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The rapid evolution of digital health technologies (DHTs) presents distinct challenges for health technology assessment (HTA). Existing HTA frameworks, largely designed for conventional health interventions, may not sufficiently address these unique complexities. This scoping review provides an overview of existing assessment frameworks for DHTs, analyzing their purpose and the guidance they offer within the domains of the EUnetHTA Core Model.
Methods
The review followed the Joanna Briggs Institute methodology and PRISMA-ScR guidelines. The literature was identified through searches in PubMed and Embase, covering publications from 2015 to 2024 in English or German, and was complemented by a manual hand search. The studies were screened and analyzed using Covidence, with data categorized inductively based on the EUnetHTA Core Model domains.
Results
Of 3,576 screened records, 15 met inclusion criteria; an additional 45 frameworks were identified through hand searching, resulting in a total of 60 frameworks. Most frameworks focused on digital health applications (68 percent), while only a few addressed technologies such as artificial intelligence (2 percent). The frameworks primarily provide guidance on assessment, with varying focus on evidence requirements. The domains of the EUnetHTA Core Model were variably represented across the frameworks. Technical characteristics were most frequently addressed, while ethical, legal, and organizational domains received limited attention.
Conclusions
This review highlights the diversity of existing frameworks for DHT assessment. This emphasizes the potential relevance of a future standardized framework that contains explanations of the methodological approach to the assessment of DHTs and is modularly customizable depending on the type of technology.
Those who have engaged with the moral and political thought of Richard Price have often commented on the striking similarities with Kant. Price, as much a polymath as he was a philosopher, was nevertheless a very different intellectual figure, widely admired at the time in Europe and America as a radical, but sporadic rather than systematic in his writing. This paper will consider his thinking holistically, in particular drawing on recent research on his economic commentaries and work on insurance. This expositional work around Price’s nascent political economy lays the basis for defending his positioning as a proto-socialist thinker – whose commitments also fit with the key tenets of 18th-century Left-Kantianism. It is argued that these claims, and his extant anti-capitalist thought, make Price an important and intriguing foil against which to consider Kant’s own leftist credentials, and for expanding the debate around the latter’s political economy and Left-Kantianism more generally.
Conservation science is constrained by conditional visibility, an epistemic trap whereby recognition depends on alignment with Global North priorities. This phenomenon represents the operational intersection of the Matthew and Matilda effects, compounded by the feminization of poverty in the Global South. By marginalizing Indigenous and local knowledge, this structural filter severs global mandates from grounded ecological realities, leading to maladaptive conservation interventions. To bridge this gap, we propose specific interventions targeting the financial, administrative and evaluative pillars of the discipline. By matching structural reform with internal empowerment, we move beyond rhetoric to ensure effective planetary stewardship.
Network analysis was employed to test whether the overall pattern of depressive–anxious symptom connections remains stable or whether specific symptom-to-symptom links shift from pregnancy to postpartum.
Methods
In a perinatal sample (n = 4,461 pregnant women, n = 5,711 postpartum women), depressive and anxiety symptoms were assessed with the Edinburgh Postnatal Depression Scale (EPDS) and Generalized Anxiety Disorder-7 (GAD-7). Phase-specific polychoric Gaussian graphical models were estimated with EBICglass. We examined strength and bridge centrality, community structure, and nodewise predictability, and compared networks using the network comparison test.
Results
Depression and anxiety formed four reproducible communities (one GAD-7 worry/arousal and three EPDS affective/anhedonic, anxious–cognitive distress, and depressed affect/sleep–suicidality modules) with identical partitions across phases. Global strength was similar, but postpartum networks showed higher edge density and more negative partial correlations, suggesting localized changes in which symptom pairs were directly linked—and how strongly—across phases. Across phases, Sadness, Crying, Uncontrollable worrying, and Trouble relaxing were most central and predictable. Worry-, arousal-, and sleep-related symptoms (e.g., hard to sleep) showed the strongest bridge centrality postpartum, and Self-harm was a prominent bridge during pregnancy; several edges shifted between phases, including stronger Enjoyment–Self-harm and weaker Hard to sleep–Self-harm postpartum.
