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Although bilinguals use both auditory and visual cues, the cognitive cost of language switching in audiovisual contexts is unclear. We investigated the cost in Tibetan–Chinese bilinguals using a task with audiovisual, visual and auditory modalities. In Study 1, the audiovisual modality yielded the fastest reaction times, reflecting improved processing efficiency. ERP data revealed smaller positive amplitudes in the early window (200–350 ms) for audiovisual modality, indicating reduced neural demand, while only auditory modality showed significant divergence in the later window (350–700 ms). Moreover, audiovisual context, L2-to-L1 switching and early neural responses predicted switching behavior. Study 2 replicated the behavioral and ERP findings of Study 1 and demonstrated that auditory input and second-language processing exacerbated switch costs. These findings shed light on multisensory integration in language switching by demonstrating that audiovisual cues reduce switch costs, whereas auditory input and second-language processing exacerbate them, with implications for language education and cognitive interventions.
Urolithiasis (UL) is a multifactorial condition whose global prevalence has been increasing in recent years, and it is closely associated with dietary factors. Diet is one of the key elements linked to the development of UL due to the intake of many nutrients that cause metabolic alterations associated with the crystallisation process and the risk of developing urinary stones. Despite the crucial role of diet, few studies have implemented dietary interventions. In this sense, dietary modifications play a fundamental role in the prevention, control and management of UL. Thus, the aim of this systematic review is to summarise the main beneficial effects of dietary interventions in populations with UL. A comprehensive search was conducted in MEDLINE/PubMed, SpringerLink, Google Scholar, Scielo and Redalyc databases for intervention studies published up to July 2025 that reported dietary interventions aimed at preventing and controlling UL. The risk of bias and quality of studies were assessed. A total of twenty-six articles were included, focusing on dietary interventions such as controlling sodium, oxalate, calcium, citrate and protein intake, as well as low-calorie diets. In addition, foods such as lemon, orange, melon, lime, cranberry, apple juices, milk, vinegar, black seed, green bean extract, probiotics and synbiotic were also explored, which promoted significant changes in serum and urinary parameters related to UL. This review compiles evidence on dietary intervention strategies that lead to significant improvements in biochemical parameters in populations with UL (PROSPERO CRD42022361702).
Attention to human rights as a central pillar of global mental health work has shifted from a focus on the right to healthcare to a deeper examination of the quality of care received, and to the way in which people with mental health conditions are treated in all aspects of life. The QualityRights programme is the World Health Organization’s flagship guidance for promotion of rights-based approaches to mental healthcare, and a means of holding service providers to account for quality of care provided. A recent evaluation of the QualityRights e-training package demonstrates promising impact on attitude change of participants, raising the prospect of an efficient scale-up of efforts to improve dignity in services and reduce stigma and discrimination.
Cet article tente de mesurer les changements possibles survenus dans la structure de l’opinion publique sur la question de l’indépendance du Québec. Plus particulièrement, nous comparons deux modèles théoriques qui ont été au coeur de notre compréhension des appuis à l’indépendance, soit le modèle du choix rationnel associé aux coûts-bénéfices prospectifs de l’indépendance et le modèle socio-psychologique qui met de l’avant les griefs et revendications que le Québec ressent face au régime canadien. Notre étude permet aussi d’évaluer la pertinence de ces modèles à travers les générations entre 2014 et 2024; et de considérer de nouveaux facteurs explicatifs contemporains. Dans l’ensemble, nos résultats suggèrent une surprenante stabilité quant à l’importance des différents facteurs considérés pour comprendre les mécaniques expliquant l’appui ou non à l’indépendance du Québec. Les attitudes populistes, nativistes et autoritaristes apportent aussi un pouvoir explicatif additionnel, quoique limité.
In the second half of the 19th century, Darboux obtained determinant formulae that provide the general solution for a linear hyperbolic second-order PDE with the finite Laplace series. These formulae played an important role in his study of the theory of surfaces and, in particular, in the theory of conjugate nets. During the last three decades, discrete analogues of conjugate nets (Q-nets) were actively studied. Laplace series can be defined also for hyperbolic difference operators. We prove discrete analogues of Darboux formulae for discrete and semi-discrete hyperbolic operators with finite Laplace series.
