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The Incas territorial expansion process was motivated not only by ideological, political, and economic factors but also involved the ritual integration of ancient sanctuaries through capacocha offerings. Notable examples include the Sacred Rock (Roca Sagrada) of the Island of the Sun (Lake Titicaca) and the Oracle of Pachacamac (Lurín Valley). The antiquity of these two sanctuaries, combined with their roles as destinations for imperial-scale pilgrimages during the Inca period, underscore their significance and uniqueness and the role of the capacocha ritual to connecting places into the Inca world. The material correlates associated with numerous capacocha rituals recorded in the Andes demonstrate that this ritual adhered to standardized conventions and criteria. The canonical archaeological remains of capacocha are characterized by human sacrifices and specific offerings, particularly anthropomorphic figurines made of precious metals or Spondylus. The absence of human corpses in certain contexts can be attributed to taphonomic factors but also to ritual adaptations specific to the locations where they were discovered. In this article, we develop this adaptive model for two of the major sites of Inca cosmology: Lake Titicaca and Pachacamac, emphasizing their close connection to Cuzco, the imperial capital and center of the Inca world.
Epidemiological evidence on the incidence and remission of anxiety and depressive disorders is limited. We estimated age- and sex-specific incidence and remission rates of moderate-to-severe anxiety and depressive symptoms using the illness-death model.
Methods
The German National Cohort (NAKO) is a cohort of over 200,000 participants aged 19–74 at baseline. Prevalence of probable cases, estimated with the Generalized Anxiety Disorder Scale and the Patient Health Questionnaire data 2014–2019 across five regions, was related to general mortality rates and disorder-specific mortality rate ratios in the illness-death model. The partial derivative of prevalence was modeled as a function of incidence and remission, with parameters estimated via least-squares optimization through 2,000 bootstrap resamples.
Results
The highest incidence rates (per 1,000 person-years) occurred at ages 19–21 for anxiety symptoms: 4.07 (95% CI: 0.00–7.57) in women and 2.55 (0.00–4.94) in men; and at ages 28–34 for depressive symptoms: 4.41 (0.00–9.81) in women and 3.30 (0.00–7.34) in men, all in Hamburg. Remission rates (per 100 person-years) were highest at older ages. For anxiety symptoms, rates peaked at 71.8 years in women (4.10 [0.00–11.94]) and 64.2 years in men (3.00 [0.00–9.23]) in Freiburg. For depressive symptoms, the highest observed was at 74.0 years, both among women (6.61 [0.00–15.50] in Münster) and men (3.58 [0.00–11.51] in Berlin).
Conclusions
Incidence and remission rates of anxiety and depressive symptoms can be estimated from prevalence and mortality data, revealing regional, sex-, and age-related variation. Validation with longitudinal data is warranted.
We consider the filtering problem associated with partially observed McKean–Vlasov stochastic differential equations (SDEs). The model consists of data that are observed at regular and discrete times; the objective is to compute the conditional expectation of (functionals) of the solutions of the SDE at the current time. This problem is challenging even in the ordinary SDE case and requires numerical approximations. Based on the ideas in Ben Rached et al. (2024) and dos Reis et al. (2023), we develop a new particle filter (PF) and multilevel particle filter (MLPF) to approximate the aforementioned expectations. We prove under assumptions that, for $\varepsilon>0$, to obtain a mean square error of $\mathcal{O}(\varepsilon^2)$ the PF has a cost per observation time of $\mathcal{O}(\varepsilon^{-5})$, and the MLPF costs $\mathcal{O}(\varepsilon^{-4})$ (best case) or $\mathcal{O}(\varepsilon^{-4}\log(\varepsilon)^2)$ (worst case). Our theoretical results are supported by numerical experiments.
This review examines barriers and facilitators to implementing infection prevention and control (IPC) practices in behavioral health settings. Among 63 studies identified, environmental design, staffing/training limitations, patient behaviors, and therapeutic conflicts were common barriers. Facilitators included targeted training, collaboration, and adaptable IPC policies, underscoring the need for tailored interventions.
