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Acute gastrointestinal infections (AGIs) can lead to significant morbidity and mortality. In diagnosing AGI, culture-independent diagnostic tests offer advantages over traditional methods and increase the chance of detecting multiple pathogens (co-detection). A retrospective analysis of data from a tertiary pediatric hospital was conducted to characterize occurrence of AGI co-detections and compare outcomes with patients who had only one AGI pathogen detected. Medical records were obtained for patients with stool samples tested using BioFire FilmArray GI Panel between 1 January 2016 and 31 December 2020. Data were described using descriptive statistics, correlation analysis, and logistic regression to identify risk factors and estimate co-detection rates. During the study period, 12,753 patients had a total of 17,159 stool samples tested. Of these, 8,212(47.9%) tested positive, with 6,040(73.6%) being single detections and 2,172(26.4%) being co-detections. Patients with single detection experienced higher hospitalization rates than patients with co-detection. Patients 1–4 years old exhibited the highest co-detection rate relative to other age groups, while Hispanic/Latino individuals were 1.75 times more likely to have co-detection than other races. This study emphasizes the significance of understanding pathogen interactions concerning clinical characteristics and epidemiology of AGI, and the necessity for effective diagnostic strategies and optimal healthcare resource allocation.
Opportunities for face-to-face interaction between sponsor-side clinical research associates (CRAs) and site-side clinical research coordinators (CRCs) have decreased with remote and risk-based monitoring, potentially impeding communication and mutual understanding – key determinants of team functioning. Accordingly, we implemented a reciprocal on-site training to enhance CRA-CRC mutual understanding and evaluated its impact.
Methods:
Seventeen sponsor staff, including 11 CRAs, joined an 8-hour hospital tour with CRC-guided process simulations and discussion; conversely, 14 hospital staff, including 11 CRCs, attended a 4-hour sponsor-office visit with system demonstrations and discussion. Self-assessed understanding of counterpart workflows and impressions of the counterpart group were rated pre- and post-training on 5-point Likert scales. Free-text feedback underwent text-mining analysis. Behavioral change was surveyed 6 months later.
Results:
CRAs improved on all 9 understanding items (e.g. “flow of daily medical practice:” median score 2.0 vs. 4.0, pre- and post-training, respectively, p < 0.0001); CRCs improved on 4 of 5. Positive impressions increased and negative impressions decreased in both groups (e.g. “bright atmosphere:” median 3.0 vs. 5.0 for CRAs, p = 0.0002; 3.0 vs. 5.0 for CRCs, p = 0.0044). Text-mining revealed the specific content participants learned, which included keywords reflecting this training’s objective of enhancing mutual understanding. At 6 months, 70% of CRAs and 88% of CRCs reported changes in their work behavior.
Conclusions:
A brief, reciprocal, on-site training improved CRA–CRC mutual understanding and perceptions, with sustained self-reported behavioral changes in work practices. From a team science perspective, such practical training may strengthen sponsor-site communication and collaboration.
In their 2016 paper on exotic Bailey–Slater SPT-functions, Garvan and Jennings-Shaffer introduced many new spt-crank-type functions and proposed a conjecture that the spt-crank-type functions $M_{C1}(m,n)$ and $M_{C5}(m,n)$ are both nonnegative for all $m\in \mathbb {Z}$ and $n\in \mathbb {N}.$ Applying Wright’s circle method, Jang and Kim showed that $M_{C1}(m,n)$ and $M_{C5}(m,n)$ are both positive for a fixed integer m and large enough integers $n.$ Up to now, no complete proof of this conjecture has been given. In this article, we provide a complete proof for this conjecture by using the theory of lattice points. Our proof is quite different from that of Jang and Kim.
This study investigated how mental imagery is engaged during first language (L1) and second language (L2) speakers’ incremental sentence processing of English phrasal verbs, using a self-paced sensibility judgment task interleaved with schematic diagrams. L1 speakers showed selective compatibility effects modulated by abstractness, semantic transparency of phrasal verbs, event plausibility and the timing of visual input. In contrast, L2 learners relied more generally on visual support, reflecting weaker integration of semantic and perceptual cues. Learner-internal factors such as L2 proficiency and language dominance modulated learners’ sensitivity to integrate and resolve competing cues between semantic coherence and perceptual input. These findings support a simulation-based model of L2 comprehension, highlighting the developmental nature of sensorimotor activation in bilingual processing.
