Abstract: More and more analyses of biological shapes are using the techniques of geometric morphometrics based on configurations of landmarks in two or three dimensions. A fundamental concept at the core of these analyses is Kendall’s shape space and local approximations to it by shape tangent spaces. Kendall’s shape space is complex because it is a curved surface and, for configurations with more than three landmarks, multidimensional. This paper uses the shape space for triangles, which is the surface of a sphere, to explore and visualize some properties of shape spaces and the respective tangent spaces. Considerations about the dimensionality of shape spaces are an important step in understanding them, and can offer a coordinate system that can translate between positions in the shape space and the corresponding landmark configurations and vice versa. By simulation studies “walking” along that are great circles around the shape space, each of them corresponding to the repeated application of a particular shape change, it is possible to grasp intuitively why shape spaces are curved and closed surfaces. From these considerations and the available information on shape spaces for configurations with more than three landmarks, the conclusion emerges that the approach using a tangent space approximation in general is valid for biological datasets. The quality of approximation depends on the scale of variation in the data, but existing analyses suggest this should be satisfactory to excellent in most empirical datasets.

Membrane-based applications such as osmotic power generation, desalination and molecular separation would benefit from decreasing water friction in nanoscale channels. However, mechanisms that allow fast water flows are not fully understood yet. Here we report angstrom-scale capillaries made from atomically flat crystals and study the effect of confining walls' material on water friction. A massive difference is observed between channels made from isostructural graphite and hexagonal boron nitride, which is attributed to different electrostatic and chemical interactions at the solid-liquid interface. Using precision microgravimetry and ion streaming measurements, we evaluate the slip length, a measure of water friction, and investigate its possible links with electrical conductivity, wettability, surface charge and polarity of the confining walls. We also show that water friction can be controlled using hybrid capillaries with different slip lengths at opposing walls. The reported advances extend nanofluidics' toolkit for designing smart membranes and mimicking manifold machinery of biological channels.

Vibrational energy created at the larynx during speech will deflect vestibular mechanoreceptors in humans (Todd et al., 2008; Curthoys, 2017; Curthoys et al., 2019). Vestibular-evoked myogenic potential (VEMP), an indirect measure of vestibular function, was assessed in 15 participants who stutter, with a non-stutter control group of 15 participants paired on age and sex. VEMP amplitude was 8.5 dB smaller in the stutter group than the non-stutter group (p = 0.035, 95% CI [−0.9, −16.1], t = −2.1, d = −0.8, conditional R2 = 0.88). The finding is subclinical as regards gravitoinertial function, and is interpreted with regard to speech-motor function in stuttering. There is overlap between brain areas receiving vestibular innervation, and brain areas identified as important in studies of persistent developmental stuttering. These include the auditory brainstem, cerebellar vermis, and the temporo-parietal junction. The finding supports the disruptive rhythm hypothesis (Howell et al., 1983; Howell, 2004) in which sensory inputs additional to own speech audition are fluency-enhancing when they coordinate with ongoing speech.

The long-held image of early Christ-believers persecuted by an intolerant state has been called into question by a “minimalist” view, which, in contrast, understands Christian obstinacy as intolerance of a largely tolerant Roman state. This article seeks to balance these two extremes by offering a new model of “modified minimalism,” which accounts for both Christian and Roman viewpoints.

Abstract: Background: Historically, safety mental health research has tended to focus on risks of homicide, suicide and deaths. Although wider safety issues are now recognized in regards to mental health services, the safety of mental health transitions, a key research and policy priority according to World Health Organisation, has not been explored. Objective: The purpose of this study was to investigate perceptions of safety in mental health transitions (hospital to community) amongst five stakeholder groups. Design and setting: An online, international cross‐sectional, open‐ended questionnaire. Participants: There were five stakeholder participant groups: service users; families/carers; mental health‐care professionals; researchers; and end users of research. Results: Ninety‐three participants from 12 different countries responded. Three overarching themes emerged: ‘individual/clinical’, ‘systems/services’ and ‘human, behavioural and social’ elements of safe mental health transitions. Whilst there was a great focus on clinical elements from researchers and healthcare professionals, service users and carers considered safety in terms of human, behavioural and social elements of transitional safety (ie loneliness, emotional readiness for discharge) and systems/services (ie inter‐professional communication). Discussion: Safety in mental health‐care transitions is perceived differently by service users and families compared to healthcare professionals and researchers. Traditional safety indicators for care transitions such as suicide, self‐harm and risk of adverse drug events are raised as important. However, service users and families in particular have a much wider perception of transitions safety. Conclusion: Future quality and safety research and policy should consider including a service user voice and consider integration of psychosocial elements in discharge interventions.

