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Native forests in Aotearoa/New Zealand are at significant risk from the plant diseases myrtle rust and kauri dieback. Mobilising for Action (MFA) was a four-year transdisciplinary research project exploring the social dimensions of these pathogens and forest health through social science, humanities, creative arts and mātauranga Māori (Māori knowledge), with experts, artists, iwi/hapū (tribes/sub-tribes) and communities, empowering and supporting them in their efforts to address forest disease and promote forest health. A waka houora (double-hulled canoe) framework guided MFA to enable Western knowledge systems to operate alongside mātaurangā Māori, allowing for collaboration, cross-cultural learning and Indigenous empowerment through artistic research and related approaches. We propose that through various creative arts approaches, MFA built relationships and partnerships between Māori and other cultures, people and forests and disciplines, in addition to developing novel research methods in forest health through storytelling and narratives, offering new possibilities in critical forest studies and care.
Aelian and Porphyry claim that only the horns of a specific species of Scythian ass can contain the corrosive water of the Styx. They also state that Alexander the Great received one of these horns from a certain Sopater as a gift, on which he had an epigram engraved before dedicating it at Delphi. This article explores the connection between this story and the reports of Alexander’s alleged assassination by the Antipatrids. In these reports, the poison used is often said to be the water of the Styx, held in an equine hoof. The tale reported by Aelian and Porphyry can be interpreted as part of the propaganda war during the time of the Diadochi, specifically as a piece of counter-propaganda responding to the accusation of treason against Antipater and his family and aiming to exonerate them.
Patients with advanced cancer, their caregivers, and healthcare professionals can differ in their preferences for patient treatment and care. The objectives of this study were to (1) identify what healthcare professionals in specialist palliative care feel aids or challenges patients with advanced cancer and their caregivers to manage their discordance, and (2) decipher what is helpful or challenging for healthcare professionals themselves to manage discordance between patients with advanced cancer and their caregivers.
Methods
A qualitative study was conducted comprising online focus groups with 19 healthcare professionals from different professions in specialist palliative care. Participants were purposively and snowball sampled, and recruited from specialist palliative care settings, including hospital, hospice, and community-based care. The data were member checked and analyzed using thematic analysis.
Results
Trust and consistent communication between the patient, caregiver, and healthcare professional, were considered by participants as helpful for patients and caregivers to manage discordance. Emotional and psychological burden for both the patient and caregiver together with preexisting conflict between the patient and caregiver, were perceived as barriers for patients and caregivers to manage their discordance. Knowledge and expertise gained from practice combined with professional resilience and peer support enabled participants to help patients and caregivers navigate discordance. Relational conflict between the patient and caregiver combined with participants’ own uncertainty about ethical and legal connotations of helping the patient and caregiver resolve their differences, were barriers to helping the patient and caregiver manage their discordance.
Significance of results
Interventions focused on assisting patients with advanced cancer in palliative care and their caregivers manage their differences in decision-making could serve to alleviate emotional burden for both the patient and caregiver. Healthcare professionals in specialist palliative care value the perspective of both patients with advanced cancer and their caregivers when helping them manage their discordance in decision-making.
Individuals with mental health difficulties (MHD) have a substantial reduction in life expectancy compared to the general population. It is increasingly recognised that mental health services need to improve physical healthcare as a priority. Sexual health, including consideration of high-risk sexual behaviours, medication side effects, and challenges in romantic relationships, is a further important but under-recognised aspect of overall health. We discuss some of the current issues relating to physical and sexual health, with a particular focus on youth with MHD and how we might implement holistic care in Ireland. Prioritising the resourcing of these issues could facilitate the implementation of a Shared Model of Care as recommended in Ireland’s National Mental Health Policy, Sharing the Vision.
The importance of additional language learning (ALL) is on the rise, but we do not yet have a full understanding of how learners with different characteristics approach this task. Here, we discuss the potential impact of attention-deficit/hyperactivity disorder (ADHD), a prevalent learning disability, on classroom ALL. Learners with ADHD show difficulties in the attention networks of sustained attention and executive control. It is critical, therefore, to ask how these difficulties of learners with ADHD might manifest in the demanding task of ALL, but to date there is very limited research examining this issue. The current paper sets out a theoretical framework for examining ALL in learners with ADHD, reviews the extant literature, and most importantly calls for future research to examine the way in which learners with ADHD manage the process of ALL, in an effort to highlight the involvement of sustained attention and executive control in ALL more generally.