This study revisits the relationship between second-language (L2) learners’ ability to distinguish sounds in non-native phonological contrasts and to recognize spoken words when recognition depends on these sounds, while addressing the role of methodological similarity. Bilingual Catalan/Spanish learners of English were tested on the identification of two vowel contrasts (VI) of diverging difficulty, /i/-/ɪ/ (difficult) and /ɛ/-/æ/ (easy), in monosyllabic minimal pairs, and on their recognition of the same pairs in a word-picture matching task (WPM). Learners performed substantially better with /i/-/ɪ/ in VI than in WPM, and individual scores were only weakly correlated. By replicating previous findings through a more symmetrical design, we show that an account of prior work rooted in methodological dissimilarity is improbable and provide additional support for the claim that accuracy in sound identification does not guarantee improvements in word recognition. This has implications for our understanding of L2-speech acquisition and L2 pronunciation training.
Jespers and Sun conjectured in [27] that if a finite group G has the property ND, i.e. for every nilpotent element n in the integral group ring $\mathbb{Z}G$ and every primitive central idempotent $e \in \mathbb{Q}G$ one still has $ne \in \mathbb{Z}G$, then at most one of the simple components of the group algebra $\mathbb{Q} G$ has reduced degree bigger than 1. With the exception of one very special series of groups we are able to answer their conjecture, showing that it is true—up to exactly one exception. To do so, we first classify groups with the so-called SN property which was introduced by Liu and Passman in their investigation of the Multiplicative Jordan Decomposition for integral group rings.
The conjecture of Jespers and Sun can also be formulated in terms of a group q(G) made from the group generated by the unipotent units, which is trivial if and only if the ND property holds for the group ring. We answer two more open questions about q(G) and notice that this notion allows to interpret the studied properties in the general context of linear semisimple algebraic groups. Here we show that q(G) is finite for lattices of big rank but can contain elements of infinite order in small rank cases.
We then study further two properties which appeared naturally in these investigations. A first which shows that property ND has a representation theoretical interpretation, while the other can be regarded as indicating that it might be hard to decide ND. Among others we show these two notions are equivalent for groups with SN.
More people than ever are receiving support for mental health issues, and instances of suicide continue to grow. Although mental health funding has increased, UK government figures evidence that the National Health Service (NHS) does not have the resources required to respond to such growth in demand. The experiences of staff working in mental health services can offer insight into the efficacy of current provision and assist in service evaluation; however, research examining this issue outside of the COVID-19 pandemic, and in the context of community mental health, is lacking.
Aims
We aimed to explore the perspectives of staff working in a variety of mental health services in North-West England, to elucidate the current standard of care provided and highlight areas for improvement.
Method
One-to-one interviews were conducted with 26 staff members as part of a qualitative grounded theory analysis.
Results
Findings portrayed a community in crisis, consisting of the following themes: stabilisation not recovery, inefficient pathways and barriers to collaboration.
Conclusions
NHS services are struggling to meet the mental health needs of the population, resulting in lengthy waiting times for therapy, a lack of intervention-focused care and an over-reliance on the third sector. While crisis cafés are provided at low cost and result in satisfaction, policy-makers must ensure that these receive adequate funding and do not become overburdened. Staff reported that collaboration between clinical and non-clinical services would improve care pathways and reduce strain on the NHS, but judgemental attitudes and inflexible service development must be challenged to achieve this.
