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Identifying confidence in recovering balance following destabilizing events is essential for helping older adults prevent falls. However, existing measures primarily assess balance confidence. The Balance Recovery Confidence (BRC) scale was developed to address this gap, but its length may limit clinical feasibility. This study aimed to develop and validate a Short-Form Balance Recovery Confidence (SF-BRC) scale that retains the psychometric integrity of the original version while improving practicality.
Methods:
A cross-sectional dataset comprising 309 older adults (≥ 65 years) was analyzed. Exploratory factor analysis using unweighted least squares extraction on polychoric correlations was conducted to determine the underlying factor structure. Confirmatory factor analysis using the weighted least squares mean and variance adjusted (WLSMV) estimator evaluated model fit. Rasch modeling assessed item fit, item difficulty, and person separation reliability. Criterion and convergent validity were examined through correlations with the original BRC, Activities-specific Balance Confidence (ABC), and Falls Efficacy Scale–International (FES-I) scales.
Results:
The final 7-item SF-BRC demonstrated a unidimensional structure with excellent model fit (CFI = 0.99, TLI = 0.99, RMSEA = 0.06, SRMR = 0.02). Internal consistency was high (α = 0.94), and Rasch person separation reliability was 0.93. Criterion validity with the full BRC was strong (r = 0.99), while convergent validity with ABC and FES-I scales was moderate, supporting theoretical distinctiveness of the construct.
Conclusions:
The SF-BRC is a psychometrically robust instrument for assessing BRC. Its strong reliability and practical utility support its use in rehabilitation, fall prevention, and community-based settings.
Post-traumatic stress disorder (PTSD) may shorten life expectancy, but evidence for Asian populations and cause-specific mortality remains limited. The aim of this study is to investigate the association between PTSD and mortality risk in an Asian population.
Methods
We used Taiwan’s National Health Insurance Research Database (2000–2022) to assemble a cohort of 28,777 individuals with incident PTSD and 115,108 age- and sex-matched unexposed individuals, plus a sibling cohort of 13,305 affected patients and 22,030 unaffected siblings. Cox models estimated adjusted hazard ratios (AHRs) for all-cause, unnatural-cause (suicide and accidents) and natural-cause mortality, with progressive adjustment for sociodemographic factors, comorbidity and familial confounding. Subgroup analyses addressed five psychiatric comorbidities, sex and age (youth, adulthood and older adults).
Results
Over a mean follow-up of 8 years, PTSD was associated with excess all-cause mortality (AHR = 1.32, 95% CI 1.24–1.41) driven by markedly increased unnatural deaths (AHR = 5.93, 5.13–6.85), especially suicide (AHR = 10.36, 8.41–12.76) and accidental deaths (AHR = 2.18, 1.67–2.86). Natural-cause mortality showed no consistent increase (AHR = 0.91, 0.85–0.98). In sibling analyses, excess risks persisted for all-cause (AHR = 2.48, 2.04–3.01), unnatural deaths (AHR = 4.76, 3.58–6.34) and suicide mortality (AHR = 7.90, 5.21–11.97), but not for accidents or natural causes. The risk patterns were similar across different psychiatric comorbidity strata and genders; suicide and unnatural-cause excess remained evident in all age groups.
Conclusions
PTSD was associated with elevated premature death risk in Taiwan, primarily through suicide and unnatural causes. Integrating targeted suicide-prevention into PTSD care pathways may be essential to reducing this avoidable mortality burden.
Outpatient parenteral antimicrobial therapy (OPAT) reduces hospitalization, yet poor standardization and implementation contribute to readmission rates near 25%. The Infectious Diseases Society of America recommends structured and multidisciplinary OPAT programs. Twelve quality indicators, spanning organization, initiation, continuation, and outcome domains, have been proposed to improve OPAT delivery. Our scoping review assessed associations between reported OPAT quality indicators and patient readmission.
Methods:
We searched PubMed, Embase, Cochrane CENTRAL, Web of Science, and Google Scholar from database inception through May 1, 2025, for studies of adults discharged on OPAT, managed by multidisciplinary teams, and reporting readmission rates. Data included presence of each quality indicator, team composition, and readmission rates. Readmission was categorized as low (<10%) or high (≥10%).
Results:
Of 2,610 studies screened, 18 (5,027 patients) met criteria. The median readmission rate was 11.3 (IQR 8–20). All studies reported a structured OPAT program and formal OPAT team. Initial patient assessment by a competent team member was more common in studies with lower readmissions. Reporting more indicators (range 4–11) did not significantly correlate with fewer readmissions. Organization and initiation indicators were reported more frequently than continuation and outcome indicators. All programs included an infectious diseases physician; 94% included nurses, 55% pharmacists, 28% social workers, and 11% hospitalists.