The aim of this review is to examine why cultural food security and cultural food sovereignty should be prioritised and embedded within conventional food security frameworks. It demonstrates how culturally grounded, community-driven approaches foster more just, sustainable and empowering food systems for ethnically diverse, Indigenous and local communities, while highlighting the limitations of conventional metrics that overlook socio-cultural, political and ecological dimensions essential to resilience. Conventional food security focuses on access to sufficient, safe and nutritious food, often sidelining access to culturally appropriate and spiritually meaningful foods that are integral to cultural identity and tradition (cultural food security) and the authority and decision-making power held by local people over their foodways (cultural food sovereignty). Its market-based, individualistic measurement paradigms further neglect collectivist, traditional and spiritual food values, resulting in assessments that may conform to global standards yet produce flawed outcomes, misaligned interventions and continued marginalisation of ethnically diverse, Indigenous and local communities. Drawing on socio-cultural, political, economic and environmental frameworks, the review demonstrates how food sovereignty and cultural food security provide more sustainable, equitable and empowering pathways for communities. It underscores the need for community-driven, culturally grounded food policies.
Object detection models, such as those in the YOLO family, are generally effective at identifying individual weeds, but their performance can be limited by occlusion of target structures in high-density scenes. These models are typically trained on images with low weed densities, where individual plants are clearly visible and easy to annotate, yet they are used in field conditions where areas of high density and dense vegetation may occur. Greenhouse experiments were conducted at the University of Florida, Wimauma, FL, to evaluate how purple nutsedge (Cyperus rotundus L.) density impacts the performance of a YOLOv8 model. A greenhouse density test dataset was developed by collecting 480 images of 12 densities ranging from 7 to 331 plants m−2, at transplant and at 3, 6, 10, and 17 d after transplanting. An independent dataset of 2,221 field and greenhouse images was used for the training of a YOLOv8 extra-large model to detect C. rotundus. A logistic sigmoidal model was fit to evaluate the F1 score as a function of increasing C. rotundus density at each data-collection time point. The F1 score showed sigmoidal relationships with density at all time points, exceeding 0.9 at low densities but dropping sharply to near 0 at the highest density and later time points. Performance decline was primarily driven by increased false negatives as density and occlusion increased, with minimal contribution from false positives, except at the highest densities. Density thresholds for optimal performance (F1 ≥ 0.90) decreased from 157 to 86 plants m−2 as canopy coverage increased, while marginal performance (F1 = 0.50) dropped from 322 to 140 plants m−2. Our findings suggest that object detection models for C. rotundus are strongly influenced by increased occlusion and morphological changes resulting from greater plant proximity and canopy coverage in high-density scenes.
While infection is a leading cause of mortality among patients on hemodialysis, there are limited data on patients’ infection prevention knowledge and attitudes. We aimed to assess hemodialysis patients’ knowledge of their elevated infection risk, their willingness to actively prevent infections, and the acceptability of a long-term intranasal decolonization intervention.
Design:
We surveyed patients as part of a stepped wedge cluster randomized trial evaluating intranasal povidone-iodine (PVI) decolonization.
Setting:
Sixteen outpatient hemodialysis centers affiliated with 5 academic medical centers.
Participants:
Patients undergoing outpatient hemodialysis.
Methods:
Patients were asked to complete a pre-intervention survey (9 questions) and two intervention surveys (13 questions; only patients interested in PVI) at 1 month and 6 months after starting PVI. We used the chi-squared test to compare responses over time.
Results:
469 (∼25%) participants completed at least one survey. Most (55%) participants underestimated their infection risk compared with an average person in the United States. The percentage of participants willing to expend “a lot of effort” to prevent an infection decreased from 79% (pre-intervention) to 63% (final survey) (p < 0.01). Among the 102 participants using PVI at 6 months, 87% said PVI felt neutral or pleasant and 75% used PVI for the past 3 dialysis sessions. Only 9.4% reported side effects.
Conclusions:
Patients on hemodialysis underestimate their infection risk. Most patients found intranasal PVI to be acceptable. Future research should aim to improve patient education on their infection risk and remove barriers to adherence with infection prevention interventions.
This systematic review and meta-analyses provide the first synthesis of the literature on trait mindfulness and psychotic-like experiences (PLEs). Theoretical models suggest a protective function of mindfulness and it is important to understand any potential role of mindfulness in the prevention and treatment of PLEs. We examined the following: (1) What is the relationship between trait mindfulness and PLEs in nonclinical populations?; and (2) What is the effect of mindfulness-based interventions (MBIs) on PLEs in nonclinical populations? Five databases were searched, and effect sizes were extracted for each study. Seventeen papers were included in the review. Eleven papers explored the relationship between mindfulness and PLEs, and the meta-regression found a small negative association between PLEs and mindfulness (k = 8; pooled correlation r = −0.25; 95% confidence interval [CI]: −0.37, −0.13, p < .001). Eight studies investigated the effect of MBIs on PLEs and the summary effect was not significant in the meta-analysis (k = 5; pooled standard mean difference = .09; 95% CI: −0.61, 0.79, p = 0.80). Overall, the findings suggest that higher levels of mindfulness are associated with reduced PLEs, with no evidence for the effectiveness of MBIs in reducing PLEs. Findings should be interpreted cautiously given the small number of studies and high heterogeneity in the meta-analyses. Future studies are needed to determine whether MBIs might prevent the transition to psychosis or an at-risk mental state and might usefully measure a broader range of clinically relevant outcomes.
