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Borderline personality disorder (BPD) is a debilitating psychiatric illness whose symptoms frequently emerge during adolescence. Critically, self-injury and suicide attempts in BPD are often precipitated by interpersonal discord. Initial studies in adults suggest that the interpersonal difficulties common in BPD may emerge from disrupted processing of socioemotional stimuli. Less is known about these processes in adolescents with BPD symptoms, despite substantial changes in socioemotional processing during this developmental period.
Methods
Eighty-six adolescents and young adults with and without BPD symptoms completed an emotional interference task involving the identification of a facial emotion expression in the presence of a conflicting or congruent emotion word. We used hierarchical drift diffusion modeling to index speed of processing and decision boundary. Using Bayesian multilevel regression, we characterized age-related differences in facial emotion processing. We examined whether BPD symptom dimensions were associated with alterations in facial emotion processing. To determine the specificity of our effects, we analyzed behavioral data from a corresponding nonemotional interference task.
Results
Emotion-related impulsivity, but not negative affectivity or interpersonal dysfunction, predicted inefficient processing when presented with conflicting negative emotional stimuli. Across both tasks, emotion-related impulsivity in adolescents, but not young adults, was further associated with a lower decision boundary – resulting in fast but inaccurate decisions.
Conclusion
Impulsive adolescents with BPD symptoms are prone to making errors when appraising facial emotion expressions, which may potentiate or worsen interpersonal conflicts. Our findings highlight the role of lower-level social cognitive processes in interpersonal difficulties among vulnerable youth during a sensitive developmental window.
A range of chronic ear complaints may be attributed to Eustachian tube dysfunction. Eustachian tube dysfunction secondary to a deviated nasal septum has been described in several clinical studies, with symptomatic improvement demonstrated following septoplasty. However, uncertainty exists as to the size of the effect and consistency between studies.
Methods
Electronic searches were carried out of Pubmed, Embase and the Cochrane Library for adult patients with complaints of nasal obstruction and/or impairment and/or complaints of ear fullness undergoing nasal surgery.
Results
Seven studies met the inclusion criteria. Studies evaluated the effect of nasal surgery on Eustachian tube dysfunction using a variety of outcomes, including Eustachian tube function tests, the Eustachian Tube Dysfunction Questionnaire-7, tympanometry and Nasal Obstruction Symptom Evaluation scores. The results demonstrated the positive impact of nasal surgery on various outcomes related to Eustachian tube dysfunction.
Conclusion
Nasal surgery has been demonstrated to have promising results as a therapeutic option for patients with Eustachian tube dysfunction and a deviated nasal septum, offering significant symptom relief and improved quality of life. Through the integration of the treatment of nasal symptoms in the management of Eustachian tube dysfunction, clinicians can adopt a comprehensive approach to addressing the underlying pathologies contributing to Eustachian tube dysfunction.
In this paper, we derive simple analytical bounds for solutions of $x - \ln x = y -\ln y$, and use them for estimating trajectories following Lotka–Volterra-type integrals. We show how our results give estimates for the Lambert W function as well as for trajectories of general predator–prey systems, including, for example, Rosenzweig–MacArthur equations.
A fundamental pillar of science is the estimation of the effect size of associations. However, this task is sometimes difficult and error-prone. To facilitate this process, the R package metaConvert automatically calculates and flexibly converts multiple effect size measures. It applies more than 120 formulas to convert any relevant input data into Cohen’s d, Hedges’ g, mean difference, odds ratio, risk ratio, incidence rate ratio, correlation coefficient, Fisher’s r-to-z transformed correlation coefficient, variability ratio, coefficient of variation ratio, or number needed to treat. Researchers unfamiliar with R can use this software through a browser-based graphical interface (https://metaconvert.org/). We hope this suite will help researchers in the life sciences and other disciplines estimate and convert effect sizes more easily and accurately.
Mass casualty incidents (MCI) overwhelm health care systems; however, MCIs are infrequent and require ongoing preparatory efforts. Although there is dedicated disaster medicine education in emergency medicine, most pediatric emergency medicine (PEM) fellows complete pediatric residencies. Pediatric residents have variable exposure to disaster training as part of their curriculum. To improve this, a quality improvement (QI) initiative was implemented to increase MCI comfort and knowledge amongst PEM fellows.
