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Hidden Markov models (HMMs) are popular for modeling complex, longitudinal data. Existing identifiability theory for conventional HMMs assume emission probabilities are constant over time and the Markov chain governing transitions among the hidden states is irreducible, which are assumptions that may not be applicable in all educational and psychological research settings. We generalize existing conditions on homogeneous HMMs by considering heterogeneous HMMs with time-varying emission probabilities and the potential for absorbing states. Researchers are investigating a family of models known as restricted HMMs (RHMMs), which combine HMMs and restricted latent class models (RLCMs) to provide fine-grained classification of educationally and psychologically relevant attribute profiles over time. These RHMMs leverage the benefits of RLCMs and HMMs to understand changes in attribute profiles within longitudinal designs. The identifiability of RHMM parameters is a critical issue for ensuring successful applications and accurate statistical inference regarding factors that impact outcomes in intervention studies. We establish identifiability conditions for RHMMs. The new identifiability conditions for heterogeneous HMMs and RHMMs provide researchers insights for designing interventions. We discuss different types of assessment designs and the implications for practice. We present an application of a heterogeneous HMM to daily measures of positive and negative affect.
People with HIV (PWH) often encounter health-harming legal needs that impede their access to care, including structural issues such as racism, discrimination, unstable housing, and stigma. Medical-Legal Partnerships (MLPs) have emerged as a promising strategy to address these challenges within HIV care settings. This study aimed to identify the characteristics and strategies of MLPs that are most effective in improving HIV care continuum outcomes. A mixed-methods analysis was conducted utilizing data from a cross-sectional survey of 60 providers in MLPs. Categorical features of MLPs, such as the personnel responsible for screening for health-harming legal needs (HHLN), the organizational structure (community-based vs. institutional), and the delivery of legal services, were examined. A multiple, variable linear regression analysis was conducted to explore the association between these variables and outcomes. Community health organizations were found to be associated with a greater number of patients achieving suppressed HIV viral load. Additionally, a higher number of on-site services were positively correlated with a greater percentage of PWH achieving decreased viral load and completing follow-up appointments. Findings underscore the significance of comprehensive care approaches within MLPs for enhancing positive patient outcomes in HIV care settings.
Auditory hallucinations (hearing voices in the absence of physical stimuli) are present in clinical conditions, but they are also experienced less frequently by healthy individuals. In the non-clinical population, auditory hallucinations are described more often as positive and not intrusive; indeed, they have received less attention.
Aims
The present study explores the phenomenology of non-clinical auditory hallucinations and their possible relationship with religiosity.
Method
Starting from previous findings suggesting that non-clinical auditory hallucinations are often described as a gift or a way to be connected with ‘someone else’, we administered standardised questionnaires to quantify proneness to experiencing auditory hallucinations, religiosity and anxiety/depression scores.
Results
Regression analysis carried out using an auditory hallucinations, index as the dependent variable on a final sample of 680 responders revealed that a total of 31% of the variance was explained by a five-steps model including demographic characteristics (i.e. being young, a woman and a non-believer) and negative (e.g. being afraid of otherworldly punishments) and positive (e.g. believing in benevolent supernatural forces) components of religiosity, anxiety and depression. Crucially, compared with believers, non-believers revealed higher scores in depression, anxiety and in a specific questionnaire measuring proneness to auditory hallucinations.
Conclusions
Results suggests that religiosity acts as a potential protective factor for proneness to paranormal experiences, but a complex relationship emerges between religious beliefs, mood alterations and unusual experiences.
This study, grounded in critical disability studies, explores ableism in language education and its impact on Deaf and hard of hearing (DHH) students learning English as a foreign or third language (L3). Using interpretative phenomenological analysis, the lived experiences of 14 Iranian DHH undergraduate students, proficient in Esharani (sign language used by the Iranian Deaf community) and Persian, were analyzed. Participants recounted their experiences with ableism in English education through interviews. Analyzing interviews resulted in the emergence of three key themes: a) lack of awareness of (dis)ability and ableism throughout their English education, b) the prevalence of overt and covert ableism viewing deafness as a marker of “otherness,” and c) the need for advocacy and more inclusive practices and environments for DHH learners acquiring L3. This study highlights the challenges DHH learners face in L3 acquisition and calls for more inclusive language education policies to better support disabled students.
Patients with posttraumatic stress disorder (PTSD) exhibit smaller regional brain volumes in commonly reported regions including the amygdala and hippocampus, regions associated with fear and memory processing. In the current study, we have conducted a voxel-based morphometry (VBM) meta-analysis using whole-brain statistical maps with neuroimaging data from the ENIGMA-PGC PTSD working group.