Conclusions
Perinatal depression and anxiety organize into cohesive yet partially distinct symptom networks that remain globally stable but show localized shifts in direct symptom-to-symptom connections from pregnancy to postpartum. Central affective and arousal nodes, particularly sadness, pathological worry, and sleep disturbance, may be high-yield targets for phase-tailored screening and intervention.
Strikes against public policies have often been classified as illegal political strikes. Nevertheless, the concept of social movement unionism (SMU) describes how trade unions in some countries have become active players in social struggles, alongside social organizations and protest groups, by using political strikes. Although the International Labor Organization (ILO) prohibits purely political strikes, it recognizes the legitimacy of protest strikes concerning public issues. In this respect, the article combines the notion of global constitutionalism with the concept of SMU to explore the issue of political strikes in times of social or democratic struggles. Global constitutionalism regards certain international principles as paramount, offering them a status akin to constitutional law. Drawing on the intersection of the theory of SMU with the concept of global constitutionalism, the article suggests that strikes against governmental policy, framed as part of broader social protests, can effectively oppose controversial public policies. The article claims that protest strikes should be recognized as legitimate exercises of workers’ freedom of association, based on the application of relevant ILO principles through global constitutionalism.
Funders increasingly emphasize the ethical imperative to return research results, yet researchers often lack training and clear strategies for effectively sharing findings with lay audiences. While publishing in academic journals is standard practice for dissemination, little guidance exists on translating findings for communities, particularly in rural areas. This qualitative community-guided pilot project aimed to explore and strengthen strategies for sharing study results in accessible ways.
Methods:
The Penn State Clinical and Translational Science Institute conducted six semi-structured focus groups in Fall 2023 with geographically dispersed Pennsylvanians. Focus groups introduced participants with and without prior research experience to evidence-based and novel dissemination methods – such as lay summaries and data walks – to gather feedback on preferences and experiences. Data were coded and analyzed using MAXQDA, achieving strong interrater reliability (kappa > 0.70). Themes were developed inductively.
Results:
Focus group participants (N = 45) were predominantly women (N = 39, mean age = 56); 10% identified as Black/African American. Geographically, 49% were rural, 44% suburban, and 7% urban. Major themes included lack of effective communication in the research process, poor representation, and limited access to results. Most participants had never received study findings. Participants preferred receiving easy-to-understand summaries shared by individuals with established community relationships. They also found data walks, where researchers bring key findings printed on posters to community events, to be especially engaging and valuable.
Conclusion:
Community-informed dissemination approaches can increase research transparency, engagement, and results translation in communities, particularly in rural areas where accessibility is limited.
Achieving enrollment goals is essential for the successful completion of a clinical trial. This includes enrolling a sample size that provides adequate power and engaging a study population that supports generalizability of research findings. Yet, trial participation is routinely hindered by its complexity, associated risks, and frequently cited barriers to participation including lack of awareness, low trust/mistrust, and logistical burdens that make participation of low value or unrealistic to potential participants [1,2].
The Canadian Ultra-Processed Product Screener (CUPS) was developed to rapidly assess ultra-processed food (UPF) and drink product intake among Canadian adults. The CUPS is an online self-administered screener that includes twenty-eight questions and assesses the intake of a variety of UPF available in Canada, both in French and English. This study aimed to assess the construct validity and reliability of the CUPS among a sample of adults in Canada.
Design:
Cross-sectional study (between July and November 2023).
Settings:
Participants completed the online CUPS screener in three versions (1-d (twice), 7-d and 30-d CUPS) and three 24-h dietary recalls (24HR) (the reference measure) over the course of 26–28 d.
Participants:
354 Canadians aged 18–60 years
Results:
The CUPS had an acceptable construct validity, with moderate correlation coefficients between the CUPS score and UPF consumption level measured using multiple 24HR (from 0·33 to 0·44). Reproducibility was also acceptable (intraclass correlation = 0·61) and internal consistency ranged from good to excellent (Cronbach’s α = 0·72 for the 1-d and 0·86 for the 30-d CUPS). CUPS scores were also associated with higher intake of added sugars, saturated fats and Na.