Conclusions:
Higher quantity of reported indicators did not predict fewer readmissions. Future research should explore team engagement, including potential roles of hospitalists and social workers to strengthen care transitions, and the impact of continuation and outcome indicators on readmissions.
John Dewey holds that uncertainty is a central feature of the concrete interaction between organism and environment, and he mobilizes this diagnosis to explain both the emergence of inquiry and the persistence of speculative and abstract philosophies. However, we show that material reality is not uncertain and that the quest for certainty cannot explain the flight from the concrete, but should explain a return to it. Drawing on historical, philosophical, and sociological sources (most notably Edgar Zilsel’s thesis and the embodied knowledge of artisans) we invert Dewey’s interpretative framework: epistemic uncertainty arises not from material reality, but from theoretical abstraction. This reinterpretation enables a reformulation of Dewey’s critique of dualism and provides the basis for a pragmatist epistemology grounded in the relative stability of practical experience. Finally, it opens the way for a reconsideration of the foundations of democracy from a non-relativistic perspective.
Adults exhibit different acoustic characteristics in infant-directed speech (IDS) compared to adult-directed speech (ADS). We investigate differences in voice quality between IDS and ADS in sentences read aloud by Hungarian mothers, using longitudinal data gathered at various child ages (4, 8, 18 months). Vowels in IDS are found to be breathier than those in ADS, regardless of the infant’s age. Possible motivations for this difference may include emotional expressions, as breathiness relates to positive emotions, and speech entrainment, since the speech of children is breathier than that of adults.
This article demonstrates how political science, particularly the emerging field of American Political Economy (APE), can more robustly theorize and study the political economy of systemic racism by drawing on insights from critical race theories, including intersectionality and racial capitalism, and post/anti-colonial theory. A paired case study of the foreclosure “noncrisis” of the 1990s and the coerced sterilization of incarcerated women in California during the early 2000s highlights three key contributions of critical race theories: (1) intersectionality reveals nonuniformity, unintended consequences of purportedly progressive policy, and underscores the importance of margins-to-center resistance; (2) feudal-colonial roots illuminate how racialized hierarchies become institutionalized in law and policy, often without explicit racial language; and (3) racial capitalist logics explain how administrative tools, such as risk assessment and cost-benefit analysis, reproduce racial hierarchy through markets. This framework offers APE a more historically grounded, power-conscious, and theoretically expansive approach to systemic racism and underscores the urgency of resisting efforts to suppress such scholarship.
The division of cognitive labor leads to what Barry has recently called epistemic alienation: a problematic separation of individuals from epistemic goods. According to Barry, individuals are alienated from epistemic virtues because an efficient division of cognitive labor requires them to manifest a lack of virtues. I argue that this is a mistaken diagnosis of the source of epistemic alienation. Participating in high-functioning collectives does not prevent individuals from being robustly virtuous; rather, our cognitive limitations make it impossible for us to live up to the highest standards of epistemic conduct. Collectives transcend these cognitive limitations to achieve what individuals cannot by harnessing those same limitations in their members. Furthermore, I argue that we should distinguish the epistemic weaknesses that facilitate the division of cognitive labor from those that result from the division of labor. Only the latter are aspects of epistemic alienation. By dividing our cognitive labor over larger populations of agents and artifacts, we have massively accelerated our rate of epistemic productivity but have thereby created conditions that are variously inhospitable for the thinking of individuals by alienating them from the products, processes, and environments of inquiry. These forms of separation are problematic insofar as they amplify intellectual vices, incapacitate reason, and induce cognitive biases.
We are self-conscious creatures thrown into a world, which is not of our making. What is the connection between being self-conscious and being related to an objective world? The Practical Self argues that self-consciousness requires faith in ourselves as the agents of our thinking and that this faith is sustained by a set of practices which relate us to a world of others.
We consider a toy model of rate-independent droplet motion on a surface with contact angle hysteresis based on the one-phase Bernoulli free boundary problem. We introduce a notion of solutions based on an obstacle problem. These solutions jump “as late and as little as possible”, a physically natural property that energy solutions do not satisfy. When the initial data is star-shaped, we show that obstacle solutions are uniquely characterized by satisfying the local stability and dynamic slope conditions. This is proved via a novel comparison principle, which is one of the main new technical results of the paper. In this setting we can also show the (almost) optimal $C^{1,1/2-}$-spatial regularity of the contact line. This regularity result explains the asymptotic profile of the contact line as it de-pins via tangential motion similar to de-lamination. Finally we apply our comparison principle to show the convergence of minimizing movements schemes to the same obstacle solution, again in the star-shaped setting.
