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Cognitive difficulties, including problems with attention and executive processing, are common in major depressive disorder (MDD), and strongly predict psychosocial and occupational functioning. Impairment in sustained attention contributes to increased intra-individual variability (IIV) in reaction times observed during cognitive tasks. Understanding brain network changes associated with IIV could guide novel neuromodulation strategies targeting cognitive difficulties.
Methods
We analyzed baseline resting-state fMRI data from 209 patients with moderate-to-severe treatment-resistant MDD who participated in the BRIGhTMIND neuromodulation trial. Following a preregistered analytic protocol, we examined associations between: functional connectivity across three core brain networks (executive control, ECN; default mode, DMN; and salience network, SN); components of IIV derived from a choice reaction time task (using a three-parameter ex-Gaussian model); and functioning.
Results
Greater IIV was linked to increased ECN-DMN functional connectivity. The ECN supports top-down control and externally directed cognition, while the DMN supports internal mentation and rumination. ECN-DMN connectivity was modulated by the SN, which prioritizes salient internal and external stimuli. Higher SN-ECN connectivity was associated with lower ECN-DMN connectivity and with faster mean reaction times. Both IIV and mean reaction time predicted functioning, with poorer functioning related to a slowed and inflexible response pattern.
Conclusions
Distinct components of reaction time variability are associated with specific patterns of brain network connectivity, largely independent of mood severity. Connectivity between the salience and executive control networks may represent a promising target for neuromodulation interventions focused on cognitive deficits in MDD.
This work investigates how ecological literacy and nature connectedness can be fostered in children aged 8–12 through engagement with a toolkit for place-based nature education. Children growing up in urban environments often lack access to nature, leading to lower ecological literacy and feeling less connected to the natural world. To help children reconnect with nature, we propose situating nature education in local environments, facilitated by a toolkit developed through a research-through-design approach that combines methods and perspectives from material-driven, participatory, and more-than-human design. Material explorations and a workshop with primary school children informed the conceptualisation of the toolkit, which invites children to shape mycelium-receptive artefacts, place them in local environments, and observe their transformation over time. Using clay as a substitute material, the shaping and placing activities were tested with 71 primary school children across four classes, alongside imaginative and reflective activities to encourage empathy and sensitivity toward fungi. Findings suggest that the shaping, placing, and reflecting activities can support ecological literacy and caring relationships with non-human organisms, indicating the potential of place-based, more-than-human learning tools to enrich nature education and reconnect children with nature.
To gain support, political actors must be visible on issues where they are seen as credible and advance these issues on the agenda. Direct online communication and negative messaging can amplify this by gaining traction on social media. While prior research assumes parties attack competitors on issues they ‘own’, we test that assumption in a highly fragmented multi-party system where ownership is fiercely contested. Here, attacks may aim to compete for ownership rather than defend it. Analysing 27,266 posts on X by Belgian party actors over two-and-a-half years, we find that sender issue ownership alone does not predict issue-based attacks. Instead, competition over ownership, especially at the target level, shapes attack patterns. During campaigns, issue-based attacks are significantly more likely to target issue owners than during routine periods. By linking issue competition and negative campaigning, we offer new insights into communication dynamics in fragmented party systems across the electoral cycle.
This study investigated the effects of therapeutic play on angiography in children aged 4–10.
Methods:
Our study was conducted as a randomised controlled experimental trial with 70 (experimental: 35, control: 35) children undergoing angiography at the paediatric cardiology clinic of a university hospital between 1 January 2022 and 31 August 2022. The “Child Information Form”, “Wong-Baker Faces Pain Rating Scale”, “Children’s Fear Scale”, “Children’s Anxiety Meter-State” and “Doll Model” were used for data collection. Percentage, mean, pearson correlation, ANOVA were used in the evaluation of the data.
Results:
It was found that 57.1% of the children who participated in our study were female, their mean age was 6.48±2.36 years, 45.7% had the diagnosis of Atrial Septal Defect (ASD), 78.6% had not undergone any surgery before and 60% were hospitalised for follow-up. It was found that the difference between pain, fear and anxiety scores of the children after the therapeutic play programme was statistically significant (p ˂ 0.05).
Conclusions:
Our study found that therapeutic play programmes can reduce pain, fear and anxiety in children. These findings demonstrate that negative experiences during invasive procedures affect children not only physiologically, but also psychologically and behaviourally. Therapeutic play can therefore be a powerful supportive intervention. Therefore, we recommend integrating therapeutic play into nursing clinical guidelines and care protocols, and providing paediatric nurses with training in this area.