Conclusions:
This study provides evidence supporting the construct validity and reliability of the CUPS among Canadian adults. The CUPS is useful for identifying low and high consumers of UPF and could serve as a proxy measure for one key dimension of diet quality, which is the type of food processing.
A benchmark road vehicle geometry – the square-back Windsor body with wheels and at zero yaw angle – is simulated using high-fidelity wall-resolved large eddy simulation. Passive control for drag reduction, in the form of optimisation of its rear roof extension, is performed. The rear roof extension is parameterised by its taper penetration distance, angle of incidence and length. This optimisation process uses Gaussian process-based surrogate modelling combined with Bayesian optimisation (Kriging), guided by an expected improvement criterion. The optimisation converged in six iterations (60 simulations), achieving a $6.5\,\%$ drag reduction. Six distinct drag-reduction mechanisms were identified: diffuser-induced pressure recovery, base-size reduction, vertical wake balance modification, separation effects, recirculation region core relocation and spanwise re-symmetrisation. Rather than isolating individual mechanisms, the study reveals how they interact when multiple geometric parameters are varied concurrently, providing a system-level picture that yields practical design rules. The optimal configuration was found at a roof extension angle of incidence corresponding to the onset of separation, with taper penetration distance and extension length at their maximum values within the analysed domain. These findings establish a robust framework for aerodynamic optimisation and reinforce the effectiveness of Bayesian optimisation in Computational Fluid Dynamics-based design. In this way, the work bridges fundamental wake studies with applied design practice, showing how coupled wake–geometry interactions can be harnessed for improved aerodynamic performance.
Visual mobility scoring to detect lame dairy cattle can be subjective and inconsistent. This study assessed the reliability of visual mobility scores from multiple assessors, using different scoring methods (live vs. video) and experience levels to evaluate their influence on label quality for machine learning applications. We gathered data from two farms using the AHDB 4-point mobility scale and a simplified post-hoc dichotomised version, with both live and video assessments. Substantial within- and between-assessor variation was seen in scores, particularly for scores 0 and 1 (consistent with normal and slightly abnormal gaits, respectively). Assessors showed only fair (weighted kappa ≈ 0.33) score consistency when they scored the same animal in different ways (live vs. video). Post-hoc simplification of the four-level scores to a dichotomous score improved agreement but reduced granularity. Assessor experience had limited influence on agreement levels (P > 0.05), and increased video viewing frequency during the assessment process was associated with lower inter-assessor agreement (probability estimate = −0.49, P = 0.005), suggesting higher uncertainty in ambiguous cases. Qualitative feedback from assessor comments revealed that the speed of the animal affected their scoring decisions (β = –1.92, P = 0.007). These results highlight the difficulties in using subjective human scores as labels for machine learning training. To improve automatic lameness detection in dairy cattle, we need strategies to reduce this variation and use more definitive labels.
On grounds of ethnographic fieldwork conducted in Uttar Pradesh and Delhi between 2021 and 2023, this paper analyses 20 cases of police violence, which occurred during the December 2019 protests against the Citizenship (Amendment) Act. I argue that majoritarian practices of policing, through legal and extra-legal mechanisms, “unmake” the victims of violence. Instead, police procedures frame victims as perpetrators. The unmaking of the victims and subsequent criminalization occur through layers of discursive, procedural, investigatory, and legal strategies employed in everyday policing. In a Kafkaesque turn in law and society, I identify the omissions, exclusions, and invocations that result in a devastating deprivation of justice.