The objective of the current study was to evaluate 30 previously uncharacterised pure plant secondary metabolites (PSM) for effects on in vitro gas production (GP) and methane concentration. Purified compounds (n = 4) were incubated in buffered rumen fluid for 48 h at a rate of 25 mg per g substrate. Gas production was measured using ANKOM RF pressure analysers and gas composition was measured using gas chromatography. Dry matter and fibre digestibility and volatile fatty acid (VFA) concentrations were determined. Data were analysed using a linear mixed model with fixed effect of treatment, random effect of experimental run and blank as a covariate and Dunnett’s test to compare each treatment to a control. Sabenine, apigenin, galangin, isoliquiritigenin, quercetin, rutin, vitexin, abscisic acid and uridine reduced methane concentration, with a tendency for reduction by kaempferol. Sabenine, thymol, apigenin, quercetin, rutin, vitexin, abscisic acid and uridine reduced methane production, with the greatest reduction occurring for rutin (81.8 %), vitexin (81.7 %) and thymol (80.5 %). Eight compounds increased methane production compared to control, with stigmasterol having the greatest increase (173.0 %). Out of the compounds that reduced methane emissions, a reduction in fibre digestibility was observed for all except quercetin and thymol. Minimal effects of PSM on VFA profile were observed, with myrtenal increasing proportion of acetate, alpha-humulene, alpha-longipinene and beta-caryophyllene increasing proportion of propionate and thymol, apigenin, hyperoside and verbenone increasing proportion of butyrate. Results suggest that quercetin and thymol warrant further exploration as potential feed additives to reduce methane emissions.
To evaluate the impact of a tailored organizational intervention on the support for family caregivers.
Methods
A convergent mixed-methods study was conducted in 17 organizations (6 hospices, 5 home care organizations, 3 nursing homes, 2 hospitals, 1 transmural organization) between November 2021 and August 2023. The intervention comprised a structured practice improvement trajectory during which each organization conducted a structured workshop to define organization-specific goals to improve their support for family caregivers and to develop an action plan to achieve those goals. The action plan was implemented over 1 year with intermittent evaluations. Pre- and post-intervention surveys were distributed among healthcare professionals (paired) and bereaved family caregivers (non-paired) to assess provided and received support. Data were analyzed with mixed models and regression analyses. Post-intervention focus groups with project team members and final evaluation reports were analyzed with qualitative content analysis.
Results
Survey respondents were 97 healthcare professionals (83% nursing staff), 123 family caregivers pre-intervention, and 99 family caregivers post-intervention. Only healthcare professionals of home care organizations reported a significant increase in attending to family caregivers’ wellbeing and needs (scale 0–20; β = 3.65; 95%CI: 1.33–5.97). Family caregivers’ reports of healthcare professionals attending to their wellbeing and needs did not change (scale 0–2; β = 0.17; 95%CI: −0.04–0.38). Across settings, healthcare professionals evaluated the care they provided more positively post-intervention (scale 0–8; β = 0.65, 95%CI: 0.38–0.97). In home care, family caregivers also evaluated care more positively (scale 0–8; β = 2.12; 95%CI: 0.89–3.34). Four focus groups and 17 evaluation reports indicated improvements at 3 levels: the support for family caregivers (increased awareness of healthcare professionals, changes in work processes, more structured support), the healthcare team (more skills, confidence, available tools), and the organization (fostering sustainability).
Significance of results
A tailored organizational intervention can strengthen the support of family caregivers in healthcare organizations.
In this work, we introduce a new class of algebras that we denominate skew-Brauer graph algebras. This class contains and generalizes the Brauer graph algebras. We establish that skew-Brauer graph algebras are symmetric and can be defined based on a Brauer graph with additional information. We show that the class of trivial extensions of skew-gentle algebras coincides with a subclass of skew-Brauer graph algebras, where the associated skew-Brauer graph has a multiplicity function identically equal to one, generalizing a result over gentle algebras. Furthermore, we characterize skew-Brauer algebras of finite representation type. Finally, we provide a geometric interpretation of cut-sets and reflections of algebras using orbifold dissections.
This article presents and discusses a table of audiovisual transformations based on practice-based experience. The transformations were designed to reinforce the link between sound and object by considering what a particular audio process would look like if translated into visual form. The creative work involves installations that focus on objects integrated with projection mapping and electroacoustic sound. Examples of other artists who create object-based works are introduced, followed by a discussion around how electroacoustic music can influence audiovisual approaches. Screen and installation-based audiovisual theory expands on this and links to a two-part table of transformation strategies. The first part of the table describes process-based links that were created to imagine how certain electroacoustic studio techniques would translate to alter visual material. The second part describes broader conceptual links between audio and visual elements. The findings offer an insight into how electroacoustic practice can inform audiovisual composition choices. Whilst the intended use was for sound installations, there is significant scope for others to adopt and adapt the transformation strategies beyond this, including visual artists who wish to work with sound and those seeking to further theorise audiovisual relationships in a variety of settings.
