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The focus of suicide research changes from traditional risk factors to acute warning signs. Patient self-reported suicidal ideation (SI) is not a reliable measure of acute suicide risk. Presuicidal syndromes such as suicide crisis syndrome (SCS) attempt to describe measurable syndromes based on warning signs other than SI.
Methods
Seven hundred and ten acutely admitted patients were included in the study. Identification of symptoms describing the five components of SCS was done by performing a retrospective text analysis of the patient records (electronic medical records). Patients were grouped according to high or low level of SCS symptoms. We performed statistical tests for group differences in demographics, traditional risk factors, and clinical variables, including agitation assessed by the Positive and Negative Symptom Scale-Excited Component (PANSS-EC).
Results
Seventy-two patients had high levels of SCS symptoms. They reported less SI the last month before admission; suicidality was less relevant for referral, the intake suicide assessment more often concluded with high suicide risk, they were more often referred and admitted involuntarily, and they had higher total scores on PANSS-EC.
Conclusion
The individual SCS symptoms may provide useful information in the evaluation of acute suicide risk at intake. A high level of SCS symptoms suggests more severe conditions. The lower reports among high-level than low-level SCS patients of self-reported SI last month before admission, shows the limitation of using SI as a warning sign. The association between the level of SCS symptoms and PANSS-EC total score suggests that agitation could give valuable additional information for suicide risk assessments.
Since the 1979 Islamic Revolution, the Shiʿi theocratic state in Iran has occasionally prioritized state interests over traditional shariʿa rulings. This dynamic is best understood through the lens of the principle of maslahat (variously translated as “public good” or “the interests of the state), which has played a central role in guiding strategic state decisions. By invoking maslahat, the state has justified the modification or suspension of certain shariʿa prescriptions in pursuit of broader political and social objectives. These objectives, primarily safeguarding the Shiʿi theocratic order (hefz-e nezām) and protecting the religion from defamation (vahn-e din), were key tenets articulated by Ayatollah Khomeini and remain foundational to the state's governance. This pragmatic utilization of maslahat has enabled the Shiʿi theocratic state to adapt its legal framework to meet contemporary challenges while ostensibly adhering to shariʿa principles. Notable examples of this adaptability include reforms such as the equalization of blood money for religious minorities and the imposition of moratoriums on stoning executions. However, the inherently subjective nature of maslahat raises concerns about potential arbitrariness and misuse, prompting debates among Shiʿi jurists regarding its legitimacy and scope. This study offers a comprehensive analysis of maslahat within Iran's legal system, exploring its mechanisms, applications, and implications, and highlighting its complex role in both advancing and potentially challenging the principles of Islamic law.
Capsules are widely used in bioengineering, chemical engineering and industry. The development of drug delivery systems using deformable capsules is progressing, yet the regulation of drug release within a capsule remains a challenge. Meanwhile, a microswimmer enclosed in a capsule can generate a large lubrication force on the capsule membrane, which could result in deformation and mechanical damage to the membrane. In this study, we numerically investigate how a capsule can be damaged by an enclosed microswimmer. The capsule membrane is modelled as a two-dimensional neo-Hookean material, with its deformability parametrised by capillary number. An isotropic brittle damage model is applied to express membrane rupture, with the Lighthill–Blake squirmer serving as the microswimmer model. In a sufficiently small capillary number regime, pusher-type squirmers exhibit stable swimming along the capsule membrane, while neutral-type and puller-type squirmers exhibit swimming towards the membrane and remain stationary. As capillary number increases, the damage to the membrane increases and rupture occurs in all swimming modes. For pusher-type squirmers, the critical capillary number leading to rupture is dependent on the initial incidence angle, whereas neutral-type and puller-type squirmers are independent of the initial value. Furthermore, we present methods for controlling membrane damage by magnetically orienting the microswimmer. The findings reveal that a static magnetic field can orient the microswimmer, leading to membrane damage and rupture even for a capsule that cannot be damaged by free swimming, while controlling the swimming path with a rotating magnetic field enables soft membranes to maintain deformation without rupture.
Opioid use disorder (OUD) is a medical condition associated with problematic opioid use, leading to addiction and severe life impairments. This research delivers an in-depth evaluation of OUD burden and trends at global, regional and national levels.