Methods
T1-weighted structural neuroimaging scans from 36 cohorts (PTSD n = 1309; controls n = 2198) were processed using a standardized VBM pipeline (ENIGMA-VBM tool). We meta-analyzed the resulting statistical maps for voxel-wise differences in gray matter (GM) and white matter (WM) volumes between PTSD patients and controls, performed subgroup analyses considering the trauma exposure of the controls, and examined associations between regional brain volumes and clinical variables including PTSD (CAPS-4/5, PCL-5) and depression severity (BDI-II, PHQ-9).
Results
PTSD patients exhibited smaller GM volumes across the frontal and temporal lobes, and cerebellum, with the most significant effect in the left cerebellum (Hedges’ g = 0.22, pcorrected = .001), and smaller cerebellar WM volume (peak Hedges’ g = 0.14, pcorrected = .008). We observed similar regional differences when comparing patients to trauma-exposed controls, suggesting these structural abnormalities may be specific to PTSD. Regression analyses revealed PTSD severity was negatively associated with GM volumes within the cerebellum (pcorrected = .003), while depression severity was negatively associated with GM volumes within the cerebellum and superior frontal gyrus in patients (pcorrected = .001).
Conclusions
PTSD patients exhibited widespread, regional differences in brain volumes where greater regional deficits appeared to reflect more severe symptoms. Our findings add to the growing literature implicating the cerebellum in PTSD psychopathology.
The control of standard contract terms has become one of the most important yet controversial areas of contract law. By comparing the Directive 93/13/EEC on unfair terms in consumer contracts with the recently adopted US Restatement of Consumer Contracts, this Article sheds light on the relative strengths and weaknesses of the EU and US regulatory approaches to the use of standard terms in consumer contracts. Particular emphasis is placed on the review of dispute resolution clauses. The central thesis of this Article is that the personal scope of the European and US consumer contract control regimes should be broadened to protect small and medium sized enterprises and that their interplay with private international law needs to be clarified.
Organizations often face moral dilemmas. For example, in 2004 the UN Refugee Agency (UNHCR) needed to decide whether to help refugees in enclosed camps in Pakistan repatriate to Afghanistan. On the one hand, helping with repatriation might have made UNHCR complicit in forced returns, as refugees sought to repatriate just to avoid life without freedom in Pakistan. On the other hand, refusing to help with repatriation would leave refugees stranded in camps: perhaps repatriation was the best option if this was what refugees wanted. When organizations face this and other dilemmas, it is not clear how they should proceed. In other words, it is unclear which policy they should pursue when all feasible policies seem wrong. Some might think that, at least for hard dilemmas, every choice is just wrong, and so no choice is right. But that is not quite true. Even difficult dilemmas can be resolved using certain methods. One method is to ask those affected by potential policies what they think the most justifiable policy is. A second method is to choose what to do randomly. Randomly selecting a course of action can sometimes be the fairest way of determining what to do when every option seems wrong.
This article is an exploration of how Christian influences manifested in Indigenous rock art, comparing two distinct case studies: western Arnhem Land in northern Australia and the southern Andes in north-central Chile. The analysis aims to understand the intersection between Indigenous artistic traditions and the introduction of Christianity through European colonization. Our comparative analysis reveals significant regional differences. In western Arnhem Land, the scarcity of Christian imagery suggests resistance to or avoidance of religious symbols, while in north-central Chile, the prevalence of Christian symbols indicates a more profound incorporation of Christianity into Indigenous artistic practices. These findings underscore the importance of considering local contexts and historical processes when examining the impact of colonization on Indigenous art. Understanding these differences provides valuable insights into the complex interactions between Indigenous cultures and European colonizers, revealing resistance and adaptation in the face of profound social and religious changes.
Witness testimony in a judicial setting is commonly viewed as a form of evidence—a means to inform a judicial body of relevant facts in a given case. In this perspective, witnesses are merely instrumental to the process of adjudication. While this viewpoint provides a useful account of how we think of witness testimony in courts today, it is illsuited to the way witnesses and their role were perceived in the ancient world. Drawing on a cross-cultural analysis of ancient and late antique texts, the article recovers a different perception of the role of witnesses that once prevailed in the societies that gave rise to Western civilization. According to this alternate view, witnesses were not seen as passive providers of information but rather as active agents with the power to adjudicate—a role that we would now associate with judges. The article offers a new conceptualization of this historical transformation, outlining two paradigms that can help us critically examine the implied assumptions about the role of witnesses in adjudication: “the instrumental paradigm,” which is dominant in contemporary thought, and “the authoritative paradigm,” emerging from ancient texts, wherein witnesses held a far more authoritative role than the contemporary understanding suggest. The study argues that the instrumental paradigm reflects a radical transformation in the meanings of testimony and witness as legal concepts—a shift that marks an unexamined revolution in the history of legal thought.