This article considers the history of Emergency Health Kits established by United Nations agencies and the larger medical non-governmental organizations of the 1980s to analyse the significance of standardized responses in humanitarian emergencies. We argue that, far from being a rigid and immutable response, the kits reflected a (not universally realized) desire to standardize and control both supplies and medical care from international organizations. As such, humanitarian medical practice remained a disputed field in which each object or drug was negotiated at the risk of creating innovation traps. Coming at a time of increasingly global logistics capacities, the Emergency Health Kits became a central feature of a more coordinated global marketplace of humanitarian aid. The kits’ promise to provide rapid transport of emergency supplies to crisis settings across the world was often experienced as a construct, with long delays and logjams in certain regions. Even so, humanitarian organizations were agents of globalization because they imagined a system of centralized production in the Global North and supply to isolated and/or insecure locations across the world.
This study aimed to evaluate the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and inactivated virus vaccination on intracytoplasmic sperm injection (ICSI) outcomes in infertile couples. A retrospective case–control study was conducted at the Royan Institute from August 2020 to March 2022. The study included 90 couples in the COVID-19 infection phase and 31 in the vaccination phase. A total of 30 infected but unvaccinated couples were compared to a control group of 60 couples with no COVID-19 infection or vaccination history. Additionally, 31 couples underwent treatment before and after receiving the Sinopharm inactivated vaccine. Key variables analysed included sperm parameters (concentration, motility, progressive motility and morphology), ovarian parameters (antral follicle count, oocyte retrieval), embryological outcomes and pregnancy outcomes. SARS-CoV-2 infection significantly reduced sperm motility (P = 0.02) and progressive motility (P = 0.01) compared to controls. Sperm concentration and morphology showed non-significant declines. Post-vaccination analysis revealed similar but statistically insignificant changes in sperm parameters. Ovarian stimulation parameters and embryological outcomes remained unaffected by both infection and vaccination. Although biochemical, clinical pregnancy and live birth rates were lower among the infected group, these differences did not reach statistical significance (p = 0.16, 0.08 and 0.09). SARS-CoV-2 infection has been associated with impaired sperm progressive motility, which may negatively influence ICSI outcomes. In contrast, vaccination with an inactivated virus does not appear to impact fertility outcomes. These findings provide crucial guidance for physicians and infertile couples managing treatments during and after the pandemic, suggesting the need for extended recovery periods before ART procedures following COVID-19 infection.
Deterministic and stochastic processes are of great importance in influencing the composition of communities. Here, we tested if deterministic and stochastic processes have the same force of influence on functional traits of tiger moth communities. Specifically, we hypothesised that the functional traits of the tribe Arctiini would be more strongly influenced by stochastic processes (associated with spatial variables), given that these moths are primarily diet and habitat generalists within a highly diverse clade. They also exhibit high morphological trait dissimilarity and are capable of occupying a wide range of vegetation habitats. On the other hand, we hypothesised that the functional traits of the tribe Lithosiini would be more influenced by deterministic processes (associated with environmental variables), given that these moths are primarily diet and habitat specialist moths and tend to occur in more specific vegetation types. In agreement with our hypotheses, the functional traits of Arctiini species were better explained by variables related to stochasticity, while the functional traits of Lithosiini were explained by deterministic processes only. Thus, the processes shaping moth distributions across communities may vary according to species’ functional traits and interspecific relationships.
Stroke remains a major public health issue globally. Tele-rehabilitation, incorporating internet-based interventions and wearable devices, offers an accessible strategy for post-discharge rehabilitation. This study evaluates their effectiveness in stroke patients.
Methods:
A total of 160 subacute stroke patients hospitalized between November 2022 and September 2023 were enrolled and randomly allocated to four groups at discharge (n = 40 per group): a control group receiving conventional rehabilitation, an internet-based tele-rehabilitation (ITR) group, a wearable-device-assisted (WDA) group and a combined intervention (IWT) group, which received both ITR and WDA training. The primary outcome was assessed by the Modified Barthel Index (MBI) at discharge, 4 weeks and 12 weeks post-discharge, with the 12-week score prespecified as the primary endpoint. Secondary outcomes included Berg Balance Scale (BBS), simplified Fugl-Meyer Assessment (sFMA), Hamilton Anxiety Scale (HAMA), Hamilton Depression Scale (HAMD), Mini-Mental State Examination (MMSE) and Zarit Burden Interview (ZBI), all assessed at discharge, 4 weeks and 12 weeks post-discharge.
