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Evidence suggests that plant-based dietary patterns —favoring plant-based foods without being strictly vegetarian or vegan — may prevent obesity and offer health benefits. Since not all plant-based foods are equally healthy, it is essential to distinguish between healthful and unhealthful plant-based options. Objective: This study aimed to analyze the associations between different plant-based dietary patterns and the incidence of obesity-related cancers. We followed-up 16,256 participants from the “Seguimiento Universidad de Navarra” (SUN) prospective cohort. Based on a validated food frequency questionnaire, we calculated adapted overall, healthful and unhealthful plant-based diet index scores. Scores for were assessed at baseline and repeatedly after 10 years of follow-up. Hazard ratios (HR) and 95% confidence intervals (CIs) were estimated using multivariable-adjusted time-dependent Cox models. After a median follow-up of 13 years, 221 incident obesity-related cancer cases were confirmed. Overall plant-based and unhealthful plant-based dietary patterns showed no association. Contrarily, participants in the highest tertile of the healthful plant-based diet score had a lower obesity-related cancer risk (HRT3vsT1 0.67; 95% CI, 0.47 -0.97; Ptrend=0.031). This association persisted after updating dietary information at 10-year follow-up (HRT3vsT1 0.68; 95% CI, 0.47 -0.99; Ptrend=0.037) and was stronger for women (HRT3vsT1 0.52; 95% CI, 0.32 -0.86; pinteraction = 0.04). In this large prospective cohort, greater alignment with a healthful plant-based dietary pattern was associated with a decreased risk of obesity-related cancer, whereas alignment with overall and unhealthful plant-based dietary patterns showed no association.
Immigrant households and those that speak languages other than English are underrepresented in disaster preparedness research. Study authors conducted a needs assessment of Spanish-speaking families to identify strengths and opportunities for education and resources in this population.
Methods
In this mixed-methods study, authors partnered with Promotoras de Salud, or Spanish-speaking community health liaisons, to conduct focus groups and surveys with Spanish-speaking family representatives. Recordings were transcribed, translated from Spanish to English, and analyzed using modified grounded theory to identify key themes.
Results
The results demonstrated that while many Spanish-speaking households have experience with disasters, there are significant gaps in information and supplies. Participants reported perceived barriers to preparation including lack of knowledge, language barriers, and lack of sense of belonging. Participants consistently indicated interest in improving disaster preparedness for themselves and their families.
Conclusions
This study demonstrates a clear opportunity to create and share climate disaster preparedness information with Spanish-speaking immigrant populations, who already have valuable experience and resources within their communities. Next steps include expanding outreach to a broader geographic scope of communities and focused assessments of special populations. This study underscores the importance of inclusive, culturally responsive disaster preparedness educational materials.
This article traces Canada’s transatlantic musical exchanges with Europe during the 1970s, as facilitated by the Canadian Government’s Department of External Affairs’ (DEA) Cultural Affairs Division. Through an archival analysis of documentation pertaining to the planning activities of the Cultural Affairs Division, this article focuses on two all-Canadian musical events funded by the division: the 1972 performance of Canadian contemporary music in Rome, and the 1977 two-week long festival of Canadian contemporary music, Musicanada, hosted in London and Paris. This article argues that these two events act as useful case studies to demonstrate how the works of Canadian contemporary composers were used for strategic soft-power purposes by the DEA’s Cultural Affairs Division in fulfilling its transatlantic diplomatic aims of projecting an image of Canadian culture which was both distinct from the United States and would appeal to European cultural elites.