This paper concerns the problem of determining whom one should trust and how much in complex testimonial exchanges featuring conflicting reports, unclear communication, and higher-order evidence bearing on the reliability of a speaker. Drawing on a Bayesian model of source reliability, I argue for testimonial underdetermination: the claim that testimonial exchanges can underdetermine whom one ought to trust and how much. The argument proceeds by showing that assessments of a source’s reliability are made relative to reference classes – sets of testimonial exchanges sharing features relevant for predicting the source’s reliability. In complex cases, an agent’s evidence may fail to determine which among several plausible reference classes is most appropriate, where different reference classes underwrite different degrees of trust. I then contend that testimonial underdetermination supports a form of synchronic intrapersonal permissivism about trust: an agent’s evidence may permit her to adopt any of several incompatible degrees of trust in a speaker. I conclude that when purely epistemic considerations underdetermine trust, practical considerations may guide one’s choice between different epistemically permissible options, putting pressure on the idea that we can have a pure epistemology of trust that applies to real-life, complex cases involving non-ideal agents.
Microfluidic systems integrated with magnetic manipulation of microparticles, serving as a functional component, have been extensively used in various applications, including biomedical diagnostics and targeted drug delivery. Microparticle dynamics in confined microchannels is governed by hydrodynamic viscous effects, magnetic dipole interactions and enhanced interactions with microchannel boundaries, while an in-depth understanding of the underlying mechanisms is still evolving. This work presents a systematic investigation on the dynamic response of microparticles suspended in a quasi-stationary liquid within a microchannel under an external magnetic field using a three-dimensional lattice Boltzmann model (LBM). The hydrodynamic viscous effects and the two-way fluid–structure interaction are fully resolved in this model. A dimensionless analysis of the microparticle dynamic equation is performed first, leading to the identification of two key characteristic parameters central to this work: the magnetic number $N_{\textit{mag}}$, which characterises the synergy of the hydrodynamic viscous effect and the magnetic dipole interaction, and the particle–wall separation distance $R/l$, which accounts for the microchannel wall interaction. Further, a series of LBM simulations with different $N_{\textit{mag}}$ and $R/l$ are carried out. The results suggest that the spatial trajectories of microparticles remain unaffected in response to variation in $N_{\textit{mag}}$, while their aggregation times demonstrate a linear dependence on the reciprocal of $N_{\textit{mag}}$ when released from the same initial position. Moreover, vortices generated by the motion of microparticles within microchannels tend to migrate toward the microparticles themselves as they approach the microchannel walls. As a result, microparticles experience an enhanced hydrodynamic viscous effect, which prolongs their aggregation time and leads to slight deviations in their spatial trajectories. A predictive model for the aggregation time is established, accounting for the effects of the external magnetic field, the microchannel wall interaction, as well as the initial positions of microparticles. The findings in this work provide significant insights into the optimisation of microparticle-based microfluidic technologies, thereby promoting their development in biomedical and chemical analytical applications.
Quality of social support is linked to mental health, but less is known about its long-term effects. We aimed to investigate the effects of the quality of social support on affective symptoms from midlife through later life.
Methods
Data were used from the MRC National Survey of Health and Development (NSHD), a prospective birth cohort originally consisting of 5,362 people born in 1946. Affective symptoms were measured at ages 53, 60–64, and 69 years using the General Health Questionnaire (GHQ-28), and longitudinal affective symptom trajectories were derived using growth mixture modeling. Quality of social support (positive and negative) was assessed at age 53 years with an adapted version of the Close Persons Questionnaire. Associations of positive and negative social support with affective symptoms at each age and with the longitudinal trajectories were tested using structural equation modeling and the R3 Step approach.
Results
Four distinct affective symptom trajectories were identified: no/low symptoms (83%), low and increasing symptoms (8%), consistently moderate/high symptoms (5%), and moderate/high and decreasing symptoms (4%). In fully adjusted models, negative social support was associated with affective symptoms at all three ages (β: 0.09–0.16, all p-values < .001) and with the ‘consistently moderate/high symptoms’ trajectory (OR = 1.65, 95% CI: 1.36, 2.01, p < .001); no association was found for positive social support.
Conclusions
Results highlight the importance of negative social support as a potential modifiable factor in prevention and intervention initiatives for affective symptoms among adults from midlife to later life.
Inappropriate antibiotic allergy labeling often leads to the unnecessary avoidance of first-line therapies. The present study aimed to evaluate the current status of antibiotic allergy documentation and its assessment in patients undergoing surgery for which cefazolin was the recommended first-line prophylaxis in a Japanese hospital.