Results:
At baseline, no significant differences were observed among groups (P > 0.05). Over 12 weeks, all intervention groups demonstrated significant improvements in MBI, BBS and sFMA compared to the control group (P < 0.05), with the IWT group achieving the greatest gains (P < 0.01). Anxiety, depression and caregiver burden significantly decreased across intervention groups, with the IWT group showing the most pronounced reductions (P < 0.01). Cognitive function also improved significantly, particularly in the IWT group (P < 0.01).
Conclusion:
ITR and WDA training enhances functional and psychological recovery in stroke patients, highlighting its potential clinical significance in managing stroke recovery.
In a normal pregnancy, glucocorticoids (GC), such as cortisol, play an essential role in early heart development. GC concentrations surge in late gestation to facilitate the maturation of fetal systems in preparation for birth. However, pregnancy complications related to stress, lifestyle factors, disease, and commonly used antenatal care treatments (GC therapy and artificial reproductive technology) can lead to prematurely increased GC concentrations that are detrimental to the heart before it is mature enough to benefit. These findings underpin the hypothesis that GC play a double-edged role that benefits normal heart development but is potentially harmful when dysregulated. However, the mechanisms by which both physiological and pathological elevations in GC concentrations influence the fetal cardiometabolic pathways that lead to detrimental long-term cardiovascular outcomes remain unclear. This review will, firstly, describe how cortisol regulates different aspects of cardiac development and, secondly, compare findings from different animal models that have provided mechanistic insight into how excess cortisol/GC during pregnancy impacts cardiac health across the life course.
While Centers for Medicare and Medicaid Services-mandated Antimicrobial Stewardship Programs are now in place across U.S. skilled nursing facilities, reported high rates of compliance may mask persistent gaps in clinical effectiveness. This review summarizes evidence-based antimicrobial stewardship interventions, their impact, and practical tools to support implementation. Resources from Centers for Disease Control and Prevention, Agency for Healthcare Research and Quality, other frameworks, and proposed metrics are highlighted to guide effective stewardship in resource-variable nursing home settings.
Mental health symptoms pose a significant vulnerability to stressful life events among currently married women, adversely impacting their overall well-being and quality of life. This study explores the spatial patterns and factors associated with anxiety, depressive symptoms and the co-occurrence of both symptoms among currently married women of reproductive age in Bangladesh. This study utilised data from 13,372 (weighted) currently married women aged 15–49 years in the Bangladesh Demographic and Health Survey (BDHS) 2022, which used a cross-sectional design. Multivariable logistic regression models determined the associated factors. Additionally, spatial distribution and hotspot analysis were conducted using ArcGIS version 10.8. The weighted prevalence of moderate to severe anxiety, depressive symptoms and co-occurrence of anxiety and depressive (CAD) symptoms among currently married women of reproductive age was 4.1% (95% confidence interval [CI]: 3.8%, 4.5%), 4.8% (95% CI: 4.7%, 5.4%) and 2.2% (95% CI: 2.1%, 2.6%), respectively. Clustering of anxiety symptoms (Moran’s I = 0.063, p < 0.001), depressive symptoms (I = 0.091, p < 0.001) and CAD symptoms (I = 0.082, p < 0.001) were observed, with hotspots in Rangpur, Sylhet and Chittagong regions. Logistics regression analysis shows that currently married women who were living in the Barishal, Khulna, Rangpur and Sylhet regions, who belong to households with a higher wealth index, who experienced high levels of intimate partner violence (IPV), have completed high school, who are sexually inactive and whose husbands are unemployed, were more likely to experience CAD symptoms. Additionally, currently married women of reproductive age, whose age was 25–34 years, who are labourers, whose pregnancies are terminated and who have ≥5 children ever born, are at a higher risk of having anxiety symptoms. Besides, currently married women aged 25–34 years and 35–44 years, who are underweight, were more likely to have depressive symptoms. The findings highlight a significant regional disparity in the burden of anxiety, depressive and CAD symptoms among currently married women of reproductive age in Bangladesh. These findings can help design site-specific programmes and actions for women in the hot spot areas of Rangpur, Sylhet and Chittagong.