The article details the complex geopolitical and national conditions that shaped the securitization of Kists — a predominantly Muslim ethnic minority who primarily reside in the Pankisi Gorge of Georgia. Securitization of Kists emerged at the intersection of colonial encounters: Russian colonial relations with the Caucasus, primarily with Georgia and Chechnya, and Western neocolonial relations with Muslims in a form of global counterterrorist policies that painted Islam as a looming threat to the Western world after 9/11. Moreover, notions about minorities within Georgia contributed to the emergence of the securitization paradigm towards Kists. These circumstances molded Georgian national politics concerning Kists — namely, securitization policies and practices that legitimized violent special operations in the valley, close surveillance, scrutiny, and intimidation of the community. Based on long-term ethnographic fieldwork, participant observation, qualitative interviews, and critical discourse analysis, this article examines these policies, practices, and the profound effects of the state’s politics on the social landscape of Pankisi. Moreover, this research also observes various everyday strategies and tactics employed by Kists to navigate the social terrains of marginality.
Compulsive sexual behavior disorder (CSBD) was included in the ICD-11 as an impulse control disorder, yet pharmacological treatment options remain limited. Naltrexone, an opioid receptor antagonist approved for alcohol and opioid use disorders, has shown promise for compulsive sexual behaviors, though the extended-release injectable formulation has not been evaluated for this indication.
Case presentation:
A 54-year-old married man with longstanding compulsive sexual behavior presented with acute symptom escalation following job loss, including compulsive pornography use, financial concealment, occupational impairment, and secondary depressive symptoms. Despite desvenlafaxine 50 mg and weekly psychotherapy incorporating motivational interviewing, cognitive-behavioral, and mindfulness-based techniques, he achieved inadequate symptomatic benefit. Extended-release naltrexone (Vivitrol) 380 mg intramuscular injection monthly was initiated as augmentation, chosen for more consistent receptor occupancy than oral formulations. Symptom severity was assessed using the Compulsive Sexual Behavior Inventory-13 (CSBI-13) and Hypersexual Behavior Inventory-19 (HBI-19) at baseline and monthly over three months. Hepatic function was monitored throughout.
Outcomes:
The patient demonstrated substantial improvement on both measures. CSBI-13 scores decreased from 65/65 at baseline to 25/65 at one month (61.5% reduction), stabilizing at 35/65 by month three (46.2% total reduction). HBI-19 scores decreased from 91/95 to 49/95 at one month (46.2% reduction), remaining stable at 47/95 through month three (48.4% total reduction). Liver enzymes remained within normal limits and no adverse events were reported.
Conclusions:
This case suggests extended-release naltrexone may be an effective augmentation strategy for CSBD unresponsive to antidepressant pharmacotherapy and psychotherapy. Controlled trials are needed to establish efficacy.
To assess whether wind-driven natural ventilation in the Infectious Diseases Treatment Module (IDTM) can achieve ventilation performance consistent with airborne precaution requirements [160 liters per second (L/s)] and to estimate associated pathogen-specific infection risks.
Methods:
An experimental campaign of air velocity measurements and CO2 decays were conducted to validate the developed computational fluid dynamics (CFD) model. The validated CFD model simulated wind-driven natural ventilation (1–4 m/s) for an L-shaped IDTM configuration under four structural scenarios defined by the presence or absence of patient porches and mosquito nets. Airborne infection risk was estimated using a Wells–Riley quanta-based model for seven representative airborne pathogens under short-duration healthcare worker exposure and prolonged patient co-exposure.
Results:
Ventilation performance varied widely based on wind speed and structural configuration. Airflow ranged from 7 L/s in the most restricted configuration (porch and mosquito nets present at 1 m/s) to over 3,100 L/s when mosquito nets were removed at 4 m/s.
When mapped to infection-risk estimates, ventilation rates at 160 L/s substantially reduced short-duration healthcare worker infection risk for all pathogens (≤1%), whereas prolonged co-exposure remained associated with high risk for high-emission pathogens despite high ventilation.
Conclusion:
Under favorable wind conditions and optimized configurations, the IDTM can achieve ventilation rates consistent with the 160 L/s recommendation for airborne precautions. While this provides substantial protection for healthcare workers, individual-room isolation remains essential for patient management. Operationally, removing window-mounted nets is the most effective way to ensure safety targets are met; hybrid ventilation measures should be considered during low-wind conditions.