An ∼0.2-km-long gravel spit (1398 m above sea level) at Sunstone Knoll in the Sevier basin, Utah, prograded into Lake Gunnison, a shallow lake in the Sevier basin that overflowed northward into the Great Salt Lake basin during the regressive phase of Lake Bonneville. Six radiocarbon dates for Anodonta shells and one optically stimulated luminescence age, which overlaps with the uncertainty range of the radiocarbon dates, yield an age for spit development and therefore, the initiation of Lake Gunnison overflow, at ∼15.5 cal ka. This age is older than the age of a larger spit 8 m lower in elevation that ended its progradation in Lake Gunnison about 12 cal ka. Strontium isotope ratios of the Anodonta shells from Sunstone Knoll (0.71049, 0.71059, 0.71064) are within the range of values for Lake Gunnison. The new date from Sunstone Knoll is consistent with cosmogenic dates from the Provo shoreline for the initiation of the regressive phase of Lake Bonneville (about 70 m higher than the spit). The major climatic shift, which caused the lake water budget and hydrology to change from overflowing while the Provo shoreline was forming to closed-basin conditions during the regressive phase, occurred by about 16.5 cal ka.
We study the homological stability of spin mapping class groups of surfaces and of quadratic symplectic groups using cellular $E_2$-algebras. We get improvements in their stability results, which for the spin mapping class groups we show to be optimal away from the prime $2$. We also prove that in both cases the $\mathbb {F}_2$-homology satisfies secondary homological stability. Finally, we give full descriptions of the first homology groups of the spin mapping class groups and of the quadratic symplectic groups.
The relationship between the European Court of Human Rights and the ideal of democracy is a complex one: Convention states tend to understand it in terms of the supremacy of national democratic arrangements, whereas the Court has conceived of the relationship in more substantive procedural terms involving Convention rights as interpreted and promoted by the Court. In recent political debates the ideal of democracy has been instrumentalized to attack the authority of the Court based on the former understanding, such that its contribution to democratic ideals has become muted. Against this background, this article seeks to rebalance political debates about the relationship between democracy and the ECtHR by clarifying ways in which we can understand the Court as playing a democratic role based on the republican democracy of Phillip Pettit. It highlights elements of Pettit’s republican democracy relevant to the Court and analyses features of the Court and its practice which can be understood as expressing those elements. In doing so it contributes to ongoing debates about the relationship between democracy and the Court with a view to protecting and promoting the ideal of democracy in an era in which it is increasingly under threat.
Scholars have shown that restrictive zoning is correlated with racial segregation, but we lack an understanding of why this occurs. I argue that the link operates through the clustering of housing costs generated by land use regulations. Using an agent-based model, I find that restrictive zoning produces racial segregation, but only when residents have homophilic preferences and unequal wealth. Then using a novel dataset of parcel-level zoning codes, I show neighborhoods that are restrictively zoned have higher home values, are less diverse, wealthier, and have more homeowners. Finally, I show that cities vary in the degree to which zoning regulations are geographically clustered. Collectively, these results indicate that land use regulations contribute to the maintenance of racial segregation across neighborhoods.
COVID-19 lockdown restrictions forced several courts to conduct remote video or telephone hearings of cases. Many argue for the continued use of these hearing formats based on claims of increased transparency and access to justice. Recent research, however, has highlighted that virtual hearings may lead to unfair proceedings, especially in trial courts. Furthermore, this research suggests that technology gaps—for example, the lack of computer literacy among litigants—may impact case outcomes. In this article, we test whether the introduction of virtual hearings due to COVID-19 affected the way in which traffic courts adjudicated traffic tickets in Arkansas. Using an original dataset of all court cases that occurred in three Pulaski County courthouses in 2020, we find that courts were less likely to dismiss charges where hearings took place through videoconferencing. Further, using a difference-in-differences design, we find that this bias is mitigated when the technology used for the hearing is equalized among litigants. We suggest reasons for this effect and offer some recommendations to mitigate the biases inherent in virtual environments. Our results invite more research into the impact of remote communication technology on judicial behavior to ensure that the long-term use of virtual hearings guarantees equitable justice to all litigants.