There is substantial international variation in recommended vitamin C intake levels. In the United States, the recommendation is 90 mg/day for men and 75 mg/day for women, while in the United Kingdom (UK), the current recommendation – established in 1991 – is only 40 mg/day for adults. This UK level was based on the 1953 Sheffield study, which found that 10 mg/day prevents scurvy, with 40 mg/day chosen as the recommended level for yielding somewhat higher plasma levels. In this commentary, we argue that the UK recommendation overlooked key evidence available at the time. Specifically, at least six controlled trials published before 1991 reported benefits from vitamin C supplementation in participants whose baseline vitamin C intake was already 40 mg/day or higher. One randomized controlled trial, published in 1993, found benefits from vitamin C supplementation even at a baseline intake of about 500 mg/day; however, this trial involved ultramarathon runners, and the findings should not be broadly generalised. Nonetheless, such results challenge the assumption that 40 mg/day is universally adequate to maintain full health. We also highlight that the UK recommendations were narrowly focused on preventing dermatological symptoms of scurvy, despite strong evidence – even at the time – that vitamin C deficiency can also cause cardiac dysfunction and greater morbidity due to respiratory infections. We conclude that the current UK vitamin C recommendation should be re-evaluated in light of controlled trial evidence and broader clinical outcomes.
This article seeks to answer the question of how interbranch organisations (IBOs) can facilitate coordination among agents involved in transactions within agri-food chains. An IBO is a complex entity that establishes relationships among agents operating at different stages of a supply chain. The empirical analysis focuses on the Italian tomato supply chain and adopts a Process-tracing approach. The study is grounded in meso-institutions theory and demonstrates how the meso-institutional nature of the analysed IBO helps explain its role in establishing coordination among agents by performing the functions outlined by the theory. The institutional outcome of this relationship is the adoption of a contractual system that facilitates coordination itself. The contractual system identified provides an example of the articulation between the meso-institutional and micro-institutional levels.
American sloughgrass [Beckmannia syzigachne (Steud.) Fernald] is a troublesome wheat weed. We tested the germination of B. syzigachne seeds under different temperatures with growth chambers (12 h dark/12 h light, 12000 lx), simulating those during the sowing periods of early- (25/15 C), ordinary- (20/10 C), late- (15/5 C), and very late-sown winter wheat (5/0 C). We also tested the accumulated temperatures required for seedling growth to the 2- to 5-leaf stages, using 225 populations collected from wheat fields in eastern China. The average 1000-seed weight of the 225 populations was 1.2 ± 0.01 g. Overall populations tested did not show seed germination after 21 days of treatment (DAT) at 5/0 C or constant 30 C. At 14 DAT with 25/15 C, 20/10 C, and 15/5 C, the mean germination rates were 85.4%, 6.4%, and 0.1%, respectively. These rates increased to 99.9%, 58.6%, and 21.7% at 21 DAT. Populations collected from lower latitude regions germinated significantly faster (P < 0.05) under optimal conditions. Accumulated temperatures required for growing the 2nd, 3rd, 4th, and 5th leaf were 139.0 ± 1.0, 127.8 ± 1.0, 115.6 ± 1.0, and 98.9 ± 0.7 C, which showed a significant decreasing trend. The narrower optimal temperature range for B. syzigachne seed germination and higher thermal requirements for early seedling growth constrain its distributions, while the heterogeneous seed germination facilitates its infestations in wheat planting areas in eastern China.
The dating of the qameṣ shift (*/aː/ > [ɔː]) in the Tiberian tradition of Biblical Hebrew has long been a scholarly puzzle. In this article I present possible evidence for this shift in the Greek transcriptions of Origen’s Hexapla, datable to the first half of the third century ce in Palestine. While the evidence is limited both in attested tokens and in grammatical scope, it is suggested that lexical diffusion may account for the gradual spread of this shift, as recorded in different stages of the transmission of Biblical Hebrew.
This study investigates the production, online processing, and offline comprehension of non-canonical structures in Mandarin-speaking children with Developmental Language Disorder (DLD). We tested three Mandarin non-canonical structures, which differed in word order, the presence or absence of morphosyntactic cues, and the distance between the displaced element and its trace. Syntactic priming was adopted to elicit production, and a self-paced listening task with picture verification was used to examine online processing and offline comprehension accuracy, among 22 DLD children aged 5 to 9 and 37 age-, SES-, and nonverbal IQ-matched typically developing (TD) children. Results showed a quantitative difference between DLD and TD children across non-canonical structures in production and offline comprehension. In online processing, TD children immediately used different cues when they were available, whereas DLD children relied on the most informative cue within a given structure and context and integrated redundant cues only at a later stage. These findings point toward a complex interaction of representational weakness and domain-general processing constraints whereby DLD children show difficulties in allocating processing resources to integrate multiple linguistic cues.