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The relation between epistemic relativism and epistemic oppression is contentious but undertheorized. Both positions rest on one or the other version of the situated knowledge thesis, based on the idea that access to and justification of knowledge is dependent on a particular context or, to be precise, an epistemic system. Whether this notion is coextensive in both schools of thought is, however, unclear. In this article, I aim to examine the relation between epistemic relativism and epistemic oppression by analyzing the notion of “epistemic system.” Through this analysis, I shall argue that the epistemic relativism literature has neglected power imbalances within epistemic systems since it rests on idealizing epistemic systems to sets of epistemic principles. Understanding epistemic systems as necessarily social and political, I then confront the idea formulated in the epistemic oppression literature that some forms of oppression are “irreducibly epistemic.” I argue that epistemic principles can never fully determine their applications and thus essentially require the social. Thus, insisting on the “irreducibly epistemic” might not be a favorable option for epistemic oppression or epistemic relativism scholarship.
Treatment interruptions in disaster victims are concerning, owing to an increase in natural disasters and the growing elderly population with chronic conditions. This study examined the temporal trends in treatment interruptions among victims of 2 recent major heavy rain disasters in Japan: West Japan heavy rain in 2018 and Kumamoto heavy rain in 2020.
Methods
Data for this study were derived from the national standardized medical data collection system called the “Japan Surveillance in Post-Extreme Emergencies and Disasters.” Joinpoint regression analysis was performed to examine the daily trends in treatment interruptions reported soon after each disaster onset.
Results
A total of 144 and 87 treatment interruption cases were observed in the heavily affected areas of the West Japan heavy rain in 2018 and Kumamoto heavy rain in 2020, respectively. In both disasters, a high number of treatment interruption cases were observed on the first day after the disaster. Joinpoint regression analysis showed that trends in the percentage of treatment interruptions differed between the 2 disasters at different disaster scales.
Conclusions
The findings suggest the importance of a prompt response to treatment interruptions in the immediate aftermath of a disaster and consideration of the specific characteristics of the disaster when planning for disaster preparedness and response.
The study objective was to develop and validate a clinical decision support system (CDSS) to guide clinicians through the diagnostic evaluation of hospitalized individuals with suspected pulmonary tuberculosis (TB) in low-prevalence settings.
Methods:
The “TBorNotTB” CDSS was developed using a modified Delphi method. The CDSS assigns points based on epidemiologic risk factors, TB history, symptoms, chest imaging, and sputum/bronchoscopy results. Below a set point threshold, airborne isolation precautions are automatically discontinued; otherwise, additional evaluation, including infection control review, is recommended. The model was validated through retrospective application of the CDSS to all individuals hospitalized in the Mass General Brigham system from July 2016 to December 2022 with culture-confirmed pulmonary TB (cases) and equal numbers of age and date of testing-matched controls with three negative respiratory mycobacterial cultures.
Results:
104 individuals with TB (cases) and 104 controls were identified. Prior residence in a highly endemic country, positive interferon release assay, weight loss, absence of symptom resolution with treatment for alternative diagnoses, and findings concerning for TB on chest imaging were significant predictors of TB (all P < 0.05). CDSS contents and scoring were refined based on the case–control analysis. The final CDSS demonstrated 100% sensitivity and 27% specificity for TB with an AUC of 0.87.
Conclusions:
The TBorNotTB CDSS demonstrated modest specificity and high sensitivity to detect TB even when AFB smears were negative. This CDSS, embedded into the electronic medical record system, could help reduce risks of nosocomial TB transmission, patient-time in airborne isolation, and person-time spent reviewing individuals with suspected TB.
The current study examined the comprehension and production of classifiers, case marking, and morphological passive structures among 414 child Japanese heritage speakers (mean age = 10.01 years; range = 4.02 – 18.18). Focusing on individual differences, we extracted latent experiential factors via the Q-BEx questionnaire (De Cat, Kašćelan, Prévost, Serratrice, Tuller, Unsworth, & The Q.-Be Consortium, 2022), which were then used to predict knowledge and use of these grammatical structures. The findings reveal that: (i) experiential factors such as heritage language (HL) engagement at home and within the community modulate grammatical performance differentially from childhood through adolescence, and (ii) HL proficiency, immersion experiences, and literacy systematically predict HL grammatical outcomes. These results indicate that particular language background factors hold differential significance at distinct developmental stages and that higher proficiency, richer immersion experiences, and literacy engagement in the HL are crucial for the development of core grammatical structures.