The Anti-Extradition Bill Movement in 2019 sparked the most radical mass protests seen in Hong Kong since the transfer of sovereignty. Scholars have proposed various explanations for the radicalization of the protests, as well as for the mass support for this radicalization across various sectors of society. However, economic grievances have been relatively downplayed in attempts to understand the radical protests. Using data from a survey conducted during the suspension of the movement in 2020 (N = 1,574), this study examines the relationship between economic grievances and support for the protests. Through mediation analysis, the findings show that individuals who perceived themselves as belonging to a lower class tended to have a diminished sense of social mobility and equality. These negative perceptions contributed to concerns about the activities of Mainland Chinese individuals and the use of public resources. Thus, these particular economic grievances were found to be positively associated with support for the 2019 movement.
Plasma-terminating disruptions represent a critical outstanding issue for reactor-relevant tokamaks. ITER will use shattered pellet injection (SPI) as its disruption mitigation system to reduce heat loads, vessel forces and to suppress the formation of runaway electrons. In this paper we demonstrate that reduced kinetic modelling of SPI is capable of capturing the major experimental trends in ASDEX Upgrade SPI experiments, such as dependence of the radiated energy fraction on neon content, or the current quench dynamics. Simulations are also consistent with the experimental observation of no runaway electron generation with neon and mixed deuterium–neon pellet composition. We also show that statistical variations in the fragmentation process only have a notable impact on the disruption dynamics at intermediate neon doping, as was observed in experiments.
The essay examines the lessons from the international intervention in Afghanistan, highlighting the failures of externally imposed state building, including neglect of local governance structures and prioritizing donor interests over Afghan ownership. The international peace- and state-building intervention in Afghanistan, which spanned two decades, culminated in the abrupt withdrawal of U.S. troops in 2021, leading to the Taliban’s swift resurgence. This event has sparked a critical examination of the strategies employed by NATO and allied nations during their engagement in Afghanistan. This essay aims to distill seven key lessons from this intervention, emphasizing the need for future peacebuilders to adapt their approaches to better align with local contexts and realities. The analysis highlights the failures of liberal peacebuilding, the importance of local ownership, the necessity of effective and legitimate institutions, and the detrimental impact of corruption. Furthermore, it underscores the significance of coherence among international actors and the need for a nuanced understanding of regional dynamics. By reflecting on these lessons, the essay seeks to provide actionable insights for future international interventions in fragile and conflict-affected states.
This paper reports a study that investigated how first language (L1) reading comprehension, L1 low-level skills, working memory capacity, and reading anxiety are related to the accuracy of responses and completion time in a second language (L2) reading test. The data obtained from Hungarian secondary school learners of English showed that anxiety related to processing the L2 reading text, time pressure, and the response tasks as well as L1 reading comprehension scores and backward digit span were significant predictors of L2 reading scores. L1 low-level skills did not contribute significantly to L2 reading accuracy. Higher levels of reading-related anxiety were associated with slower reading, and L2 learners with concurrently lower levels of L1 and L2 reading ability needed more time to complete the reading test. These findings highlight that L2 reading tests should be flexibly timed so that everyone, including test takers with literacy-related difficulties such as dyslexia, can demonstrate their abilities.
Cultural evolution of traditional music around the world has been the subject of recent quantitative investigations. Researchers have explored cultural diffusion of music as well as patterns of geographic variation that may result. By comparison, less has been studied about the process of music diversification; in particular, under what circumstances music diversifies is yet to be understood. In this study, we examine possible factors that may facilitate music diversification, using data from folk songs in the Ryukyu Archipelago, south-western islands of Japan. For a quantitative analysis, we first transform the melody of each folk song, following an automated scheme, into a sequence of alphabets, which is then used to quantify the melodic dissimilarity between each pair of songs. Our particular interest is in the dissimilarity between putative sister songs, or songs that are inferred to have derived from a common origin, and factors that have positive or negative effects on it. Our results suggest that sister songs tend to diversify more when they are sung in different islands, probably as a result of one being transmitted from one island to another, and when they have come to be sung in different social contexts.
We investigate the energy transfer from the mean profile to velocity fluctuations in channel flow by calculating nonlinear optimal disturbances, i.e. the initial condition of a given finite energy that achieves the highest possible energy growth during a given fixed time horizon. It is found that for a large range of time horizons and initial disturbance energies, the nonlinear optimal exhibits streak spacing and amplitude consistent with direct numerical simulation (DNS) at least at ${Re}_\tau = 180$, which suggests that they isolate the relevant physical mechanisms that sustain turbulence. Moreover, the time horizon necessary for a nonlinear disturbance to outperform a linear optimal is consistent with previous DNS-based estimates using eddy turnover time, which offers a new perspective on how some turbulent time scales are determined.
