Predicting healthcare costs for chronic diseases is challenging for actuaries, as these costs depend not only on traditional risk factors but also on patients’ self-perception and treatment behaviors. To address this complexity and the unobserved heterogeneity in cost data, we propose a dual-structured learning statistical framework that integrates covariate clustering into finite mixture of generalized linear models, effectively handling high-dimensional, sparse, and highly correlated covariates while capturing their effects on specific subgroups. Specifically, this framework is realized by imposing a penalty on the prior similarities among covariates, and we further propose an expectation-maximization-alternating direction method of multipliers (EM-ADMM) algorithm to address the complex optimization problem by combining EM with the ADMM. This paper validates the stability and effectiveness of the framework through simulation and empirical studies. The results show that our framework can leverage shared information among high-dimensional covariates to enhance fitting and prediction accuracy, while covariate clustering can also uncover the covariates’ network relationships, providing valuable insights into diabetic patients’ self-perception data.

Abdol-Hossain Taymourtash, Reza Shah’s first minister of court, was universally recognized as the most powerful man in Iran after the shah himself. He was the lieutenant, ran the government for him. He played a key role at the shah’s side in selecting cabinet ministers and the deputies to be elected to parliament. He helped shape and realize Reza Shah’s vision for the revival and modernization of Iran. Yet in 1933, royal favor was suddenly withdrawn, and Taymourtash was arrested and imprisoned where, in all probability Reza Shah had him put to death. This article focuses on the always fraught relationship between a powerful autocrat and his loyal and efficacious lieutenant, and on the dilemma of those who wish to serve their countries and end up doing so at the cost of serving as the agents of a dictatorship.

Exposure to adversity during the perinatal period has been associated with cognitive difficulties in children. Given the role of the nucleus accumbens (NAcc) in attention and impulsivity, we examined whether NAcc volume at age six mediates the relations between pre- and postnatal adversity and subsequent attention problems in offspring. 306 pregnant women were recruited as part of the Growing Up in Singapore Towards Healthy Outcomes Study. Psychosocial stress was assessed during pregnancy and across the first 5 years postpartum. At six years of age, children underwent structural MRI and, at age seven years, mothers reported on their children’s attention problems. Separate factor analyses conducted on measures of pre- and postnatal adversity each yielded two latent factors: maternal mental health and socioeconomic status. Both pre- and postnatal maternal mental health predicted children’s attention difficulties. Further, NAcc volume mediated the relation between prenatal, but not postnatal, maternal mental health and children’s attention problems. These findings suggest that the NAcc is particularly vulnerable to prenatal maternal mental health challenges and contributes to offspring attention problems. Characterizing the temporal sensitivity of neurobiological structures to adversity will help to elucidate mechanisms linking environmental exposures and behavior, facilitating the development of neuroscience-informed interventions for childhood difficulties.

Greenstone is commonly used to produce culturally significant items across Mesoamerica, including axes, earspools, figurines, and beads. This research characterizes the mineralogy of greenstone materials recovered from sites in the Jovel Valley, Chiapas, Mexico, to document the range of green minerals utilized by the inhabitants. Our analysis of the objects suggests that the Late Classic and Early Postclassic Maya of the Jovel Valley had access to a variety of greenstone minerals, including serpentinites, green micas, grossular, and jadeite. X-ray diffraction and X-ray fluorescence spectrometry characterization of reference materials suggests procurement of greenstone resources from the well-documented sources of the Motagua–Polochic Fault Zone, and also potentially from sources in the Chalchihuitán–Chenalhó area of Chiapas, Mexico. The Jovel Valley had access to materials over long distances through historically documented trade routes that allowed the movement of greenstone materials west from the Motagua River Valley into highland Chiapas or south from the Chalchihuitán–Chenalhó area.

This article explores the subjective experiences of transition to employment in the outsourced/offshored business service sector in Romania. Based on 138 interviews with junior and senior graduates, it maps how different ‘tidal economic waves’ associated with Romania’s economic transition have intersected working biographies since the 1990s. The paper argues that the sector generates many middle-class employment opportunities, legitimising consensus around the idea that ‘this is the best time to be young.’ Yet, informed by elements of political economy, it challenges the conventional repertoires of optimism. In doing so, it tentatively questions the long-term occupational prospects of those who take up entry-level positions in (arguably) automatable, on-the-move, and standardised jobs with lesser high-end value. The paper communicates using the structure of opportunity theory by highlighting how, alongside location, the concept of time (personal, historical, and company time) is woven into the work biographies of members of an under-researched group.

A subfossil robber fly (Diptera: Asilidae) from the genus Lasiopogon Loew is reported from a Beringian rodent, Arctic ground squirrel, Urocitellus parryii Richardson (Rodentia: Sciuridae), midden in the Yukon Territory, Canada, dated to about 16 500 years old. This is the first asilid reported from Quaternary-aged material and represents the first (sub)fossil for this genus and for the subfamily Stichopogoninae.