Educational attainment is related to more political trust. In this study, we adopt a global perspective, arguing that this ‘education effect’ is conditional on the development of ‘schooled societies’. In such societies, schooling as a central institution installs educational attainment as a main source of social status, granting the higher educated a dominant position in the political field. Consequently, higher educated citizens have high levels of political trust, while the less educated are distrusting. In less schooled societies, however, the ‘education effect’ is more ambiguous, as the social status of the higher educated is less guaranteed and depends on their relationship to the state. Consequently, there may be a large gap in political trust between those who are publicly employed and those who are not. We, therefore, examined the relationship among educational attainment, a schooled society, sector of employment, and political trust. We combined the Schooled Society Index with data from the World Values Survey and European Values Study. Multilevel analyses across 84 countries (Nindividual = 102,102) revealed that the positive relationship between educational attainment and political trust was conditional on the development of ‘schooled’ society. Furthermore, in less strongly schooled societies, there was an important gap in political trust among the higher educated, depending on whether or not they were publicly employed. Such patterns cannot be explained by educational differences in political knowledge or cognitive sophistication. In contrast, our results imply that the ‘educational effect’ on political trust is strongly dependent on the social status of education-based groups.
This article explores how clinical language used to describe long-standing and severe eating disorders shapes treatment experiences and outcomes. Drawing on critical discourse theory and the authors’ lived experiences, the paper analyses the impacts of language through intrapersonal, interpersonal and systemic lenses.
Results
The analysis highlights how the language used to describe illness can foster therapeutic nihilism, internalised hopelessness and disengagement from treatment for both clinicians and patients, reducing the impetus for developing or accessing better care. These labels may obscure systemic shortcomings in treatment provision and can become self-fulfilling, undermining clinician motivation and patient recovery.
Clinical implications
The authors propose a paradigm shift toward recovery-oriented, co-created language that centres epistemic justice. Clinical discourse should promote therapeutic optimism and support inclusive, patient-centred care. Recovery-focused language can strengthen engagement, improve outcomes and support a treatment culture grounded in mutual respect and hope.
The propulsion speed of spheroidal squirmers was obtained by Keller & Wu (J. Fluid Mech., 1977, vol. 80, p. A31). It has become the benchmark to investigate the effect of shape on the propulsion of ciliated microorganisms. However, their study focused on translational motion whereas many biologically relevant organisms also experience rotational (or swirling) motion. We derive an analytical expression for the angular velocity of a swirling spheroidal squirmer. Our analysis reveals that spheroidal squirmers rotate faster than their spherical counterparts in Newtonian fluids. We also determine the contribution of the second azimuthal mode to the power dissipation generated by a spheroidal squirmer, and uncover a behaviour uniquely distinct from the power dissipation of a strictly translating swimmer.
The writer, Chimamanda Adichie, was sent out of an Nsukka chapel for wearing a short-sleeved blouse. The TV presenter, Funmi Iyanda, was harassed by police for wearing a knee-length dress. Nigeria’s response to a suit at the ECOWAS Court of Justice brought by an actress, Dorothy Njemanze, included that she “dress[ed] naked or half naked”. Firdaus Amasa was initially denied call to the Nigerian bar because she wore a hijab beneath her lawyer’s wig, and several young women have been decamped from the mandatory National Youth Service Corps programme for wearing skirts instead of trousers and shorts. Analysing the above incidents, alongside the Supreme Court’s decision in Lagos State Government v Abdulkareem, this article finds that though it is easier to enforce women’s rights to choose their dress when religious liberty is engaged, the constitutionally guaranteed protection against degrading treatment is one thread that runs across all instances of policing women’s dress. Consequently, prioritizing dignity rights for Nigeria’s womenfolk will shield them from indignities associated with policing their dress choices.
From manifesto pledges to election victory in 2024, the Labour Party has positioned ‘spiralling economic inactivity’ as the central employment and welfare challenge. This article critically examines Labour’s first year in power, with a focus on employment policies at the intersection of in-work poverty, economic insecurity, and inactivity. We begin by outlining the current labour market context, questioning the narrative underpinning Labour’s welfare reform agenda. We then analyse key policy shifts in social security and employment support, especially as they affect marginalised groups. This is followed by a review of Labour’s wider labour market strategy, including the Employment Rights Bill, Pathways to Work, Get Britain Working, and the significance of devolution. The article concludes by assessing the current direction of travel, and explores the tension between the structural roots of work insecurity and the incremental policy responses likely to leave the deeper labour market challenges across the UK largely intact.