Methods:
This retrospective observational study was conducted at a university hospital in Tokyo from 2021 to 2023; included patients with a history of antimicrobial allergy who underwent surgery for which cefazolin was recommended; and assessed patient demographics, details of the allergies in electronic health records (EHR), and perioperatively administered antimicrobial agents.
Results:
Of 2,402 eligible patients, 243 (10.1%) had a registered antimicrobial allergy. The drug classes most frequently recorded in the EHR were cephalosporins (25.0%) and penicillins (24.0%). Documentation of allergy assessments by a physician (9.0%) or specialist (7.0%) was rare. Although 51.9% of the labeled patients had received cefazolin, non-first-line agents had also been frequently administered. Notably, clindamycin had been administered to 30% of the cases and had been widely used even among patients with only a penicillin allergy label despite the low risk of cross-reactivity.
Conclusions:
Antibiotic allergy labels in the EHR were often incomplete, infrequently assessed, and associated with substantial avoidance of first-line prophylaxis. Redesigning the EHR format to allow allergies to be distinguished from adverse events while retaining the standard evaluation pathways is essential to optimizing perioperative antimicrobial stewardship.
Let $f(x)=x^{2p}+ax^p+b^p$, where p is a prime and $a,b\in {\mathbb Z}$ with $ab\ne 0$. If $f(x)$ is irreducible over ${\mathbb Q}$, we say that $f(x)$ is monogenic if $\{1,\theta ,\theta ^2,\ldots ,\theta ^{2p-1}\}$ is a basis for the ring of integers of ${\mathbb Q}(\theta )$, where $f(\theta )=0$. We give a characterisation of the monogenic trinomials $f(x)$ according to their Galois groups. These results extend prior investigations of the authors.
This article reconsiders the International Criminal Tribunal for Rwanda (ICTR) “Media Trial” that followed in the wake of the 1994 Rwandan genocide. While both the original trial (2000–03) and its appeal (2007) have been widely analyzed, most observers have approached it as a case against three media bosses. This article suggests that the Media Trial was not only invested in the line between press freedom and criminal hate speech and, in relation to Ferdinand Nahimana, not solely concerned with his role at “hate radio” station Radio Télévision Libre des Mille Collines (RTLM). Drawing on trial transcripts, other court records, and press coverage of the trial, I show how the tribunal actively interrogated Nahimana’s status as a historian and his research and scholarship as part of its judicial process. As such, I argue that the Media Trial helped codify the notion that Rwandan history had become “deadly” before the genocide and that the Rwandan historical field would need to be fundamentally transformed.
Comprehenders must accommodate variable speech rates during real-world communication, including rapid speech that necessitates rapid processing. This research investigated whether non-native comprehenders predict (i.e., what will come next) even when hearing rapid speech. Native and non-native participants heard predictive and non-predictive sentences (e.g., “ride…” vs. “spot…”) at normal and fast speech rates (e.g., averaging ~3 vs. 9 syllables per second) while viewing visual arrays with predictable and unrelated objects (e.g., bike vs. kite). Across both groups and rates, participants made predictive mouse cursor movements to predictable objects (e.g., before hearing “bike”). In addition, these groups and rates differed quantitatively. These results suggest that prediction has a qualitatively similar function in native and non-native sentence processing, which supports speeded comprehension.
Although mental health and healthy lifestyle interventions are associated with functional outcomes in adolescence, the extent to which particular lifestyle factors explain relationships between mental health and outcome are unclear. Here we examined mediating effects of lifestyle factors on relationships between mental health and two functional outcomes measured 2–3 years later, as well as moderating effects of environmental risk factors on mediation strength in early adolescence.
Method
We analyzed data from three waves of the Adolescent Brain Cognitive Development Study (ages 10–11, 11–12, and 12–13 years). Mediating effects of sleep quality, screen time, physical activity, and Mediterranean diet on the relationships between depression, anxiety, psychotic-like experience (PLE) distress, and total problems with two subsequent functional outcomes (academic functioning and social problems) were examined. Secondary analyses included environmental factors as moderators.
Results
Sleep quality mediated 18.5%, 36.3%, and 8.3% of the relationships between depression, anxiety, and PLE distress with academic functioning, respectively (total problems mediation was nonsignificant). Screen time was the second strongest mediator. For social problems, only sleep quality showed >3% mediation (19.6–23.3%). Mediating effects of sleep and screen time on academic functioning decreased as financial adversity increased. Conversely, mediating effects of sleep quality on social problems increased with worsening family conflict, financial adversity, and school environment.
Conclusions
These results suggest that healthy lifestyle factors (particularly sleep quality) may partially explain associations between mental health and functioning in adolescents and suggest that these effects are modulated by environmental factors. These results may have implications for future intervention studies.