This study conducted an approximate replication of Teravainen-Goff (2023) to validate the Intensity and Perceived Quality of Engagement Scale for university students in the Japanese EFL context. Teravainen-Goff (2023) developed this scale based on an action-oriented definition of engagement and proposed a novel approach to measuring engagement among secondary school language learners in the UK. The study identified an 18-item, five-factor structure from a pool of 36 items through exploratory factor analysis (EFA). In this replication, we examined the validity and reliability of Teravainen-Goff’s scale in a different context, focusing on the replicability of the EFA results. We undertook this replication because engagement is context-dependent and EFA results can vary across samples. We compared the factorial structure with that of the initial study while modifying the target language and participant demographic. Results revealed a 22-item, six-factor structure with good fit. Although the same underlying factors emerged, several notable differences were observed. This approximate replication provided stronger evidence for the psychometric properties of the scale in a new context. Transparent documentation of modifications to the initial study and systematic comparison offered a promising approach to building robust evidence for engagement research and improving the rigour of questionnaire-based research overall.
Caregivers of older individuals with dementia experience substantial and enduring burden, often exacerbated by patient neuropsychiatric symptoms (NPS). Few longitudinal studies have examined how specific NPS contribute to prolonged caregiver burden.
Methods:
We conducted a 6-month prospective cohort study of 100 dyads of caregivers and older adults with Alzheimer’s disease, frontotemporal dementia and Lewy body dementia recruited from specialized neurology and geriatric clinics. Caregiver burden was assessed using the Zarit Burden Interview (ZBI), and NPS were measured with the neuropsychiatric inventory (NPI) and associated distress scale (NPI-D). Correlation analyses examined associations between baseline NPS and both concurrent and prolonged high caregiver burden.
Results:
At baseline, nearly one-third of caregivers reported moderate-to-severe burden (mean ZBI 31.4 ± 15.4), a prevalence that persisted at 6 months. Higher burden was strongly correlated with total NPI and NPI-D scores (p < 0.001). Specific symptoms – including delusions, hallucinations, agitation, anxiety, disinhibition, depression, sleep disorders and irritability – were consistently associated with greater burden. Depression, anxiety, disinhibition and sleep disturbances predicted prolonged high burden over 6 months. Sex-specific patterns emerged: psychotic symptoms and sleep disorders were more strongly associated with burden in female caregivers, whereas depression and irritability were key drivers for male caregivers.
Conclusion:
Caregiver burden in dementia is both prevalent and persistent, with NPS emerging as major correlates and predictors. Recognition of sex-related patterns may enable earlier identification of at-risk caregivers. Interventions addressing both patient NPS and caregiver coping resources could help reduce long-term distress and improve outcomes for both caregivers and patients.
Brazil has a longstanding and significant tradition in the development of social housing; however, this topic remains underexplored within the field of social policy. This study adopts qualitative methods, including an analysis of housing legislation, from the past two decades and, and data from 20 semi-structured interviews conducted between June and September 2021 with key stakeholders in housing policy, such as policymakers, and activists. The findings reveal a persistent gap between policy promises and actual implementation, alongside a continuing trend toward the financialization and commodification of social housing – particularly in programs such as Minha Casa, Minha Vida (My House, My Life) and Casa Verde e Amarela (Green and Yellow House). The study offers novel empirical insights into the role of social housing within broader ecosocial policy frameworks. One of the central findings is the interconnection between social housing, environmental concerns, and sustainability. The Brazilian case, in particular, stands out as a distinctive and pioneering contribution to the field.
To describe neuropathological findings in autopsies of patients with isolated, partial or all classic features of the septo-optic-pituitary dysplasia (SOD) triad, speculate on SOD etiology and ascertain the causes of death.
Method:
Retrospective review of autopsy reports of patients with one or more features of the SOD triad.
Results:
Twenty-one (14 females) cases were identified. Median age at death was 2.3 years. Two fetuses died soon after birth, and the rest died at postnatal ages of 3 weeks to 50 years. Ten cases had optic nerve hypoplasia (ONH) with either (i) small pituitary gland/hypopituitarism (five cases) or (ii) absent septum pellucidum (SP)/abnormal corpus callosum (CC) (two cases) or (iii) both (three cases). Eleven cases had one or two features of the SOD triad. A wide spectrum of neuropathological findings was evident, with 12 cases resulting from in utero/perinatal vascular lesions in brain regions that led to ONH/chiasm hypoplasia, hypothalamus/pituitary gland anomalies and agenesis or abnormalities in the SP, CC and olfactory bulbs and tracts. Other suspected causes included three genetic (one with holoprosencephaly), two in utero infection and one arachnoid cyst with hydrocephalus. The most common cause of death was a respiratory illness.
Conclusions:
The autopsy findings appear to be the result of destructive or less commonly impaired developmental processes. Our findings suggest that SOD is not a single disease entity but represents a syndrome with ONH and one or more of: hypothalamic-pituitary dysfunction and absent SP or abnormal CC. We consider ONH an essential part of SOD.