Automatic license plate recognition (ALPR) systems are increasingly used to solve issues related to surveillance and security. However, these systems assume constrained recognition scenarios, thereby restricting their practical use. Therefore, we address in this article the challenge of recognizing vehicle license plates (LPs) from the video feeds of a mobile security robot by proposing an efficient two-stage ALPR system. Our ALPR system combines the on-the-shelf YOLOv7x model with a novel LP recognition model, called vision transformer-based LP recognizer (ViTLPR). ViTLPR is based on the self-attention mechanism to read character sequences on LPs. To ease the deployment of our ALPR system on mobile security robots and improve its inference speed, we also propose an optimization strategy. As an additional contribution, we provide an ALPR dataset, named PGTLP-v2, collected from surveillance robots patrolling several plants. The PGTLP-v2 dataset has multiple features to cover chiefly the in-the-wild scenario. To evaluate the effectiveness of our ALPR system, experiments are carried out on the PGTLP-v2 dataset and five benchmark ALPR datasets collected from different countries. Extensive experiments demonstrate that our proposed ALPR system outperforms state-of-the-art baselines.
Conventional survey tools such as weighting do not address non-ignorable nonresponse that occurs when nonresponse depends on the variable being measured. This paper describes non-ignorable nonresponse weighting and imputation models using randomized response instruments, which are variables that affect response but not the outcome of interest. This paper uses a doubly robust estimator that is valid if one, but not necessarily both, of the weighting and imputation models is correct. When applied to a national 2019 survey, these tools produce estimates that suggest there was nontrivial non-ignorable nonresponse related to turnout, and, for subgroups, Trump approval and policy questions. For example, the conventional MAR-based weighted estimates of Trump support in the Midwest were 10 percentage points lower than the MNAR-based estimates.
Augustinian accounts of ‘primal sin’ face a dilemma: either ‘Lucifer’s’ fall is arbitrary, or it results from God creating a flawed creature. Augustine and others hold that an omnipotent God faces unavoidable limits in creating creatures. In particular, creatures cannot enjoy God’s own first-person awareness of God’s goods, but must experience them second-personally. The resulting qualitative phenomenological difference between (1) the first-person awareness Lucifer had of the goods of his own being, and (2) his second-person awareness of the goods of God means that self-regarding goods would ‘light up’ for Lucifer very differently than other-regarding goods. This opens a psychologically resonant and metaphysically potent account of how the pre-Fall Lucifer could have faced a genuine value conflict – a conflict for which God is not culpable – in which Lucifer might come to love the goods presented first-personally (his own) over the goods presented second-personally (God’s).
Suicide is one of the leading causes of death among individuals aged 10–24. Research using intensive longitudinal methods to identify near-term predictors of suicidal thoughts and behaviors (STBs) has grown dramatically. Interpersonal factors may be particularly critical for suicide risk among young people, given the heightened salience of interpersonal experiences during adolescence and young adulthood. We conducted a narrative review on intensive longitudinal studies investigating how interpersonal factors contribute to STBs among adolescents and young adults. Thirty-two studies met the inclusion criteria and focused on theoretical and cross-theoretical interpersonal risk factors. Negative interpersonal states (e.g., perceived burdensomeness), hopelessness, and social support were consistently associated with proximal within-person changes in concurrent, but not prospective, suicidal thoughts. Further, work examining how these processes extend to suicidal behavior and among diverse samples remains scarce. Implications for contemporary interpersonal theories and intensive longitudinal studies of STBs among young people are discussed.
This study aimed to understand the current landscape of USA-based disaster medicine (DM) programs through the lens of alumni and program directors (PDs). The data obtained from this study will provide valuable information to future learners as they ponder careers in disaster medicine and allow PDs to refine curricular offerings.
Methods
Two separate surveys were sent to USA-based DM program directors and alumni. The surveys gathered information regarding current training characteristics, career trajectories, and the outlook of DM training.
Results
The study had a 57% response rate among PDs, and 42% response rate from alumni. Most programs are 1-year and accept 1-2 fellows per class. More than 60% of the programs offer additional advanced degrees. Half of the respondents accept international medical graduates (IMGs). Only 25% accept non-MD/DO/MBBs trained applicants. Most of the alumni hold academic and governmental positions post-training. Furthermore, many alumni report that fellowship training offered an advantage in the job market and allowed them to expand their clinical practice.
Conclusions
The field of disaster medicine is continuously evolving owing to the increased recognition of the important roles DM specialists play in healthcare. The fellowship training programs are experiencing a similar evolution with an increasing trend toward standardization. Furthermore, graduates from these programs see their training as a worthwhile investment in career opportunities.