This article theorizes on the mobilization of R-TANS (right-wing transnational advocacy networks [Payne 2023]) globally, with a focus on those that target gender, reproductive, and sexuality-based (GRAS) rights. An international anti-GRAS network has emerged, increasing their power through transnational allyship. This article describes and analyses an original database of anti-GRAS actors that form this network, asking: who are the groups; where do they originate and mobilize; how do they mobilize; and why? I develop an original analytical framework drawing on transnational social movements and anti-gender mobilization literature. Applying this framework to database analysis, I hypothesize on these questions while drawing on social network theory to examine the strength of ties between groups and the extent of the transnational network. It is unique in its contribution, considering the overlap of groups that oppose both LGBTQIA+ and reproductive rights and the alliances they develop to further the goals of the entire network.
Traditional lecture-based learning (LBL) is often insufficient for cultivating the practical decision-making skills required in high-stakes environments like Emergency Medical Response (EMR). While game-based learning (GBL) offers an immersive alternative, it can lack immediate expert guidance. This study addresses this gap by exploring the integration of generative Artificial Intelligence (AI) as an “intelligent tutor” within GBL. The objective was to evaluate and compare the effectiveness of LBL, GBL, and generative AI-powered game-based learning (AI-GBL) on medical students’ knowledge acquisition, retention, learning motivation, and cognitive load in an EMR course.
Methods:
A retrospective, comparative study was conducted with 86 medical students from three consecutive cohorts (2022-2024), each exposed to one of the three teaching modalities (n = 29 LBL, n = 28 GBL, n = 29 AI-GBL). Knowledge was assessed via pre-test, post-test, and final-test scores with a maximum score of 10 points. Student feedback was collected for learning motivation, cognitive load, and technology acceptance.
Results:
For immediate knowledge acquisition, both GBL (mean difference = 1.124/10 points; 95% CI [0.297, 1.952]; P = 0.008) and AI-GBL (mean difference = 0.897/10 points; 95% CI [0.076, 1.717]; P = 0.033) significantly outperformed LBL. For delayed knowledge retention, the AI-GBL group demonstrated significantly superior retention compared to both the GBL group (mean difference = 0.689 points; unadjusted 95% CI [0.080, 1.299]) and the LBL group (mean difference = 1.310 points; unadjusted 95% CI [0.706, 1.915]). The AI-GBL group also reported significantly lower cognitive load than the GBL group (mean difference = −0.273 points; unadjusted 95% CI [−0.456, −0.090]). Finally, students perceived the AI-powered approach as significantly more useful than the standard game-based approach (mean difference = 0.513 points; unadjusted 95% CI [0.137, 0.889]).
Conclusion:
The AI-enhanced GBL model for EMR training improves knowledge acquisition and retention while reducing cognitive load, representing a promising approach for developing proficiency in complex, high-stakes medical competencies.
This cross-sectional study examined the independent and combined associations of breakfast frequency, forced vital capacity (FVC) and psychological symptoms among Chinese adolescents. A total of 2776 adolescents aged 12-17 years were recruited from three regions of Anhui Province using stratified cluster random sampling. Breakfast frequency was self-reported as days per week over the past month and categorised as low, medium or high. FVC was measured with a standardised electronic spirometer (CSTF-FH) following CNSSCH protocols. Psychological symptoms were assessed using the Multidimensional Subhealth Assessment Questionnaire for Adolescents (MSQA) and dichotomised according to established cut-offs. Covariates included age, height, weight, grip strength, standing long jump, sleep duration and parental education. Binary logistic regression was used, building three models. The overall prevalence of psychological symptoms was 14%. Breakfast frequency was inversely correlated with psychological symptoms (P < 0.001). Low breakfast frequency (1-2 d/week) was associated with a higher symptom rate (31%) than high frequency (5-7 d/week, 12%) and increased odds of symptoms (OR = 3.34, 95% CI 2.04–5.60). No independent association was found between FVC and psychological symptoms. However, adolescents with both low breakfast frequency and low FVC had 4.10 times higher odds of psychological symptoms (95% CI 1.83–9.21, P < 0.001) than those with high breakfast frequency and high FVC. These findings suggest that low breakfast frequency is a robust correlate of psychological symptoms in adolescents, and that the combination of low breakfast frequency with low FVC identifies a particularly high-risk group.