The relationship between parliaments and governments during the Covid-19 pandemic has been closely examined by various disciplines, which have typically analysed data on the laws and procedures enforced to manage the emergency. This literature generally agrees that the government dominated the management of the pandemic, often at the expense of parliamentary prerogatives. However, such data may not be sufficiently detailed to fully grasp some nuances. Above all, they may provide limited information on the factors that influenced the balance of powers between the two institutions. This article focuses on the Italian case. It complements data on legislation with the findings of semi-structured interviews conducted with members of parliament and government, as well as high-ranking bureaucrats, to gain a more in-depth understanding of these processes. The data on legislation suggest that governmental dominance was strong at every stage of the emergency, although parliament slightly regained some prerogatives over time. This recovery began under Prime Minister Giuseppe Conte, but it became more pronounced under Mario Draghi. The acquisition of knowledge about the pandemic was perceived by several interviewees as a factor that helped parliament regain some control, making it a possible outcome of a policy learning process. However, other factors also emerged as significant, such as the direct role of the prime ministers in strengthening the role of the executive and the difficulties of the technocratic members of the government in navigating parliamentary dynamics during Draghi’s tenure.
Female genital schistosomiasis (FGS) is a chronically disabling gynaecological condition, impacting up to 56 million women and girls, mostly in sub-Saharan Africa. In lieu of a gold standard laboratory test, it is possible to diagnose FGS visually. Visual diagnosis is performed through inspection of the cervix and surrounding tissue to identify signs of Schistosoma egg deposition, associated inflammation and granuloma formation. The change related to egg deposition can be very subtle and heterogeneous and is often seen in the context of other altered cervical morphology. Visual diagnostics for FGS are therefore currently highly subjective and lack specificity, with low consistency of grading between trained expert reviewers. Computer vision, driven by artificial intelligence, is an enticing prospect to overcome these issues due to the potential to accurately detect and classify the subtle changes and patterns that are indiscernible to human graders. Computer vision also offers the opportunity to support resource-constrained regions with few staff trained on visual diagnostics. However, several challenges stand in the way of progressing and successfully implementing computer vision tools for FGS. These challenges are particularly related to the variation in the appearance of the cervix (with or without disease) and FGS lesions, as well as the difficulty with accurately labelling cervical images. Exploring alternative annotation methods and model architectures is likely to improve the performance of FGS computer vision tools. This paper will explore the challenges of FGS computer vision and provide suggestions on how to overcome these barriers to enhance visual diagnostics for FGS.
Safety planning is a commonly used, evidence-based intervention for suicide prevention. There is a need for continuous engagement with safety plans post-discharge, and the improvement of safety plan portability has been discussed within our mental health organisation. This has led to the development of an app, called the Hope App. This study aims to implement this app into routine practice in a Canadian psychiatric emergency department.
Aims
We aimed to describe a collaborative, theoretically driven approach to co-design implementation strategies to elicit behaviour change among emergency department clinicians; co-develop a set of tailored, theory-informed, multifaceted implementation strategies for embedding an app into a psychiatric emergency department; and describe engagement evaluation received by the co-design team.
Method
Co-design approaches and the Behaviour Change Wheel were used to develop implementation strategies with clinicians, patients and care partners. The co-design team consisted of 12 members, and we held four design sessions. Design sessions were iterative in nature and organised such that the findings of each session fed into the next session.
Results
We identified 11 implementation strategies encompassing different combinations of intervention functions and behaviour change techniques, targeting barriers and leveraging facilitators identified in our previous work.
Conclusions
The tailored implementation strategies developed in this study have the potential to fill existing gaps in integrating digital technology. A key strength of this study is its use of behaviour change theories and a collaborative approach. The strategies are designed to align with the needs and preferences of clinicians, patients and care partners.
Nitrous oxide may possess antidepressant effects; however, limited data exist on repeated administrations and active placebo-controlled studies in treatment-resistant depression (TRD).
Aims
We aimed to test the feasibility of a randomised controlled trial examining a 4-week course of nitrous oxide or midazolam, an active placebo.
Method
In this randomised, active, placebo-controlled pilot trial, 40 participants with TRD were assigned either a 1-h inhalation of 50% nitrous oxide plus intravenous saline (n = 20) or a 1-h inhalation of 50% oxygen plus intravenous midazolam (0.02 mg/kg, up to 2 mg; n = 20) once weekly, for 4 weeks. Feasibility was assessed by examining rates of recruitment, withdrawal, adherence, missing data and adverse events. The main measure of clinical efficacy was the change in depression severity (Montgomery–Åsberg Depression Rating Scale (MADRS)) score from baseline to day 42.