This article presents the first complete biography in English of the early hadith critic al-Jūzjānī (d. 259/873?), in addition to a thorough analysis of his work Aḥwāl al-rijāl, the earliest Syngramma dedicated to the genre of al-jarḥ wa-l-taʿdīl. Through a detailed examination of al-Jūzjānī's engagement with the opinions of earlier hadith critics, his use of the terms of hadith criticism and his own remarks, this article delineates his conception of the function of hadith, methodological framework and approach to the appraisal of hadith transmitters, arguing that al-Jūzjānī may have been the first and only hadith scholar to methodically incorporate the consideration of transmitters’ conformity to the “correct” doctrines in hadith criticism. His methodological innovation, however, departs from existing convention among ahl al-ḥadīth. As a result, although al-Jūzjānī's authority as a hadith critic was well recognized, his approach failed to appeal to succeeding contributors to hadith criticism.
Indigenous peoples are often not routinely included in iodine programmes because of language barriers and remote access and may thus be at higher risk of iodine deficiency disorders, which could adversely impact their quality of life. We conducted this cross-sectional study in the remote Pwo Karen community of Thailand to determine the urinary iodine concentration of school-aged children and women of reproductive age and investigate the iodine content in household salt. We measured urinary iodine concentration in spot urine samples from healthy school-aged children and women of reproductive age, administered a questionnaire, estimated daily iodine intake and collected household salt samples to determine salt iodine concentration. The median urinary iodine concentration (range) of school-aged children (n 170) was 192 (136–263) µg/l, which was significantly higher than women of reproductive age (n 306) (147 (89–233) µg/l) (P < 0·001). The estimated daily iodine intake in school-aged children and women of reproductive age were 135 and 195 μg/d, respectively. The median (range) iodine concentration in rock and granulated salts consumed in the households were 2·32 (0·52–3·19) and 26·64 (20·86–31·01) ppm, respectively. Surprisingly, the use of iodised salt and the frequency of seafood consumption were NS predictors of urinary iodine concentration in these two groups. Our data suggest that school children and women of the Pwo Karen community have sufficient iodine intake, indicating the Thai salt iodisation programme is effectively reaching even this isolated Indigenous community. Sentinel surveys of remote vulnerable populations can be a useful tool in national iodine programmes to ensure that programme coverage is truly universal.
We study how Spanish equity investors assessed firms’ exposure to political risk during the regime change of the 1930s. We show that shifts in political uncertainty regularly predicted a general deterioration of future investment opportunities in the stock market. However, we also find that firms differed in their sensitivity to uncertainty, reflecting important differences in their perceived exposures to political risk. The negative impact of uncertainty was significantly milder for firms with political connections to republican parties. The price of some stocks increased in periods of heightened uncertainty, thus allowing investors to hedge against reinvestment risk. In the case of firms that became targets of hostile political actions, we observe that investors frequently adjusted their assessment of individual stocks to changes in firm-specific political circumstances. Over the whole period of the Second Republic, investors’ systematic preference for safer equity hedges led to a continuous decline in the price of stocks perceived as more exposed to political risk.
Low iron (Fe) stores at birth may adversely influence child cognitive and motor development. The aims of this study were to assess cord blood Fe levels and explore maternal and neonatal factors associated with Fe status. Cord blood specimens (n 46) were obtained from the BC Children’s Hospital BioBank in Vancouver, Canada. The primary outcome was cord plasma ferritin, measured using sandwich-ELISA. Predictors of interest included maternal age, gestational age, gravidity, infant sex, birth weight and delivery method. Median (interquartile range (IQR)) maternal age and gestational age at delivery was 33·5 (29·3–35·8) years and 36·5 (30·0–39·0) weeks, respectively, and 44 % of infants were female. Median (IQR) cord ferritin was 100·4 (75·7–128·9) µg/l, and 26 % had low Fe status (ferritin <76 µg/l). Among preterm deliveries, a 1-week increase in gestational age was associated with a 6·22 (95 % CI (1·10, 9·52)) µg/l increase in median cord ferritin. However, among term deliveries, a negative trend was observed (–2·38 µg/l per week of gestation (95 % CI (–34·8, 0·78))), indicating a potential non-linear relationship between gestational age and cord ferritin. Female term infants had higher cord ferritin compared with males (β (95 % CI): 30·3 (18·4, 57·9) µg/l), suggesting sex-specific differences in Fe transfer, acquisition and utilisation. Cord ferritin was higher with vaginal deliveries compared with caesarean sections (β (95 % CI): 39·1 (29·0, 51·5) µg/l). Low Fe status may be a concern among infants in Canada; however, further research is needed to inform appropriate thresholds to define optimal Fe status in cord blood.