The Japanese occupation of the Philippines (1942–1945) caused the loss of 500,000–1,000,000 Filipino lives—a tragedy largely erased from Japanese visual media. A 2017 study of Japanese television and a 1980–2023 study of Japanese films found Filipino victims scarcely represented or omitted entirely. Unlike Chinese and Korean victims, whose narratives remain visible owing to activism and diplomatic pressures, Filipino experiences have been marginalized. This study reveals Japan’s selective war memory and advocates for addressing overlooked histories and fostering inclusive media representation to enhance societal cohesion and strengthen Japan’s international relations.
Asymptomatic bacteriuria (ASB) frequently results in inappropriate antimicrobial use. Urinalysis (UA)-driven reflex urine culture order sets can reduce inappropriate urine cultures. Most special indications on free text overrides within a (UA)-driven reflex culture protocol were inappropriately defined and rarely symptom-based. Eliminating the “other” indication could strengthen diagnostic stewardship and reduce unnecessary urine cultures.
The discovery of radiocarbon (14C) peaks in AD 774–775 and AD 993–994 sparked the search for other anomalous events, leading to the identification of one around 660 BC. However, the ∼660 BC event appears to show a more prolonged increase, raising the question whether the event is qualitatively different. To investigate this, we measured high-latitude tree rings from Finnish Lapland, expected to be highly sensitive to energetic particle events. We measured the 14C content of full rings, as well as their separated earlywood and latewood components. We found that the 14C concentrations start rising already in the latewood of 665 BC and reach almost its full intensity by 664 BC. This rapid increase is similar to that at another high-latitude site (Yamal, Russia) but contrasts with that of low-latitude sites, which show a later peak. The earlier increase of the 14C at high-latitude tree rings compared to lower latitudes is consistent with similar observations for the AD 774 and AD 993 Miyake events. Based on carbon-cycle box modeling, the structure of the subsequent amplitude increase can be explained by either single or double initial 14C pulses. The fast increase coupled with a slower subsequent peak structure suggests similar mechanisms behind the high-latitude observations, i.e., tropospheric 14C production and/or a fast component of polar air flow across the tropopause combined with the full stratospheric-tropospheric CO2 exchange. Our results strongly emphasize the need for dynamic carbon cycle models to understand the observed differences between high- and lower-latitude data.
Vortical flows over spinning cones with half-angles of $\theta _c =$$10^\circ$, $15^\circ$, $22.5^\circ$, $30^\circ$ and $45^\circ$ at incidence angles of $\alpha$ between 0$^\circ$ and 36$^\circ$ are experimentally studied employing smoke streak flow visualisation and planar particle image velocimetry at Reynolds numbers of $\mathcal{O}(10^4)$ and base rotational speed ratios between 0 and 3. Symmetric vortex triads are observed on the leeward side of the stationary cones at incidence that grow in cross-section and strength along the surface. Spin breaks down this symmetry. Asymmetries in the vortex systems over the spinning cones are characterised by anti-cyclonic vortices forming in the counter-rotating meridian and cyclonic vortices in the co-rotating meridian. The anti-cyclonic vortices increase in strength as they are pushed in the direction of rotation and embrace the surface of the cone, whereas cyclonic vortices detach from the surface and exhibit unchanging vortex strength. For the most slender cone of $\theta _c = 10^\circ$, the cyclonic vortices are pushed past the plane of symmetry into the counter-rotating meridian and are squeezed between the anti-cyclonic vortex and the surface of the cone. This appears to trigger the detachment of the anti-cyclonic vortices. The thickest cone of $\theta _c = 45^\circ$ exhibits characteristics similar to flows over a disc (Kuraan & Savaş J. Visual. vol. 23, 2024, pp. 191–205), a limiting case of the cone family. As $\alpha$ increases, the stagnation point departs from the vertex and monotonically shifts along the windward surface. Regular vortex shedding events in the wake region behind the $\theta _c=45^\circ$ cone are detected in the streakline images, also a common characteristic of flows over discs. Wave patterns are observed near the leeward surface of spinning cones, which are likely signatures of the well-known centrifugal spiral wave instabilities. The bead-like features leave small-scale wave patterns on detached portions of the neighbouring trailing vortices. Inclined wave patterns form on streaklines over the entire surface of the cones, and are present in both non-spinning and spinning cases; hence, they are likely signatures of classical cross-flow boundary layer instabilities.
The Finnish parental leave system has undergone numerous reforms to encourage fathers’ leave uptake, in part to redress unequal divisions of early childcare, yet many fathers have not taken full advantage of it. Leave is usually taken from the workplace, and though workplace factors are often cited as typical barriers to uptake, they remain understudied compared to policy and individual-level motivators. We systematically investigated the association of important workplace structural characteristics and parental leave decisions of private-sector-employed first-time fathers in 2013–2017, using Finnish register data and a multilevel Bayesian approach. While the probability of taking father’s quota varied by workplace gendered structures and competitiveness, these differences were due to the selection of fathers into workplaces on individual-level characteristics, rather than resulting from differing workplace structures. Workplace educational level was important, but only for tertiary-educated fathers: highly-educated fathers in low-educated environments were less likely to take longer leaves, suggesting that replaceability may be the main mechanism behind the differences. These findings suggest that differing workplace contexts have less to do with structural factors than with workplace cultures and fathers’ individual situations, calling for further study on the interplay of individual and contextual factors in usage of paternal leave entitlements.