Methods
This study analysed the global burden of OUD from 1990 to 2021 using data from the 2021 Global Burden of Diseases, Injuries, and Risk Factors Study. Key metrics included age-standardized prevalence, incidence, mortality and disability-adjusted life years (DALYs), disaggregated by gender, age, region, country and socio-demographic index (SDI) quintiles. The average annual percentage change described trends, while the age-period-cohort model evaluated age, period and cohort effects. A Bayesian Age-period-cohort model predicted future OUD trends from 2022 to 2040.
Results
In 2021, the global burden of OUD remained substantial, with a total of 16,164,876 cases and a prevalence of 154.59 cases per 100,000 population (95% uncertainty interval [UI]: 131.06–181.26). In 2021, the global incidence of OUD reached 1,942,525 cases (95% UI: 1,643,342–2,328,363), and its global mortality reached 99,555 deaths (95% UI: 92,948–108,050), with DALYs amounting to 11,218,519 (95% UI: 9,188,658–13,159,551). Regionally, high SDI regions, particularly in the High-income North America, exhibited the greatest burden. Among countries, the United States faced the most severe burden and increase, with the highest prevalence (2014.62 per 100,000), incidence (151.84 per 100,000), mortality (15.37 per 100,000) and DALYs (1594.63 per 100,000), and all APPC values exceeding 5%. Males aged 20–39 years were the most affected demographic. However, forecasts indicate that the OUD burden among females will significantly increase over the next 20 years, with the prevalence and incidence expected to rise by 39% and 49%, respectively.
Conclusions
The global burden of OUD has statistically significantly increased from 1990 to 2021. There are marked disparities across regions, countries and SDI levels. High-SDI regions, particularly High-income North America, bear the heaviest burden, with young males (aged 20–39 years) being the most affected groups. However, caution should be exercised regarding the female population, as the number of affected individuals is rapidly increasing.
Large-scale glacier mass-balance models often rely on positive degree-day (PDD) melt models, which have known limitations. This study evaluates a relatively simple, elevation-dependent surface energy balance (SEB) model that requires minimal downscaling of climate input data to simulate glacier melt. Using ECMWF Reanalysis v5 (ERA5) reanalysis data and multi-year mass-balance observations from 23 glaciers across Canada, we compare mass-balance models incorporating SEB and PDD components under various calibration scenarios. Initial tests with the uncalibrated SEB model highlight the importance of accurate ERA5 inputs, particularly lapse-rate corrections for 2 m air temperature. Mass-balance simulations with the SEB model that includes calibrated corrections for precipitation and albedo match or outperform those with the PDD model, especially when using a machine learning-derived albedo trained on remote sensing data, which tends to underestimate summer albedo in accumulation zones. Seasonal calibration further improves accuracy of the mass-balance simulations by addressing biases in summer melt and winter accumulation. Despite its simplicity, the SEB model provides a good balance of performance and computational efficiency, emphasizing its utility for regional-scale applications when calibrated appropriately.
Limb salvage surgery (LSS) with megaprosthesis is a common treatment for distal femur tumors, but its impact on gait remains poorly understood. Traditional gait analysis methods are costly and require specialized equipment. This study aims to compare spatiotemporal gait parameters between patients with distal femur megaprosthesis and healthy controls using an inertial measurement unit (IMU). We conducted a case–control study with 79 participants: 31 patients with distal femur megaprosthesis and 48 healthy controls. Gait data were collected using an IMU placed at L5-S1, capturing metrics such as gait quality index (GQI), pelvic kinematics, propulsion index, and gait speed. Statistical analysis included Student’s t-test, Mann–Whitney U test, and one-way ANOVA to compare gait parameters across groups. Patients with megaprosthesis exhibited significantly lower gait speed, propulsion index and anteroposterior acceleration symmetry index compared to controls (p < .05). GQI was reduced in the healthy legs of the cases (92.3%) compared to control legs (96.6%). Adaptations included prolonged stance phases in healthy legs and decreased single support phases in prosthetic legs. Despite these changes, gait patterns remained within functional ranges. IMU-based gait analysis reveals significant but functional alterations in gait mechanics among patients with distal femoral megaprosthesis. These findings underscore the need for tailored rehabilitation strategies to address compensatory mechanisms, optimize mobility, and enhance long-term outcomes. The use of IMU technology offers a cost-effective and portable alternative for clinical gait assessments.