A cylindrical cascade on $\mathbb {T}^d\times \mathbb {R}^r$ can be seen as a deterministic random walk on $\mathbb {R}^r$ driven by an observable over the irrational toral translation on the base torus. We prove that, when the observable is the indicator function of a generic (straight) rectangle in $\mathbb {T}^2$, the cascade on $\mathbb {T}^2\times \mathbb {R}$ is ergodic for a $G_{\delta }$-dense set of translation vectors. We also provide examples of ergodic cylindrical cascades in higher dimensions with more restrictive conditions on the side lengths of the rectangles.
In order to take on arbitrary geometries, shape-changing arrays must introduce gaps between their elements. To enhance performance, this unused area can be filled with meta-material inspired switched passive networks on flexible sheets in order to compensate for the effects of increased spacing. These flexible meta-gaps can easily fold and deploy when the array changes shape. This work investigates the promise of meta-gaps through the measurement of a 5-by-5 λ-spaced array with 40 meta-gap sheets and 960 switches. The optimization and measurement problems associated with such a high-dimensional phased array are discussed. Simulated and in-situ optimization experiments are conducted to examine the differential performance of metaheuristic algorithms and characterize the underlying optimization problem. Measurement results demonstrate that in our implementation meta-gaps increase the average main beam power within the field of view (FoV) by 0.46 dB, suppress the average side lobe level within the FoV by 2 dB, and enhance the field-of-view by 23.5∘ compared to a ground-plane backed array.
Earthquakes cause great destruction due to their suddenness and intensity. Although all people are affected by earthquakes, children are among those most affected. Every year, millions of children and young people are exposed to many natural disasters and are affected differently. Earthquakes can cause physical, mental, and sleep disorders in children. The aim of this study is to investigate the post-traumatic response and its effects on sleep on child and adolescent earthquake survivors living in the earthquake zone in Turkey.
Methods
This research was carried out between June and August 2023 as a descriptive and cross-sectional study. A total of 230 earthquake survivor children from Adıyaman were included in the study. Personal information forms, the Child Posttraumatic Stress Reaction Index (CPTS-RI), and the Sleep Disturbance Scale for Children (SDSC) were used to collect data.
Results
It was determined that the scale scores of the children who were financially affected by the earthquake, who were injured, and who were under the rubble were higher (P < 0.05).
Conclusions
It was observed that more than half of the children had severe trauma and had sleep disorders. Children who experience trauma from an earthquake have more sleep disorders. For this reason, in addition to emergency aid and interventions in earthquakes, arrangements should be made for the mental health of children and social and psychological support should be provided.
The new mineral manganonewberyite (IMA2024–004), Mn(PO3OH)(H2O)3, was found underground at the Cassagna mine, Liguria, Italy, where it is a secondary phase formed by the interaction of bat guano with Mn-rich rock. Manganonewberyite occurs with niahite, kutnohorite, sampleite and serrabrancaite on a tinzenite–quartz–braunite matrix. Crystals are prisms and blades, up to ∼0.15 mm long, elongated parallel to [001], flattened on {100} and exhibiting the forms {100}, {010} and {111}. Crystals are colourless and transparent, with vitreous lustre and white streak. The mineral is brittle with curved fracture. The Mohs hardness is ∼3. Cleavage is perfect on {010}. The density is 2.34(2) g·cm–3. Optically, manganonewberyite is biaxial (+) with α = 1.541(2), β = 1.547(2) and γ = 1.559(2) (white light). The 2V is 71.6(3)°. The optical orientation is X = a, Y = b and Z = c. The empirical formula is (Mn0.960Mg0.016Ca0.015)Σ0.991(H1.02P1.00O4)(H2O)3. Manganonewberyite is orthorhombic, space group Pbca, with cell parameters: a = 10.4273(6), b = 10.8755(8), c = 10.2126(4) Å, V = 1158.13(11) Å3 and Z = 8. The crystal structure (R1 = 2.79% for 892 I > 2σI reflections) is the same as that of newberyite with Mn in place of Mg.
The COVID-19 pandemic is highly contagious, with symptoms such as myalgia, cough, fever, and weakness, posing a greater risk to older adults and individuals with chronic conditions. Effective management requires meaningful community involvement to reduce health inequalities and ensure people-centered health care. Engaging local voices, including leaders, health care professionals, and vulnerable populations, enhances decision-making, transparent communication, and resource mobilization. A whole-community approach, involving collaboration across various sectors, strengthens prevention, testing, and recovery efforts. By prioritizing vulnerable groups and adapting interventions to local contexts, community engagement plays a vital role in addressing the pandemic’s challenges and building a resilient health care system. This strategy not only aids in managing the current crisis but also prepares public health systems for future emergencies, emphasizing equity and comprehensive public health responses.