Abstract: Background: Contemporary health policy is shifting towards remotely delivered care. A growing need to provide effective and accessible services, with maximal population reach has stimulated demand for flexible and efficient service models. The implementation of evidence-based practice has been slow, leaving many services ill equipped to respond to requests for non-face-to-face delivery. To address this translation gap, and provide empirically derived evidence to support large-scale practice change, our study aimed to explore practitioners’ perspectives of the factors that enhance the delivery of a NICE-recommended psychological intervention, i.e. guided self-help by telephone (GSH-T), in routine care. We used the Theoretical Domains Framework (TDF) to analyse our data, identify essential behaviour change processes and encourage the successful implementation of remote working in clinical practice. Method: Thirty-four psychological wellbeing practitioners (PWPs) from the UK NHS Improving Access to Psychological Therapies (IAPT) services were interviewed. Data were first analysed inductively, with codes cross-matched deductively to the TDF. Results: Analysis identified barriers to the delivery, engagement and implementation of GSH-T, within eight domains from the TDF: (i) Deficits in practitioner knowledge, (ii) Sub-optimal practitioner telephone skills, (iii) Practitioners’ lack of beliefs in telephone capabilities and self-confidence, (iv) Practitioners’ negative beliefs about consequences, (v) Negative emotions, (vi) Professional role expectations (vii) Negative social influences, and (viii) Challenges in the environmental context and resources. A degree of interdependence was observed between the TDF domains, such that improvements in one domain were often reported to confer secondary advantages in another. Conclusions: Multiple TDF domains emerge as relevant to improve delivery of GSH-T; and these domains are theoretically and practically interlinked. A multicomponent approach is recommended to facilitate the shift from in-person to telephone-based service delivery models, and prompt behaviour change at practitioner, patient and service levels. At a minimum, the development of practitioners’ telephone skills, an increase in clients’ awareness of telephone-based treatment, dilution of negative preconceptions about telephone treatment, and robust service level guidance and standards for implementation are required. This is the first study that provides clear direction on how to improve telephone delivery and optimise implementation, aligning with current mental health policy and service improvement.

Abstract: Background: Euthanasia can be thought of as being either active or passive; but the precise definition of “passive euthanasia” is not always clear. Though all passive euthanasia involves the withholding of life-sustaining treatment, there would appear to be some disagreement about whether all such withholding should be seen as passive euthanasia. Main text: At the core of the disagreement is the question of the importance of an intention to bring about death: must one intend to bring about the death of the patient in order for withholding treatment to count as passive euthanasia, as some sources would indicate, or does withholding in which death is merely foreseen belong to that category? We may expect that this unclarity would be important in medical practice, in law, and in policy. The idea that withholding life-sustaining treatment is passive euthanasia is traced to James Rachels’s arguments, which lend themselves to the claim that passive euthanasia does not require intention to end life. Yet the argument here is that Rachels’s arguments are flawed, and we have good reasons to think that intention is important in understanding the moral nature of actions. As such, we should reject any understanding of passive euthanasia that does not pay attention to intent. Short conclusion: James Rachels’s work on active and passive euthanasia has been immensely influential; but this is an influence that we ought to resist.

Despite the notorious invisibility of toxicity, an aesthetic narrative has developed around the threat of e‐waste. In reports about toxicity in New Delhi, India, the dirt, grime and discarded remnants of electronics are presented in a particular visual manner to instil horror among readers and viewers. Such a representation has far‐reaching influences on policy. The seven pictures and the accompanying text in this article seek to challenge such a linear narrative of e‐waste's toxicity and offer fragments of other untold stories that challenge the established narrative and evoke the rich social life entwined with e‐waste.

Abstract: Black women across the African diaspora experience more aggressive breast cancer with higher mortality rates than white women of European ancestry. Although inter-ethnic germline variation is known, differential somatic evolution has not been investigated in detail. Analysis of deep whole genomes of 97 breast cancers, with RNA-seq in a subset, from women in Nigeria in comparison with The Cancer Genome Atlas (n = 76) reveal a higher rate of genomic instability and increased intra-tumoral heterogeneity as well as a unique genomic subtype defined by early clonal GATA3 mutations with a 10.5-year younger age at diagnosis. We also find non-coding mutations in bona fide drivers (ZNF217 and SYPL1) and a previously unreported INDEL signature strongly associated with African ancestry proportion, underscoring the need to expand inclusion of diverse populations in biomedical research. Finally, we demonstrate that characterizing tumors for homologous recombination deficiency has significant clinical relevance in stratifying patients for potentially life-saving therapies.