Globally, child marriage is a persistent issue, adversely affecting the rights and well-being of girls. With a special focus on religious affiliation, this study explores the contributing factors leading to child marriage, such as cultural norms, religious beliefs, and socioeconomic conditions. From the Census of India 2011 data, percentage distributions of child marriage were used to assess the trends and magnitude of child marriage over the years. From NFHS-5 data, bivariate and multivariate analyses were conducted to assess factors like education and wealth index. Spatial analysis techniques, including Moran’s I statistics, helped identify the geographic distribution of child marriage. Findings reveal a history of relatively high child marriage rates among Muslims and their faster decline over the last decades. In 2011, under-14 marriages among Hindus exceeded 1.03% more than that of Muslims, with a 0.33% higher incidence of under-18 marriages among Muslims. The sample-based NFHS-5 study highlights significant disparities in child marriage based on the sample populations’ religious affiliations, regions, social categories, education, and wealth. In conclusion, the issue transcends religious boundaries, is rooted in broader social and economic contexts, and advocates for multidimensional interventions.
This article examines the role of the African Union’s Peace and Security Council (PSC) in strengthening compliance with international humanitarian law (IHL), a dimension of its mandate that remains largely unexplored in the literature. The article argues that although this mandate is explicit and carries significant normative potential, its implementation remains limited, fragmented and inconsistent. To demonstrate this, the study proceeds in three steps. First, it analyzes the normative foundations of the PSC’s IHL mandate through an interpretative and systemic reading of its constitutive texts. Second, it critically assesses the Council’s concrete practice, highlighting the limits and inconsistencies of its actions and instruments. Third, it identifies avenues for improvement, emphasizing the need to institutionalize compliance monitoring, to structure PSC decisions with greater precision and gradation, and to make fuller use of available legal mechanisms and partnerships. The central argument is that the PSC holds under-utilized legal and institutional tools which, if fully mobilized, could significantly enhance its effectiveness in fulfilling its IHL-related mandate and establish it as a key regional actor in the promotion of respect for IHL and the protection of victims of armed conflict.
The article discusses the unfolding of the anticorruption campaign in Romania, from pre-accession to present day. Its argument is that the risk-induced anticorruption paradigm has produced effects that have been from the very beginning irreconcilable with liberal-constitutional normativity. To generate results, normative understandings regarding fundamental rights, institutional autonomy, and judicial independence were subordinated to the policy imperatives and manipulated to achieve them. In the long run, normative considerations resurfaced as a backlash, in equally distorted and instrumental forms. I argue that a single-minded pursuit of policy imperatives thought conducive to risk-abatement has not only not reduced or managed the risk of corruption but also has generated more intractable, systemic threat patterns. Some of these paradoxical, unintended consequences are not contained, resulting in normative spillover within the common constitutional area. The first part of my paper discusses the politicisation of the judicial system. A second substantive section analyses the protracted saga of judicial salaries and pensions and repeated attempts to manipulate the retirement conditions in order to generate personnel and policy changes. A third probes into the dialogues between the CJEU, the Romanian Constitutional Court and the High Court of Cassation and Justice regarding the statute of limitations and its implications.
We study the locus of smooth hypersurfaces inside the Hilbert scheme of a smooth projective complex variety. In the spirit of scanning, we construct a map to a continuous section space of a projective bundle, and show that it induces an isomorphism in integral homology in a range of degrees growing with the ampleness of the hypersurfaces. When the ambient variety is a curve, this recovers a result of McDuff about configuration spaces. We compute the rational cohomology of the section space and exhibit a homological stability phenomenon for hypersurfaces with first Chern class going to infinity. For simply connected varieties, the rational cohomology is shown to agree with the stable cohomology of a moduli space of hypersurfaces, with a peculiar tangential structure, as studied by Galatius and Randal-Williams.