Results
The recruitment rate was 22.3% (95% CI 16.9–29.0). Withdrawal rates were 10% (95% CI 2.8–30.1) in both groups and adherence rates were 100.0% (95% CI 82.4–100) in the nitrous oxide group and 94.4% (95% CI 74.2–99.0) in the placebo group. There were no missing primary clinical outcome data in either group (0.0%, 95% CI 0.0–17.6). MADRS score changed by −20.5% (95% CI −39.6 to −1.3) in the nitrous oxide group and −9.0% (95% CI −22.6 to 4.6) in the placebo group. Nearly all adverse events were mild to moderate and transient.
Conclusions
The findings support the feasibility and necessity of conducting a full-scale trial comparing nitrous oxide and midazolam in patients with TRD.
Return of fear after successful exposure therapy for a phobia is a common clinical challenge. A previous study on mice demonstrated that the persistent attenuation of remote fear memories can be achieved by combining histone deacetylase inhibitors (HDACis) with fear-memory retrieval prior to extinction training.
Methods
To evaluate the translational potential of this approach, we conducted a randomized, double-blind, placebo-controlled trial. Forty-eight individuals with DSM-IV spider phobia received either HDACi valproic acid (VPA, 500 mg) or a placebo prior to the retrieval of fear memory, followed by exposure therapy in virtual reality.
Results
No significant group difference was found in terms of behavioral change on the behavioral approach test at 3 months follow-up and baseline (primary outcome). However, the VPA group displayed significantly reduced fear in two self-report questionnaires related to spider phobia (Fear of Spiders Questionnaire; Spider Phobia Beliefs Questionnaire) as compared to the placebo group. No group differences were observed for psychophysiological indicators of fear.
Conclusions
The favorable impact of a single administration of VPA in combination with fear-memory retrieval prior to exposure therapy suggests that it might be an effective way to enhance symptom improvement at the subjective level in the treatment of phobias. Further studies need to investigate the conditions under which an improvement on the psychophysiological and behavioral levels can be achieved as well.
Cyber breaches pose a significant threat to both enterprises and society. Analyzing cyber breach data is essential for improving cyber risk management and developing effective cyber insurance policies. However, modeling cyber risk is challenging due to its inherent characteristics, including sparsity, heterogeneity, heavy tails, and dependence. This work introduces a cluster-based dependence model that captures both temporal and cross-group dependencies, providing a more accurate representation of multivariate cyber breach risks. The proposed framework employs a cluster-based kernel approach to model breach severity, effectively handling heterogeneity and extreme values, while a copula-based method is used to capture multivariate dependence. Our findings, validated through both empirical and synthetic studies, demonstrate that the proposed model effectively captures the statistical characteristics of multivariate cyber breach risks and outperforms commonly used models in predictive accuracy. Furthermore, we show that our approach can enhance cyber insurance pricing by generating more profitable insurance contracts.
This paper examines the likely economic consequences of a unilateral US trade policy, particularly those involving across-the-board tariffs and retreat from multilateral commitments. Drawing on computable general equilibrium (CGE) models, dynamic macroeconomic frameworks, and a rich body of empirical literature, the paper demonstrates that the static efficiency losses, estimated by standard trade models, understate the true costs of protectionism. It identifies five key amplification channels – loss of economies of scale, supply chain fragility, diminished technological spillovers, investment hold-up under policy uncertainty, and financial market reactions – that interact to depress both short-run output and long-run growth potential. The analysis estimates that comprehensive unilateral trade measures could reduce US GDP by 2–3% in the short term and lower the long-term growth trajectory by 0.4–0.7 percentage points annually. While some strategic interventions may yield resilience or national security benefits, the paper concludes that unilateralism generates systemic economic risks and should be approached with caution. The findings underscore the need for integrated policy frameworks that combine targeted trade tools with domestic support and international cooperation.