Methods
This study took place in a single-center tertiary pediatric hospital, amongst 1 cohort of PEM fellows. Following a baseline survey, a key driver diagram was developed to guide Plan-Do-Study-Act (PDSA) cycles. A focused disaster curriculum was provided to fellows and specific quick references were developed. Knowledge application interventions included mock triage, response scavenger hunt, and tabletop MCI exercise.
Results
PEM fellow comfort and knowledge of MCI response improved from an average of 2.93 to 6.56 on a 10-point Likert scale, and 3.71 to 6.58 on 10-point Likert scale respectively following the active intervention cycle and showed sustained results over a 6-month period without further interventions.
Conclusions
Utilizing QI methodology, PEM fellow comfort with MCI response, and knowledge of MCI response increased. As MCIs are a rare occurrence, ongoing assessment is necessary to evaluate the need for further interventions to maintain knowledge and comfort levels.
As the use of guided digitally-delivered cognitive-behavioral therapy (GdCBT) grows, pragmatic analytic tools are needed to evaluate coaches’ implementation fidelity.
Aims
We evaluated how natural language processing (NLP) and machine learning (ML) methods might automate the monitoring of coaches’ implementation fidelity to GdCBT delivered as part of a randomized controlled trial.
Method
Coaches served as guides to 6-month GdCBT with 3,381 assigned users with or at risk for anxiety, depression, or eating disorders. CBT-trained and supervised human coders used a rubric to rate the implementation fidelity of 13,529 coach-to-user messages. NLP methods abstracted data from text-based coach-to-user messages, and 11 ML models predicting coach implementation fidelity were evaluated.
Results
Inter-rater agreement by human coders was excellent (intra-class correlation coefficient = .980–.992). Coaches achieved behavioral targets at the start of the GdCBT and maintained strong fidelity throughout most subsequent messages. Coaches also avoided prohibited actions (e.g. reinforcing users’ avoidance). Sentiment analyses generally indicated a higher frequency of coach-delivered positive than negative sentiment words and predicted coach implementation fidelity with acceptable performance metrics (e.g. area under the receiver operating characteristic curve [AUC] = 74.48%). The final best-performing ML algorithms that included a more comprehensive set of NLP features performed well (e.g. AUC = 76.06%).
Conclusions
NLP and ML tools could help clinical supervisors automate monitoring of coaches’ implementation fidelity to GdCBT. These tools could maximize allocation of scarce resources by reducing the personnel time needed to measure fidelity, potentially freeing up more time for high-quality clinical care.
The idea of a “public humanities” reflects a specific understanding not only of the humanities as a field of interest or set of disciplines but also of citizens’ needs in a democracy. This understanding was most fully articulated in the United States, where it informed the national understanding of the goals of education that emerged in the aftermath of WWII. What distinguishes the American conception of the humanities from other systems is the place of privilege accorded the activities of interpretation and judgment, and the conviction that these were most effectively inculcated through the study of literature.
Plusieurs personnes atteintes d’un cancer incurable sont des hommes, âgés de plus de 65 ans. Même si, à notre connaissance, aucune recherche ne porte sur les souffrances de ces hommes, des écrits dévoilent que ces dernières pourraient être considérables. Les réalités du vieillissement au masculin couplées à celles d’être atteint d’une maladie incurable peuvent effectivement engendrer des souffrances particulières. Cette recherche qualitative vise à mieux comprendre les souffrances vécues par les hommes âgés atteints d’un cancer incurable (HACI). Nous explorerons si et comment leurs souffrances se rapportent à des enjeux identitaires de genre et/ou aux transformations de leurs rôles. Dix-sept hommes âgés de 65 ans et plus atteints d’un cancer incurable furent rencontrés en milieu urbain (Montréal) dans le cadre d’entretiens semi-dirigés. L’analyse thématique des résultats a permis de relever des enjeux identitaires et de rôles, la nature des changements affectant l’identité et ses rôles et les enjeux de genre vécus par les HACI.