The dynamics of non-spherical particles in wall-bounded flows plays a fundamental role in numerous natural and industrial processes, such as pollen dispersion, fibre suspensions and biomedical flows. Predictive simulations of such systems often employ an Euler–Lagrange approach, for which the accuracy hinges on the drag model used. Although reliable correlations exist for particles in unbounded flow or in direct contact with a wall, the intermediate regime of finite wall distance has received little attention, despite its prevalence in practical applications. For prolate spheroids – a common non-spherical particle shape – the drag force in this regime results from a complex interplay among the particle Reynolds number, the wall-normal distance and the particle’s three-dimensional orientation. In this work, we develop a drag model for prolate spheroids (aspect ratio $\lambda = 2$) that incorporates these coupled effects through a hierarchical framework based on three reference orientations and wall correction factors. The formulation recovers the exact unbounded Stokes behaviour and establishes near-wall asymptotic limits. Validation against direct numerical simulations across the parameter space considered yields a mean relative error below 2 %. Within its validated range, the proposed model accurately captures orientation-dependent wall effects for drag predictions, and is applicable in Euler–Lagrange simulations of non-spherical particles in wall-bounded flows.
Healthcare spaces are “contact zones,” where care may be practised using a lingua franca, or in various configurations of language codes. This paper examines two foundational constructs, communicative competence and health literacy, that are implicated in the contact zones of health care. I propose a heuristic framework of spheres of activity for locating, articulating, and understanding the facets and workings of measured constructs as a basis for a multiperspectival, interdisciplinary research agenda. The framework is applied to a health literacy test to explore the multilayered texture of construct activity. Moving to the applicable world of the hospital ward, I consider what “health literacy” may look like in authentic doctor–patient interaction. Finally, I discuss the relationship between the different activities: what is operationalized in tests, what is wished for in policy, and what is evident in practice. Even though the capacity to communicate is considered a key ingredient in mobilizing health literacy for shared decision-making, communication is barely represented in operationalized constructs. An orientation to the interactional repertoires of health care and the dynamic nature of knowledge co-construction in health decision-making could generate useful development in theory, measurement, and practice.
The accountability gap in Africa’s extractive sector is not a result of the absence of binding legal frameworks or investment regulations. The African human rights system has advanced global jurisprudence by introducing and applying innovative human rights and investment norms. Despite the robust human rights regime, including legally binding regional norms for redressing human rights abuses, local communities continue to suffer the consequences of extractive MNCs’ egregious human rights abuses without access to remedies. Corporate impunity is often fueled by governments’ reluctance or inability to hold these corporations accountable and by local communities’ limited access to effective remedies. While extractive MNCs in Africa are legally obligated to respect human rights, the continent needs a robust enforcement mechanism and the political will to hold defaulting enterprises accountable. Hence, I propose strategies to implement the region’s rich human rights and investment initiatives and to narrow the accountability gap in the extractive sector.
Climate change is deeply unsettling—both ecologically, as reflected in the rise of climate disasters and biodiversity loss, and materially, as seen in the widespread disruptions and displacements it causes. The impacts of climate change are increasingly experienced as constant and material impact on bodies, and the disruption and displacement of connections to place and entangled environments. This continuous turbulence is creating an experience of being unmoored, disconnected from attachments, both human and environmental. This essay will address both the reality of climate turbulence and the growing intersection of such turbulence and conceptions of environmental, ecological, and climate justice. How and why can the changed, disrupted, turbulent life of climate change, specifically, be understood as a unique form of climate injustice? A variety of conceptions of climate justice are addressed, with a particular focus on the way that climate turbulence unsettles individual and community capabilities and functioning in multiple ways. The essay addresses how a more just response to climate turbulence means more inclusive and capabilities-based approaches to climate justice.