose for NATO and the strengthening of the EU’s resolve in responding to a crisis in its backyard and a willingness by many European states to do more to contribute to defence. Whilst there is apparent unity of intent in supporting Ukraine in the long term, this article argues that solidarity rests upon a familiar working pattern in transatlantic relations. This can be elucidated most …