How does the politicization of identities like race, ethnicity, religion or sexual orientation shape populist activism on the left? In this article, I demonstrate that left-wing populists engaged in identity politics resort to two contrasting – but not incompatible – types of activism: identity-based advocacy and identity-based threat construction. The paper examines these types of activism by studying how four major populist leaders on the left – two leaders each from Europe (Jean-Luc Mélenchon and Sahra Wagenknecht) and Africa (Ousmane Sonko and Julius Malema) – have positioned themselves vis-à-vis specific identity groups. Building on the distinction between identity-based advocacy and threat construction, the article conceptualizes different types of identity-based populist references. The paper thereby contributes to existing research as it detects how left-wing populist leaders integrate identity politics into the discursive construction of the elite vs. the people antagonism. Finally, by facilitating comparative cross-area research on a specific branch of leftism, the paper also goes beyond existing debates about leftist identity politics.
This paper argues that to liberal authoritarianism – defined here as a liberal technique of government fusing authoritarianism with liberalism for the purpose of the ‘free market’, following Hermann Heller – corresponds a form of dual constitutionalism or fragmented legality. Dual constitutionalism, originally a colonial technique of governance, relies on a liberal constitution enshrining a state of exception which suspends it on specific matters, territories, and during certain times. It can be either military – called in France the ‘state of siege’, the continental version of the British Martial Law – or civilian – the ‘state of emergency’. In the case of France, liberal authoritarianism has witnessed several declinations since the French Revolution, flourishing in the liberal colonialism of the late 19th century, then the full-fledged liberal authoritarianism of the interwar period, and eventually in the neoliberal authoritarianism of the 4th and 5th republic. Focusing on the relationship between France and its Algerian colony during the Third Republic (1870–1940), one of the most liberal periods ever in French history, it documents how the State of Exception was used to establish a legalised state of dictatorship where all executive, legislative and judicial powers were vested in the hands of a governor, in order to force the creation of markets by breaking down collective land ownership and use and other non-liberal economic customs of the local population, using, in particular, the legal tool of the ‘sequestre’ which allowed the State to forcibly expropriate land and seize assets of the local population without compensation, forced labour and internment camps – all in order to incentivise ‘free enterprise’ by the colonisers. Many of these legal tools and techniques migrated back to the metropolis when the Third Republic officially dissolved into a Nazi State in 1940, through legal means and in accordance with the constitutional procedures of the Third Republic.
Antimicrobial resistance (AMR) is among the most urgent global health challenges of our time. However, it is also a human rights and environmental crisis deeply entwined with climate change, biodiversity loss, and pollution. Historically, AMR was framed as a public health challenge, with little consideration given to its environmental factors and human rights implications. In this article, we examine AMR through the lens of the right to a healthy environment, exploring whether a normative human rights framework could open up new avenues to seek justice and accountability for the environmental drivers of AMR. Drawing on recent developments in international law, we suggest that this newly recognized right widens the narrative of AMR, drawing attention to the role of microbial environments in the global ecosystem and compelling more holistic responses that extend beyond public health interventions to address the underlying structural inequalities and environmental drivers of AMR.
Microswimmers in suspension exhibit collective swimming behaviour, forming various self-organised structures including ordered, aggregated and turbulent-like structures. When mixed with passive particles phase-separation is known to occur, but due to the difficulty of accurately handling many-body hydrodynamic interactions, the formation of self-organised structures in mixed suspensions has remained unexplored so far. In this study, we investigate the dynamics of mixed dense suspensions of spherical bottom-heavy squirmers and obstacle spheres using Stokesian dynamics in three dimensions, taking hydrodynamic interactions into account. The results show that without an external orienting mechanism the formation of orientational order is in general disturbed by the presence of passive spheres. An initially phase-separated state is metastable for neutral or puller squirmers at high packing densities. When the squirmers are bottom-heavy, phase-separation can occur dynamically in some cases, notably as a fibrillar kind of separation for neutral squirmers and pullers at medium densities. We also observed a novel form of lamellar phase-separation for pullers at high densities with strong bottom-heaviness, with a sandwich-like structure consisting of a layer of passive particles pushed by a layer of swimmers, followed by a gap. These results indicate that microstructure and particle transport undergo significant changes depending on the type of swimmer, highlighting the importance of hydrodynamic interactions. These insights allow for a deeper understanding of the behaviour of active particles in complex fluids and to control them using external torques.