We conduct an ensemble of simulations of the englacial temperature field of the Antarctic ice sheet to gauge the sensitivity to uncertainties in geothermal heat flow, surface climatic conditions, ice thermodynamics and dynamics. We compare the modeled temperature fields with observational constraints, including deep-borehole temperature measurements, englacial temperatures retrieved from the Soil Moisture and Ocean Salinity satellite observations, and the distribution of subglacial lakes to determine the most likely boundary conditions. Results show that temperate basal conditions prevail over 60% of the Antarctic ice sheet, with a mean basal melt rate of 6.9 mm a−1. The ensemble mean subglacial meltwater production over the grounded ice sheet is 69 Gt a−1, with a contribution of 51% from geothermal heat and 49% from frictional heat. While geothermal heat flow remains the largest source of uncertainty, heat flow datasets leading to colder conditions tend to fit englacial temperature measurements better. However, ice thermomechanical approximations influence the shape of temperature profiles and may, in some cases, be more important than the geothermal heat flow. Furthermore, since frictional heat contributes significantly to basal melt in regions hosting fast-flowing glaciers, uncertainties in basal slipperiness affect the basal melt estimates as much as the geothermal heat flow.
Numerous efforts are focused on building the clinical and translational research (CTR) workforce. Approaches to evaluate CTR initiatives are varied, and efforts often rely on research project-level outcomes. This article applies an evaluation tool to capture individual-level data.
Objective:
The study used a novel Researcher Investment Tool (RIT) to measure researchers’ experience as well as perceptions of institutional support, including an analysis based on researcher characteristics. The study also evaluated the RIT based on common measures, including a bibliometric indicator, investigator status, and percent time dedicated to research.
Methods:
The RIT was administered to researchers who received funding or targeted research support from a CTR initiative. Mean scores were assessed by RIT section, domains/sub-domains, and for each item. Mean scores per section were compared across researcher characteristics using t-tests, and associations between common measures and average domain scores were tested using linear regression.
Results:
Thirty researchers completed all RIT items. RIT domain scores ranged from a high mean of 4.0 for the research skills domain to a low mean of 2.6 for researcher productivity and community engagement domains. Analysis of indicators of commonly used measures across domains suggest that researchers with a higher bibliometric score had more advanced research skills, service to profession, research productivity, and research collaboration (p < .05). New investigators had lower perceptions of institutional support (p < .05).
Conclusions:
As an evaluation tool, the RIT captures individual-level data that may help to determine key areas of strength and opportunities for growth of a CTR program.
Temporal arteritis (TA) is the most common vasculitis over age 50. Untreated, many patients will suffer blindness or stroke. Gold standard diagnosis is achieved by temporal artery biopsy. The aim of this study was to investigate the relevance of small vessel inflammation.
Methods:
Our dataset was comprised of 72 temporal artery biopsies subjected to a blinded uniform re-examination paired with clinical data including demographics, history, physical examination and laboratory findings. Documented pathology variables included the presence or absence of TA, angiitis of vasa vasorum (AVV) and inflammation of small peri-adventitial vessels (small vessel vasculitis, SVV).
Results:
Clinical and pathological variables were subjected to multivariate analysis. In brief, 25% of cases were identified as TA, 20% as isolated AVV, 7% as isolated SVV and 5% as mixed isolated AVV/SVV, while 43% had no inflammation (NI). All cases of TA were accompanied by small vessel inflammation: 95% exhibited AVV with or without SVV, and 5% exhibited SVV alone, demonstrating a strong association between TA and small vessel inflammation. Of the 24 cases with isolated AVV/SVV, 26% received a clinical diagnosis of TA within one year in comparison to 13% of cases that had NI. Furthermore, isolated AVV/SVV was identified in 25% of patients with a high clinical probability for TA, 60% of whom acquired a diagnosis of TA on clinical grounds within one year of follow-up.
Conclusions:
Our findings suggest that isolated AVV/SVV identifies a subgroup of patients with a higher risk of harboring or developing TA.