This study examines how the blind Russian poet Vasily Eroshenko (1890–1952) was visually constructed in 1920s China through Chu Baoheng’s photography, transforming him from political exile to transcultural icon during the May Fourth Movement (1919–1924). Through formal visual analysis of six key photographs taken between 1921 and 1923, this research reveals how these images functioned simultaneously as documentary evidence, cultural allegory, and philosophical “metapictures” – images that reflect on the process of pictorial representation itself. The investigation proceeds through four analytical dimensions: the strategic framing of Eroshenko through translations and media following his 1921 expulsion from Japan; his photographic documentation at Stopani’s memorial in Shanghai as revolutionary allegory; his intimate portrayal in Zhou Zuoren’s traditional courtyard house and Beijing’s social spaces, revealing visual evidence of cultural integration and domestic harmony; and the iconic “poet on a donkey” image that crystallized the dialectical tension between these photographs of social belonging and the Zhou brothers’ textual accounts of “desert-like” loneliness. This contradiction illuminates May Fourth intellectuals’ complex negotiation between cosmopolitanism and nationalism. Eroshenko’s evolving portrayal from revolutionary exile to literati scholar reveals how transnational figures become screens for local intellectual projections about modernity. By examining how these photographs gained new significance across changing political contexts – particularly in Zhou Zuoren’s post-1949 reinterpretations – this study contributes to our understanding of visual media’s role in constructing cultural memory and articulating intellectual identity during China’s pivotal engagement with global modernity.
Cover crops have been progressively adopted by growers as a sustainable approach to control problematic and herbicide-resistant weeds. Understanding the critical period of crop-weed competition is essential for timely and effective weed management tactics in cropping systems. The two-year field experiment was conducted in Alabama to evaluate the effect of a cover crop mixture that included cereal rye, crimson clover, and hairy vetch, and solo cereal rye on the critical period for weed control (CPWC) in soybean. The experiment was implemented in a split-plot design in which the main plots were cover crop mixture, cereal rye, and winter fallow, and subplots were five durations of weed-free and weed-interference plots. The presence of a cover crop mixture and cereal rye delayed the critical timing for weed removal (CTWR) by approximately 2 wk compared with winter fallow. The results in 2019 showed the predicted duration of CPWC following cover crop mixture, cereal rye, and winter fallow was 4.8 wk, 0 wk, and 5.1 wk, respectively. Furthermore, in 2020, the estimated CPWC duration following cover crop mixture, cereal rye, and winter fallow was 1.4 wk, 0.1 wk, and 2.6 wk, respectively. In both years, single-species cereal rye resulted in the shortest CPWC due to its early-season weed suppression, while winter fallow resulted in the longest CPWC duration. In conclusion, a shorter duration of CPWC with the incorporation of cover crops could help soybean growers enhance their weed control and provide greater yield protection to soybeans.
Hearing distressing voices is a strong signal of potential mental health concerns and can lead to negative outcomes. Evidence-based practices to address distressing voice-hearing developed in western clinical settings may not be appropriate in sub-Saharan Africa. This study recruited patients who reported hearing voices at an outpatient clinic in semi-urban Arusha, Tanzania. Forty-three participants consented to the study and reported hearing auditory verbal hallucinations, including 88% (n = 38) reporting distressing hearing voices. The sample was split by gender, representative of a range of ages and included a primarily Maasai-related, Christian and unmarried sample with limited education. Ninety-one percent (n = 39) met criteria for moderate to severe psychopathology (Kessler-10-Swahili). Qualitative interviews (n = 43) revealed how this sample thought about mental health, how they experienced and explained their voices, and their pathways to care for help with mental health concerns that arose from their experiences. People who heard distressing voices typically approached religious healers first, but had a strong preference for biomedical care, attributed both biomedical and social causes to their symptoms, believed that voice-dialoguing practices endorsed in the west could signal participation in witchcraft, and had few resources to engage in multi-session, professional-led or high-tech interventions currently being used in Euroamerican contexts. In this region, patients with psychosis symptoms relied on and trusted family, religious leaders and biomedical treatment providers for support with their mental health needs. Networking the three together for persons experiencing psychotic symptoms could create a sustainable resource for long-term follow-up and mutual support.
This article compares the historical trajectories of democratic innovations across space and time in the UK by analysing the development and impact of collaborative governance, participatory budgeting, referendums, and mini-publics. This is an interesting country for longer-term analysis. First, the UK has been considered an inhospitable environment for democratic innovation. Second, it has experienced asymmetrical decentralisation of legislative and executive powers from national to subnational institutions. Third, these changes have taken place during a period of democratic backsliding. We analyse how these dynamics are interrelated by charting the trajectory of four types of democratic innovations in four different countries of the UK (space) from the 1970s to the present (time). We find that, after years of limited democratic innovation there has been rapid, although geographically asymmetrical, development in recent decades. We argue that the importance of these differences should not be overstated in relation to democratic deepening. We conclude that, to advance democratic innovations in the UK, a constitutional convention is required.