The COVID-19 pandemic exposed the fragility and adaptability of democratic orders. While confinement accelerated cross-border ‘tele-life’, rights and protections remained territorially locked. This essay argues that democracy need not be tied to the Westphalian state: it can be re-imagined as unterritorial democracy – voluntary, overlapping and portable communities of belonging. Building on panarchist thought, Austro-Marxist proposals for non-territorial autonomy and Jewish Bundist experiments with cultural self-rule, I advance a model of pan-citizenship and polycentric governance in which rights and representation follow persons rather than places. The contribution is threefold: (1) a genealogy that situates unterritorial democracy within longer traditions of political imagination; (2) analytical criteria – membership portability, competence clarity, equity and accountability – that render such institutions evaluable; and (3) contemporary proto-examples – from diaspora voting to indigenous electoral registers – showing that elements of unterritorial democracy already exist. By integrating historical, analytical and empirical strands – and by engaging debates on emergency powers and derogations of rights – the essay positions unterritorial democracy as a normative horizon for global constitutionalism, inviting person-linked indicators capable of capturing democratic belonging within a framework of multiterritorial pluralism. In this way, the essay contributes to both the normative debates and the methodological agenda of global constitutionalism.
Recent excavations at Gre Fılla, located in the northern part of the Upper Tigris region in modern-day Türkiye, have revealed an architecturally diverse settlement that was occupied during much of the Pre-Pottery Neolithic (c. 9300–7500 BC). While early architecture at the site aligns with developments seen more widely in northern Mesopotamia, the typological diversity that fluoresces during the Pre-Pottery Neolithic B (c. 8800–7500 BC) has previously been under-represented in the region. Here, the author examines the evolution of the architecture uncovered at Gre Fılla, arguing that the increasing architectural complexity reflects the developing social complexity of Neolithic communities.
This article argues that the extent and longevity of dry conservancy systems in urban England between the 1870s and 1920s is underappreciated for its impact on health and disease. Using Birmingham as a case-study, it advances knowledge on the systemized development of municipal pail systems and offers a deeper understanding of living with conservancy. It draws out the importance of looking at the fly problem and the transmission relationship, largely ignored until the second decade of the twentieth century. It also explores and challenges existing ideas in the debates surrounding investment in sanitation infrastructure and mortality decline.
Psychosis and bipolar I disorder are severe mental disorders with significant adverse impacts on patients, their families and society overall. Patients’ follow-up in rural areas is often challenging owing to stigma and limited access to mental health services.
Aims
The primary aim was to evaluate the effectiveness of follow-up by a mobile mental health unit (MMHU) operating in underserved rural areas of Crete in preventing readmissions to hospital across its 10 years of operation. Additionally, we investigated sociodemographic and clinical factors associated with patients’ readmissions.
Method
The study included 288 patients with psychosis (n = 201) or bipolar disorder (n = 87). The effectiveness of the MMHU is assessed by comparing patients’ voluntary and involuntary admissions pre- and post-follow-up.
Results
Hospital readmissions were reduced by half and involuntary readmissions by 50–70%. This effect was significant for patients with both single and multiple prior admissions. Regression analysis revealed that older age, depot medication, no substance misuse history and being ever married were associated with reduced readmissions. Also, the normative visit frequency of 5–9 visits per year (approximately 1 visit every 1.5 months) was associated with reduced readmissions.
Conclusions
The operation of an MMHU in rural Crete is effectively preventing overall and involuntary readmissions, particularly when patients are followed up on a regular basis. These findings highlight the effectiveness of community services in addressing the mental health needs of people living in rural and remote areas with limited access to mental health services.
Galaxies undergo perturbations, either gravitational or hydrodynamic in origin, which can generate extragalactic structures such as rings and tails, where in situ star formation may take place. We selected a sample consisting of JO201 and JW100, undergoing ram-pressure stripping, and NGC 5291 and NGC 7252, formed through gravitational interactions, to investigate how different perturbation mechanisms influence dust content and star formation in extragalactic features. In both cases, star formation can be observed outside the main disks of the galaxies. We present new results of dust attenuation for JO201 and JW100, while for NGC 5291 and NGC 7252 we use results from our previous study, based on high-resolution observations obtained with the Ultraviolet Imaging Telescope onboard AstroSat. Dust attenuation is determined from the ultraviolet continuum slope ($\beta$) calculated using the FUV–NUV colour, and the star formation rates of the star-forming knots are corrected accordingly. It is seen that dust attenuation and dust-corrected SFR densities of the knots in the ram-pressure stripped tails of JO201 and JW100 are comparable to those in the collisional ring of the NGC 5291 system and the tidal tails of the NGC 7252 system. We conclude that, though the formation scenarios of the tails of JO201 and JW100, the NGC 5291 ring, and the NGC 7252 tails are different, their dust content and star formation activity are notably similar.