This article extends the validity of the conditional likelihood ratio (CLR) test developed by Moreira (2003, Econometrica 71(4), 1027-–1048) to instrumental variable regression models with unknown homoskedastic error variance and many weak instruments. We argue that the conventional CLR test with estimated error variance loses exact similarity and is asymptotically invalid in this setting. We propose a modified critical value function for the likelihood ratio (LR) statistic with estimated error variance, and prove that our modified test achieves asymptotic validity under many weak instruments asymptotics. Our critical value function is constructed by representing the LR using four statistics, instead of two as in Moreira (2003, Econometrica 71(4), 1027-–1048). A simulation study illustrates the desirable finite sample properties of our test.

While recent aDNA and other scientific analysis has served to underline the recurrent role of migration in the process of Neolithisation right across Europe, there remains plenty of scope for better integration of archaeogenetic and archaeological interpretations and for detailed narratives of local and regional trajectories. This paper focuses on relations between Britain and Ireland in the early Neolithic, in the first part of the 4th millennium cal BC. I argue that direct connections between Britain and Ireland have been overlooked and underplayed — hidden in plain sight — in the search for perceived common sources in continental Europe. I advance four propositions for debate: that the first Neolithic people in Ireland came mainly from Britain, perhaps from several parts of western Britain; that subsequent connections, long described but curiously not much further interpreted, constitute an intense set of interactions; that such links were probably spread over time through the early Neolithic, coming thick and fast near the beginning and perhaps even intensifying with time; and that such relations were maintained and intensified because of the concentrated circumstances of beginnings. The latter arguably contrast with those of the relationship between the Continent and southern Britain. The maintenance of connections was political, because a remembered past was actively used; lineage founders, concentrated lineages and other emergent social groupings may have developed through time as part of such a process.

To enhance radiological and nuclear emergency preparedness of hospitals while responding to the refugee crisis, the Government of the Republic of Moldova implemented an innovative approach supported by the World Health Organization (WHO). This initiative featured a comprehensive package that integrated health system assessment, analysis of existing plans and procedures, and novel medical training component. The training, based on relevant WHO and International Atomic Energy Agency (IAEA) guidance, combined theory with contemporary adult learning solutions, such as practical skill stations, case reviews, and clinical simulation exercises.

This method allowed participants to identify and address gaps in their emergency response capacities, enhancing their ability to ensure medical management of radiological and nuclear events. This course is both innovative and adaptable, offering a potential model for other countries seeking to strengthen radiological and nuclear emergency response capabilities of the acute care clinical providers.

Seasonal variation in maternal exposure to sunlight during pregnancy, which relates to variation in vitamin D and other micronutrient availability for a fetus, is a prevalent explanation for the variation of offspring traits with birth season. However, little consensus exists about the pregnancy period during which the fetus is most sensitive to maternal UV exposure and which offspring traits are most sensitive. We examined the association between 11 anthropometric traits and birth season/month among 18,459–23,876 Estonian children born in 1937–62. Nine traits showed seasonal patterns, which were generally weak, compared to the effects of family socioeconomic position (SEP). Most prominent nonlinear associations between offspring traits and birth month emerged among children of mothers in unskilled manual professions. A possible explanation is that the growth of children in high-SEP families is more strongly buffered against any external exposures (including possible shortage of maternally synthesised vitamin D and essential micronutrient availability) than in low-SEP settings. For most traits, children born in spring/summer were larger than those born in autumn/winter. Hip width, trunk length and weight showed the most distinct seasonal patterns. If these birth-season-related patterns are related to maternal sunlight exposure, our results support the view that UV exposure benefits offspring growth towards the end of pregnancy. It is also possible that children born in spring and summer benefitted from the seasonally increasing nutrient availability during the first post-natal months.

Protein-losing enteropathy remains a formidable and underrecognised complication following Fontan surgery, contributing significantly to morbidity and mortality among affected patients. Despite substantial progress in managing single-ventricle CHDs, protein-losing enteropathy persists as a major clinical challenge, particularly in resource-constrained environments where specialised diagnostic modalities are scarce. This manuscript discusses the prevalence, clinical presentation, diagnostic hurdles, and management of protein-losing enteropathy in post-Fontan patients, drawing from clinical experiences in Vietnam. Among 95 post-Fontan patients reviewed, the prevalence of protein-losing enteropathy was 4.2%, with considerable morbidity necessitating invasive interventions and, in some cases, resulting in mortality. Diagnostic limitations, including restricted access to alpha-1-antitrypsin clearance testing, highlight the urgent need for heightened clinical suspicion and pragmatic diagnostic approaches. We advocate for integrating low-cost, widely accessible screening measures, such as routine serum protein monitoring, into standard post-Fontan care protocols to enhance early detection and management of protein-losing enteropathy. Furthermore, we underscore the critical importance of global collaboration and multicentre research initiatives to address the worldwide burden of protein-losing enteropathy, facilitate resource-sharing, and develop evidence-based interventions. Coordinated international efforts are essential to closing diagnostic and treatment gaps, ultimately improving survival and quality of life for patients living with the Fontan circulation.