This work proposes a new near-horizon transition model for black holes within the Kun-based Cosmos Relativity Redefined (KCRR) framework. The model introduces a formative transition field Φ(r) that governs a smooth shift from the standard general-relativistic phase to a non-spacetime “retq phase”. Using observational constraints from the S2 star (GRAVITY Collaboration) and black-hole shadow measurements from the Event Horizon Telescope (M87 and Sgr A), we derive a best-fit transition sharpness parameter of n = 4.0 ± 0.5. The model avoids singularities, preserves information, matches current observations, and provides testable predictions for future EHT and VLBI facilities.**
The newspapers and media as well as scientific papers reveal that alcohol and illicit drug abuse is of major concern in rural and urban areas of Rwanda. Especially in the areas nearing the borders of the country, the illicit gin known as Kanyanga is being consumed. The government of Rwanda has tried to take various measures to stop its use but seems to need more efforts because the local population has not stopped its use, and its smugglers and users increase day to day. The use of Kanyanga was found to bring some consequences that can even lead to death. With this background, the research was conducted to investigate people’s perceptions of its use and how a behavioural approach can be used to change them. To achieve the objective of the paper, a quantitative exploratory study was conducted where data were collected via an online survey, and respondents were citizens of Rwanda from six districts of the northern part where the gin is common. The data analysis was done through visualisation and explained using the prospect theory. The findings have shown that what people expect to get from the use of Kanyanga is the opposite of what they get from it because of bad consequences including death, poverty, and domestic conflicts. From these findings, the paper recommended counselling services along with nudging a behavioural perspective to deal sustainably with this illicit gin
FIGURE 2 Elements of the EEFIt feels like there's no end to this…the different themes that you can explore and the growth that can happen.I can't overstate how foundational the territory is that we've gone through together...it's so fundamental to how we think about our practice around learning.And personally, I've picked up a lot of ways of working... how we come together as a group and talk and bring our full humanity to discussions.
Military field hospitals typically provide essential medical care in combat zones. In recent years, the United States (US) Army has deployed these facilities to assist domestic humanitarian emergency and natural disaster response efforts. As part of the nation’s whole-of-government approach to the coronavirus disease (COVID-19) pandemic, directed by the Federal Emergency Management Agency and the Department of Health and Human Services, during New York City’s (NYC) initial surge of COVID-19, from 26 March to 1 May 2020, the US Army erected the Javits New York Medical Station (JNYMS) field hospital to support the city’s overwhelmed healthcare system. The JNYMS tasked a nutrition operations team (NuOp) to provide patient meals and clinical nutrition evaluations to convalescent COVID-19 patients. However, few guidelines were available for conducting emergency nutrition and dietary response efforts prior to the field hospital’s opening. In this case study, we summarize the experiences of the NuOp at the JNYMS field hospital, to disseminate the best practices for future field hospital deployments. We then explain the challenges in service performance, due to information, personnel, supply, and equipment shortages. We conclude by describing the nutrition service protocols that have been implemented to overcome these challenges, including creating a standardized recordkeeping system for patient nutrition information, developing a meal tracking system to forecast meal requirements with food service contractors, and establishing a training and staffing model for military-to-civilian command transition. We highlight the need for a standardized humanitarian emergency nutrition service response framework and propose a Nutrition Response Toolkit for Humanitarian Crises, which offers low-cost, easily adaptable operational protocols for implementation in future field hospital deployments.
Darunavir/cobicistat/emtricitabine/tenofovir alafenamide (D/C/F/TAF) 800/150/200/10 mg was investigated through 96 weeks in EMERALD (NCT02269917). Virologically-suppressed, HIV-1-positive treatment-experienced adults (previous non-darunavir virologic failure [VF] allowed) were randomized (2:1) to D/C/F/TAF or boosted protease inhibitor (PI) plus emtricitabine/tenofovir-disoproxil-fumarate (F/TDF) over 48 weeks. At week 52 participants in the boosted PI arm were offered switch to D/C/F/TAF (late-switch, 44 weeks D/C/F/TAF exposure). All participants were followed on D/C/F/TAF until week 96. Efficacy endpoints were percentage cumulative protocol-defined virologic rebound (PDVR; confirmed viral load [VL] >= 50 copies/mL) and VL < 50 copies/mL (virologic suppression) and >= 50 copies/mL (VF) (FDA-snapshot analysis). Of 1141 randomized patients, 1080 continued in the extension phase. Few patients had PDVR (D/C/F/TAF: 3.1%, 24/763 cumulative through week 96; late-switch: 2.3%, 8/352 week 52-96). Week 96 virologic suppression was 90.7% (692/763) (D/C/F/TAF) and 93.8% (330/352) (late-switch). VF was 1.2% and 1.7%, respectively. No darunavir, primary PI, tenofovir or emtricitabine resistance-associated mutations were observed post-baseline. No patients discontinued for efficacy-related reasons. Few discontinued due to adverse events (2% D/C/F/TAF arm). Improved renal and bone parameters were maintained in the D/C/F/TAF arm and observed in the late-switch arm, with small increases in total cholesterol/high-density-lipoprotein-cholesterol ratio. A study limitation was the lack of a control arm in the week 96 analysis. Through 96 weeks, D/C/F/TAF resulted in low PDVR rates, high virologic suppression rates, very few VFs, and no resistance development. Late-switch results were consistent with D/C/F/TAF week 48 results. EMERALD week 96 results confirm the efficacy, high genetic barrier to resistance and safety benefits of D/C/F/TAF.