Plague and famine are two of the worst killers in human history. Both struck the Czech lands in the Middle Ages not long after each other (the famine of 1318 CE and the plague of 1348–1350 CE). The aim of our study was to try to relate the mass graves found in the vicinity of the Chapel of All Saints with an ossuary in the Kutná Hora–Sedlec site to these two specific events. For this purpose, we used stratigraphic and archaeological data, radiocarbon dating, and Bayesian modeling of 172 calibrated AMS ages obtained from teeth and bones of 86 individuals buried in the mass graves. Based on the stratigraphic and archaeological data, five mass graves were interpreted as famine graves and eight mass graves were interpreted as plague graves. Using these data and the calibration of the radiocarbon results of the tooth-bone pairs of each individual, we constructed the Bayesian model to interpret the remaining mass graves for which no contextual information was available (eight mass graves). In terms of Bayesian model results, the model fits stratigraphic data in 23 out of 34 cases and in all seven cases based on calibration data. To validate the model results on archaeologically and stratigraphically uninterpreted data, ancient DNA analysis is required to identify Yersinia pestis.
While most research on time preference has focused on gains, understanding time preference for losses is also crucial in practice. Some studies have shown that people prefer to bear a loss earlier rather than later, suggesting negative delay discounting. Nonetheless, most previous research either disallowed an exhibition of negative discounting or analyzed data suggesting opposite directions of discounting together. Furthermore, such research tended to draw conclusions based on aggregate data, although individual behavioral patterns could differ starkly from aggregate ones. To improve knowledge on individual time preference for losses, we conducted 3 experiments examining how systematically changing attribute values affected such preference. Using a choice method with delayed losses, Experiment 1 revealed 3 behavioral effects (i.e., the magnitude, common difference, and delay duration effects) at the aggregate level. For each effect, opposite changes in discount rate were found in data suggesting positive versus negative discounting. Similar results emerged in Experiment 2 using a matching task with delayed losses. Experiment 3 adopted a special form of the matching paradigm, where the amount of an immediate loss should be filled (i.e., an evaluation method). Distinct influences of loss amount were again found under opposite directions of delay discounting. Additionally, a reverse magnitude effect was found more often in Experiment 3 than the other experiments under positive discounting, illustrating the distinctiveness of the evaluation method. Finally, individual analyses revealed more diverse behavioral patterns than aggregate analyses in each study. This underscored the importance of understanding time preference for losses based on individual data.
Regret risk is not consistently part of information sharing within informed consent. Yet two kinds of decisions that often invoke concerns about future regret, abortion and sterilization, raise considerations for the role of regret in clinical decision-making and informed consent, particularly regarding decisions about potentially transformative experiences. We distinguish between first-personal and second-personal anticipatory regret and argue that first-personal anticipatory regret can play a productive role, but second-personal anticipatory regret can function in ways that are pernicious. Introducing second-personal anticipatory regret into medical informed consent processes is, we argue, not only not required for informed medical decision-making, but impermissible within the clinical encounter. This view has broader implications for medical decision-making about potentially transformative experiences, and for empirical research on regret regarding healthcare decisions.
Macro-financial stability plays a crucial role amidst global crises and can significantly impact the economic security of European Union members. It is crucial to have sufficient resources to address macroeconomic challenges since economic vulnerability can worsen risks, threats and instability, ultimately resulting in greater inequality. The article aims to investigate the influence of EU macro-financial stability on the economic security among EU member states with different development levels. Indicators that serve as the foundation for assessing the Macroeconomic Imbalance Procedure (MIP) have been chosen for studying the economic security of advanced, emerging, and developing economies within the EU. Studies utilizing correlation and regression analysis have revealed an interconnection between the EU’s macro-financial stability and its member countries’ economic indicators. This correlation is found to be significant regardless of the country’s level of development. The findings highlight the vulnerability of national economies to macro-financial shocks within the EU and the potential adverse effects on the economic security of member countries. Insights into the impact of macro-financial stability on economic security help identify destructive trends and risks arising from macro-financial destabilization, proving beneficial to EU members and countries aspiring to EU membership. The novelty lies in establishing the link between financial stability and economic security of EU member countries at the macroeconomic level, regardless of their development level, and elucidating potential consequences of macro-financial destabilization on economic indicators.
Human language is increasingly written rather than just spoken, primarily due to the proliferation of digital technology in modern life. This trend has enabled the creation of generative artificial intelligence (AI) trained on corpora containing trillions of words extracted from text on the internet. However, current language theory inadequately addresses digital text communication’s unique characteristics and constraints. This paper systematically analyzes and synthesizes existing literature to map the theoretical landscape of digitized language. The evidence demonstrates that, parallel to spoken language, features of written communication are frequently correlated with the socially constructed demographic identities of writers, a phenomenon we refer to as “digital accents.” This conceptualization raises complex ontological questions about the nature of digital text and its relationship to social identity. The same line of questioning, in conjunction with recent research, shows how generative AI systematically fails to capture the breadth of expression observed in human writing, an outcome we call “homogeneity-by-design.” By approaching text-based language from this theoretical framework while acknowledging its inherent limitations, social scientists studying language can strengthen their critical analysis of AI systems and contribute meaningful insights to their development and improvement.