Understanding the dynamics of flames at small scales opens up opportunities to enhance the performance of small-scale power generation devices, micro-reactors, fire safety devices and numerous other systems that confine combustion to micro/meso scales. The current study investigates the dynamics of laminar premixed methane–air flames in meso-scale channels. A cylindrical quartz tube, functioning as an optically accessible meso-scale combustor, is externally heated by a primary heater to facilitate the auto-ignition of the reactant mixture flowing through the tube. Experiments were conducted over a wide range of Reynolds numbers ($Re$) and equivalence ratios ($\Phi$). Apart from the previously documented observations of unsteady flames with repetitive extinction and ignition (FREI) characteristics, this study identifies an additional unsteady propagating flame (PF) regime. While FREI appeared at stoichiometric and fuel-rich conditions, PFs were observed at the equivalence ratio of $0.8$. Unlike the FREI regime, where the flame extinguishes after a characteristic travel distance, PFs continue to travel till they reach the upstream end of the combustor tube, where they extinguish upon encountering a meshed constriction. These flames are associated with a characteristic heat release rate oscillation that couples with the pressure fluctuations at frequencies close to the natural harmonic of the combustor tube. The study further investigates how variations in the wall temperature profile affect the dynamics of FREI and PF regimes. To achieve this, a secondary heater is introduced at varying distances from the primary heater, effectively imposing distinct bimodal wall heating profiles over the combustor tube. The observations and trends from the study were justified using simplified theoretical arguments based on the estimate of the mean flow temperature of the reactant mixture and a flame propagation model that accounts for wall heat losses. The novel findings from this work provide valuable insights that can significantly impact the design and development of advanced micro/meso-scale combustion systems.
Machine learning has exhibited substantial success in the field of natural language processing (NLP). For example, large language models have empirically proven to be capable of producing text of high complexity and cohesion. However, at the same time, they are prone to inaccuracies and hallucinations. As these systems are increasingly integrated into real-world applications, ensuring their safety and reliability becomes a primary concern. There are safety critical contexts where such models must be robust to variability or attack and give guarantees over their output. Computer vision had pioneered the use of formal verification of neural networks for such scenarios and developed common verification standards and pipelines, leveraging precise formal reasoning about geometric properties of data manifolds. In contrast, NLP verification methods have only recently appeared in the literature. While presenting sophisticated algorithms in their own right, these papers have not yet crystallised into a common methodology. They are often light on the pragmatical issues of NLP verification, and the area remains fragmented. In this paper, we attempt to distil and evaluate general components of an NLP verification pipeline that emerges from the progress in the field to date. Our contributions are twofold. First, we propose a general methodology to analyse the effect of the embedding gap – a problem that refers to the discrepancy between verification of geometric subspaces, and the semantic meaning of sentences which the geometric subspaces are supposed to represent. We propose a number of practical NLP methods that can help to quantify the effects of the embedding gap. Second, we give a general method for training and verification of neural networks that leverages a more precise geometric estimation of semantic similarity of sentences in the embedding space and helps to overcome the effects of the embedding gap in practice.
Do ideologically extreme candidates enjoy fundraising advantages over more moderate candidates? Extant work documents a relationship between candidates’ positions and campaign contributions subnationally and in donor surveys, yet identification challenges have hampered investigation in the congressional context. I employ a close primaries regression discontinuity design to examine how “as-if random” nominations of extreme versus moderate House candidates influence general election contributions from individual donors and corporate political action committees (PACs) from 1980 to 2020. Results at both the nominee and contributor levels demonstrate that corporate PACs financially penalize extremists, while individual donors respond similarly to extreme and moderate candidates. These findings contribute to ongoing debates regarding the extent and nature of campaign contributors’ role in congressional polarization.
This article examines the death of Colin Roach in Stoke Newington Police Station, Hackney, in 1983, and explores the emotional politics of the campaigns that followed his death. These campaigns were focused on both determining the circumstances of Roach's death and highlighting tensions between the police and the Black community of Hackney. Using hitherto unpublished archival sources, local newspapers, and visual sources, the article documents racial politics in Hackney in the early 1980s and examines the relationship between race and policing at that time. The article argues that the experience and expression of grief and anger were critical to understanding the political problem of race and policing in London in the 1980s, to forming and mobilizing political communities, and to interrogating the power of the state. The article also argues that a critical element of the emotional economy around race in Hackney in 1983 was the indifference and lack of empathy of the police in Stoke Newington to ethnic minority communities. This lack of empathy not only illustrated the problem of race within the police force at this time but further fueled local campaigns to make the police accountable. This links the Roach case to a later turning point—the 1999 Macpherson inquiry into the murder of Stephen Lawrence, which characterized the Metropolitan Police as institutionally racist.