Exoskeletons that make running easier could increase users’ physical activity levels and provide related health benefits. In this paper, we present the design of a portable, powered ankle exoskeleton that assists running and uses lightweight and compact twisted string actuators. It has limited durability at this stage of development, but preliminary results of its power to mass density and potential for reducing the metabolic cost of running are promising. The exoskeleton can provide high peak power of 700 W per leg, 7 times more than prior twisted-string devices, and high peak torques of 43 Nm. Kinetostatic and dynamic models were used to select mass-optimal components, producing a device that weighs 1.8 kg per leg and 2.0 kg in a backpack. We performed preliminary tests on a single participant to evaluate the exoskeleton performance during both treadmill running and outdoor running. The exoskeleton reduced metabolic energy use by 10.8% during treadmill running tests and reduced cost of transport by 7.7% during outdoor running tests compared to running without the device. Unfortunately, the twisted string wore out quickly, lasting an average of 4 min 50 s before breaking. This exoskeleton shows promise for making running easier if string life challenges can be addressed.
To achieve more efficient and comprehensive maternal and child health (MCH) care services in rural areas through optimizing resource allocation and enhancing service quality.
Background:
With the increasing awareness of health among rural residents and the growing demand for MCH care, township health centers, as a crucial component of primary medical services, have emerged as a key factor in ensuring the health of women and children in rural areas.
Methods:
Using a multi-stage stratified random sampling method, this study conducted on-site investigations on 49 township health centers across six districts and counties of Guilin, Guangxi. Descriptive statistics, entropy weight coefficient method, Data Envelopment Analysis (DEA) Banker–Charnes–Cooper (BCC) Model and Malmquist index were employed for dynamic analysis.
Findings:
The results indicate an upward trend in the incidence rates of birth defects and low birth weight in MCH services. Disparities in efficiency across regions are observed, which are associated with the economic status and capacity of MCH services in each area. Dynamic results from the Malmquist index show that the total factor productivity of MCH services experienced an upward trend from 2016 to 2021, with efficiency primarily influenced by scale efficiency. Updating management concepts is crucial for effectively addressing the relationship between scaling up and quality improvement.
The secrecy of intelligence institutions might give the impression that intelligence is an ethics-free zone, but this is not the case. In The Ethics of National Security Intelligence Institutions, Adam Henschke, Seumas Miller, Andrew Alexandra, Patrick Walsh, and Roger Bradbury examine the ways that liberal democracies have come to rely on intelligence institutions for effective decision-making and look at the best ways to limit these institutions’ power and constrain the abuses they have the potential to cause. In contrast, the value of Amy Zegart’s and Miah Hammond-Errey’s research, in their respective books, Spies, Lies, and Algorithms: The History and Future of American Intelligence and Big Data, Emerging Technologies and Intelligence: National Security Disrupted, is the access each of them provides to the thoughts and opinions of the intelligence practitioners working in these secretive institutions. What emerges is a consensus that the fundamental moral purpose of intelligence institutions should be truth telling. In other words, intelligence should be a rigorous epistemic activity that seeks to improve decision-makers’ understanding of a rapidly changing world. Moreover, a key ethical challenge for intelligence practitioners in liberal democracies is how to do their jobs effectively in a way that does not undermine public trust. Measures recommended include better oversight and accountability mechanisms, adoption of a ‘risk of transparency’ principle, and greater understanding of and respect for privacy rights.
We present a simulation study based on a cognitive architecture that unifies various early language acquisition phenomena in laboratory and naturalistic settings. The model adaptively learns procedures through trial-and-error using general-purpose operators, guided by learned contextual associations to optimise future performance. For laboratory-based studies, simulated preferential focusing explains the delayed behavioural onset of statistical learning and the possible age-related decrease in algebraic processing. These findings suggest a link to continuous, implicit learning rather than explicit strategy acquisition. Moreover, procedures are not static but can evolve over time, and multiple plausible procedures may emerge for a given task. Besides, the same model provides a proof-of-concept for word-level phonological learning from naturalistic infant-directed speech, demonstrating how age-related processing efficiency may influence learning trajectories implicated in typical and atypical early language development. Furthermore, the artile discusses the broader implications for modelling other aspects of real-world language acquisition.
The brachyurans Tehuacana tehuacana Stenzel, 1944 and Dromilites americana Rathbun, 1935 have historically been difficult to place in families. A reevaluation of type and referred material from several institutions suggests that the two species are referrable to separate genera in Palaeoxanthopsidae. Hyphalocarcinus new genus is erected to accommodate H. americanus new combination, and Tehuacana remains a distinct genus. Palaeoxanthopsidae evolved and radiated in the Atlantic Ocean, ranging from Late Cretaceous (Maastrichtian) to early Eocene (Ypresian) in age. This work adds to the known diversity of Palaeoxanthopsidae and demonstrates that the family survived and thrived in the Atlantic Ocean in the wake of the end-Cretaceous extinction. Differential preservation of specimens must be evaluated carefully when placing superficially similar taxa at the family, genus, and species level.