Transposable elements (TEs) have the ability to move and amplify inside the host genome, making them a pivotal source of genome plasticity. Presently, only 4 TE clades (all classified as Class I retrotransposons) have been identified in trypanosomatids. We predicted repeat content and manually curated TEs across the genomes of 57 trypanosomatids, shedding light on their proportions, diversity and dynamics. Our analysis yielded 214 TE consensus sequence models across the dataset, with abundance ranging from 0.1% to 7.2%. We found evidence of recent transposon activity in most species, with notable bursts in the Vickermania, Lafontella, Porcisia and Angomonas spp., along with Leishmania (Mundinia) chancei, L. (M.) orientalis and L. (M.) procaviensis. We confirmed that the 4 TE clades have colonized virtually all lineages of trypanosomatids, potentially playing a role in shaping their genome architecture. The effort of this work culminated in the establishment of the Trypanosomatid TE Database 1.0, a resource designed to standardize the TE annotation process that can serve as a foundation for future studies on trypanosomatid TEs.
The flow-induced oscillations of a clamped flexible ring in a uniform flow were explored using the penalty immersed boundary method. Both inverted and conventional ring configurations were examined, with systematic analysis focused on the effects of bending rigidity and eccentricity. Four distinct oscillation modes were identified across parameter variations: flapping (F), deflected oscillation (DO), transverse oscillation (TO) and equilibrium (E) modes. Each mode exhibited a 2S wake pattern. The inverted ring sustained the DO mode under low bending rigidity with a deflected shape, transitioning to the TO mode at higher bending rigidity. In the TO mode, a lock-in phenomenon emerged, enabling the inverted ring to achieve a high power coefficient due to a simultaneous rise in both oscillation amplitude and frequency. By contrast, the conventional ring exhibited the F mode at low bending rigidity and transitioned to the E mode as rigidity increased, although its power coefficient remained lower because of reduced critical bending rigidity. For the inverted ring, low eccentricity enhanced oscillation intensity but limited the operational range of the TO mode. In contrast, for the conventional ring, reducing eccentricity led to an increase in oscillation amplitude. Among the investigated configurations, the inverted-clamped ring achieved the highest energy-harvesting efficiency, surpassing those of the conventional clamped ring and a buckled filament.
In 2009, the University of Michigan’s Michigan Institute for Clinical and Health Research developed a three-session K Writing workshop. Beginning in 2016, we implemented a non-attendance fee to encourage attendance across the three sessions. We examined whether this fee improved attendance, increased submission of an NIH K or R grant proposal, and improved success rates. Between 2012 and 2021, 373 participants attended the workshop. After the non-attendance fee was implemented, significantly more participants attended all three sessions of the workshop, and there was a statistical trend suggesting an increase in the success rate, while submission rates remained constant.
The work investigates the response dynamics of non-premixed jet flames to blast waves that are incident along the jet axis. In the present study, blast waves, generated using the wire-explosion technique, are forced to sweep across a non-premixed jet flame that is stabilised over a nozzle rim positioned at a distance of 264 mm from the source of the blast waves. The work spans a wide range of fuel-jet Reynolds numbers ($Re$; ranging from 267 to 800) and incident blast-wave Mach numbers ($M_{s,r}$; ranging from 1.025 to 1.075). The interaction imposes a characteristic flow field over the jet flame marked by a sharp discontinuity followed by a decaying profile and a delayed second spike. The second spike in the flow field profile corresponds to the induced flow that follows the blast front. While the response of the flame to the blast front was minimal, it was found to detach from the nozzle rim and lift off following the interaction with the induced flow. Subsequently, the lifted flame was found to reattach back at the nozzle or extinguish, contingent on the operating $Re$ and $M_{s,r}$. Alongside flame lift-off, flame-tip flickering was aggravated under the influence of the induced flow. A simplified theoretical model extending the vorticity transport equation was developed to estimate the change in flickering time scales and length scales owing to the interaction with the induced flow. The observed experimental trends were further compared against theoretical predictions from the model.