Numerous consumer protection regulations (e.g., No Surprises Act, Transparency in Coverage) have been implemented recently in the United States that could impact private health insurance prices and patient cost-sharing for many health care services. We use a large multi-payer database of health insurance claims for employer-sponsored health plans in the U.S. to describe the trajectory of prices and patient cost-sharing for the services of clinicians that are likely most affected by these regulatory changes: emergency physicians, radiologists, pathologists, and neonatologists. We find that in-network prices and patient cost-sharing generally increased for all four specialties between 2012 and 2022. However, all four specialties experienced periods of decline in out-of-network prices and cost-sharing, with different starting points, and substantial reductions in prices and cost-sharing from 2021 to 2022, particularly for self-funded health plans. Although we cannot isolate the causal impact of any law or regulation, our results suggest that out-of-network prices and cost-sharing decreased when the NSA and TIC were implemented in 2022, especially for the previously less regulated self-funded health plans. Our results imply that patients who previously struggled with the financial burdens of surprise out-of-network medical bills may have benefited significantly from the recent regulatory changes.
Long-term light-trap records provide a rare opportunity to examine spruce budworm (Lepidoptera: Tortricidae) population behaviour at the southern edge of the species’ range. We analysed statewide moth counts from Maine, United States of America (1961–2024), to characterise temporal patterns and assess their relevance for outbreak risk. The time series showed a saw-toothed rise from 1961 to its peak in 1978, followed by a precipitous collapse across the state after 1982, and an extended quiescent period in 1990–2012, punctuated finally by abrupt but moderate increases in adult abundance, with no evidence of a smooth oscillation. Recruitment dynamics were nonlinear, with multiple equilibrium points, which is consistent with a metastable process. These dynamics limit the utility of classical forecasting approaches and complicate expectations about outbreak development following the recent pulse in moth numbers after nearly two decades of low activity.
This study develops a network-level model of banking alliances by integrating neo-institutional isomorphism and tie strength theory. Based on an integrative review of 98 empirical studies and deductive–inductive content analysis, the model explains how institutional pressures and relational mechanisms shape alliance portfolios among interconnected banking actors. The analysis identifies recurring patterns: strong-tie alliances, such as mergers and acquisitions and joint ventures, appear more often under high coercive and normative isomorphism, whereas moderately and loosely coupled alliances, including information sharing and outsourcing, are more common where institutional alignment is weaker and uncertainty is higher.
Trilobites, iconic ancient arthropods that endured throughout the Paleozoic Era, are represented by a great number of fossils and a high species richness. However, only a very small number of taxa have their soft tissues preserved, which means that the morphology and ecology of most trilobites have not been specifically determined, even though the morphology of their exoskeletons is well studied. Fortunately, modern technologies (e.g., Micro-CT and μ-XRF) provide non-destructive methods to unveil the soft tissues of fossils that might be buried in rocks. Here we use Micro-CT and μ-XRF to make a detailed study on exceptionally preserved specimens of Palaeolenus douvillei Mansuy, 1912 from the Guanshan Biota. The uniramous antennae, four pairs of post-antennal cephalic appendages, 13–15 thoracic appendages, and at least two pygidial appendages underneath the dorsal shield were revealed for the first time. In addition, we observed that the hypostome and labrum were differentiated in P. douvillei, and this species possesses both typical trilobite digestive systems—namely the crop and digestive glands—simultaneously within a single individual. From the combined evidence of morphological features and phylogenetic analysis, it is reasonable to place P. douvillei within the family Palaeolenidae, thereby contributing new perspectives to the understanding of broader trilobite evolution.
The performance of the wavy leading edge (WLE) on the self-noise from a cambered NACA 65(12)-10 airfoil at a Reynolds number of 100 000 is investigated in this paper. The self-noise from the airfoils is measured in an anechoic wind tunnel while the flow details are obtained from both planar particle image velocimetry measurements and the wall-resolved large eddy simulations. It turns out that the WLE is effective in reducing both the tonal and the broadband separation noise in the mid-to-low-frequency range from the baseline airfoil. The underlying mechanisms of the noise reduction are also examined carefully from both the tonal and the broadband aspects. By introducing the WLE, the generated streamwise vortices can modify the boundary-layer development and reduce the spanwise coherence of the flow structures. As a consequence, the acoustic feedback loop responsible for the tonal noise from the baseline airfoil is disturbed. Additionally, the WLE decreases the convection velocity and generates less coherent wall pressure fluctuations in the low-to-mid-frequency range, leading to broadband separation noise reduction.