The article examines the European Union’s neutrality toward Kosovo’s statehood and its influence on the EU’s enlargement process and engagement strategy in view of internal divisions among the EU Member States over Kosovo’s recognition. It assesses how the EU’s mantra of neutrality shapes the dimensions of EU actorness, balancing differences among EU Member States while ensuring Kosovo’s inclusion in the EU enlargement process. Next, the article explores how the EU engages with Kosovo despite the lack of unanimous recognition of Kosovo’s statehood from five EU Member States, arguing that neutrality unfolds both as a legitimising principle and an authorisation mechanism. Our hypothesis is that neutrality has enabled Kosovo’s incremental involvement in the enlargement process without undermining the EU’s internal cohesion. Drawing on three illustrative examples, notably, the EU Rule of Law Mission in Kosovo, the Stabilisation and Association Agreement and the CJEU’s interpretation of EU-Kosovo SAA Agreement, the article demonstrates the variations of the concept of neutrality and its impact in maintaining Kosovo’s attachment to enlargement policy. The findings suggest that neutrality has been instrumental in authorising the EU missions in Kosovo and in sustaining Kosovo’s European trajectory.
We propose a B-integral management strategy for manipulating the nonlinear effects by employing a discrete single-crystal fiber (SCF) configuration, enabling direct amplification of 2-μm femtosecond pulses at high repetition rates without additional pulse picking, stretching and compression. The system delivers an average power of more than 56 W at 75.45 MHz with extremely high extraction efficiency (>55%) and near-diffraction-limited beam quality (M2 < 1.2). The dynamic evolution of the optical spectra and temporal properties in the power amplifier reveals that detrimental nonlinear effects are largely suppressed due to the low accumulated nonlinear phase shift in the discrete SCF layout. This straightforward, compact and relatively simple approach is expected to open a new route to the amplification of 2-μm ultrashort pulses at MHz and kHz repetition rates to achieve high average/peak powers, thereby offering exciting prospects for applications in modern nonlinear photonics.
Urban Latin America: Inequalities and Neoliberal Reforms. Edited by Tom Angotti. Lanham, MD: Rowman & Littlefield Publishers, 2017. Pp. 306. $37.00 paperback. ISBN: 9781442274488.
Urbanización y revolución en América Latina: Santiago de Chile, Buenos Aires y Ciudad de México (1950-1980). By Óscar Calvo Isaza. Mexico City: El Colegio de México and Universidad Nacional de Colombia, 2023. Pp. 398. $13.00 paperback. ISBN: 9786075644189.
Monstrous Politics: Geography, Rights, and the Urban Revolution in Mexico City. By Ben A. Gerlofs. Nashville, TN: Vanderbilt University Press, 2023. Pp. xiv + 262. $39.95 paperback. ISBN: 9780826504777.
La ciudad latinoamericana: Una figura de la imaginación social del siglo XX. By Adrián Gorelik. Mexico City: Siglo XXI, 2022. Pp. 424. $55.82 hardcover, $7.99 ebook. ISBN: 9789878011370.
Representing the Barrios: Culture, Politics, and Urban Poverty in Twentieth-Century Caracas. By Rebecca Jarman. Pittsburgh, PA: University of Pittsburgh Press, 2023. Pp. xvii + 352. $60.00 hardcover. ISBN: 9780822947653.
Reclaiming the Discarded: Life and Labor on Rio’s Garbage Dump. By Kathleen M. Millar. Durham, NC: Duke University Press, 2018. Pp ix + 248. $24.95 paperback. ISBN: 9780822370505.
Historia de las villas en la ciudad de Buenos Aires. By Valeria Snitcofsky. Buenos Aires: Tejido Urbano, 2021. Pp. 326. Open-access ebook. ISBN: 9789873779541.
Despite international calls to abolish the use of segregation in prisons, the practice has been defended by some Canadian correctional workers as a sometimes-necessary practice to preserve prisoner and staff safety. Informed through a lens of risk and the socio-legal literature on segregation, the current interview study explores perspectives on segregation from 28 correctional officers (COs) employed in provincial correctional services at a prison in Atlantic Canada. COs expressed a need to continue using segregation—albeit less often and under reformed contexts—to ensure safety for prisoners and staff and preserve prisoner accountability. Findings indicate COs recognize the structural, situational, and personal factors and complexities that shape decisions to impose segregation. They call for increased available resources to improve prisoner safety, dignity and wellness, prevent harm and self-injury, and reduce the use of segregation. We conclude with recommendations for provincial and territorial correctional institutions to consider moving forward.