We investigate the role of visual attention in risky choice in a rich experimental dataset that includes eye-tracking data. We first show that attention is not reducible to individual and contextual variables, which explain only 20% of attentional variation. We then decompose attentional variation into individual average attention and trial-wise deviations of attention to capture different cognitive processes. Individual average attention varies by individual, and can proxy for individual preferences or goals (as in models of “rational inattention” or goal-directed attention). Trial-wise deviations of attention vary within subjects and depend on contextual factors (as in models of “salience” or stimulus-driven attention). We find that both types of attention predict behavior: average individual attention patterns are correlated with individual levels of loss aversion and capture part of this individual heterogeneity. Adding trial-wise deviations of attention further improves model fit. Our results show that a decomposition of attention into individual average attention and trial-wise deviations of attention can capture separable cognitive components of decision making and provides a useful tool for economists and researchers from related fields interested in decision-making and attention.
Emotion recognition, the ability to interpret others’ emotional expressions and infer mental states, is crucial for caregiver–child interactions. The ability to accurately recognize infant emotions may facilitate attuned and responsive caregiving. Across two studies, we validate a novel measure to assess the recognition of infants’ emotions (Reading the Mind in Infant Eyes Test [RMIET]) and investigate how this ability relates to observed caregiving. Study 1 examined item-level performance in 55 infant mental health experts and 100 undergraduate students. Study 2 examined RMIET scores in 133 pregnant people and their later caregiving when their children were 18-month-old. In Study 1, agreement was high among both mental health experts (ICC = .82) and undergraduate students (ICC = .93), providing evidence of the content validity of the RMIET. In Study 2, scores assessing the recognition of adult and infant emotions were positively correlated (r = .22, p = .012). After accounting for covariates, RMIET scores were statistically significantly associated with higher sensitivity and warmth and lower negative regard. Taken together, these studies provide preliminary evidence of content and predictive validity for the RMIET.
Classroom discussions of current events and controversial topics can devolve into unproductive and highly charged debates. This article describes an in-class exercise used to foster respect during difficult conversations by encouraging students to design rules for discussions and guidelines to create a safe space for dialogue. This activity relies on three underlying principles: trust, empowerment, and empathy. These principles can be integrated into a broader pedagogical approach that emphasizes a democratic classroom and active learning. Student feedback shows that the intervention can be useful for promoting respectful and engaging discussions during moments of tension and polarization. However, an emphasis on civility also may undermine the diversity of opinions and require respecting students’ silences.
President Theodore Roosevelt once called the Chautauqua movement “typical of America at its best.” Arguably, no public humanities effort in the United States has been as popular or influential as the Chautauqua movement. Those seeking educational, religious, and cultural fulfillment have flocked to the lakeside retreat in western New York since 1874. From lectures and book clubs to theater and debates, Chautauqua has provided visitors with endless opportunities to engage with the arts, humanities, and cultural studies to help them better understand their world, themselves, and each other. Efforts to expand the experience beyond the summer include the adult education movement the Chautauqua Literary and Scientific Circle, one of the nation’s longest-running book clubs. Shrewd businessmen, and communities who did not see themselves represented in the Mother Chautauqua, also opened their own copycat offshoots across the country. As the pillar of “edutainment” and tourist destination wraps its 150th season, are the utopian visions of the founders enough to sustain it for another 150 or is a new model needed for a nationwide public humanities movement?
The aim of this descriptive study was to assess diabetes self-management and health care demand procrastination behaviors among earthquake victims with type 2 diabetes.
Methods
The population of the study consisted of earthquake victims with Type 2 diabetes in Hatay, Türkiye. The sample included 202 people with type 2 diabetes who lived in 7 distinct container cities. Data were collected using the Introductory Information Form, Diabetes Self-Management Scale, and Healthcare Demand Procrastination Scale via face-to-face interviews.
Results
Participants’ average score on the diabetes self-management scale was 58.34 ± 9.11. Being under the age of 60, employed, visiting a medical center on their own, having received diabetes education, and owning a glucometer were associated with better diabetes self-management, whereas being illiterate and having difficulty covering diabetes-related expenses were associated with poor diabetes management (P < 0.05). Participants’ average score on the Healthcare Demand Procrastination Scale was 2.35 ± 0.72. Respondents who didn’t have a nearby health care institution, whose diabetes diagnosis duration was between 1-5 years, and who didn’t have a glucometer had significantly higher scores on the Healthcare Demand Procrastination Scale (P < 0.05).
Conclusions
Diabetes self-management among earthquake victims with Type 2 diabetes was low. It was also determined that participants’ health care demand procrastination behaviors were at a moderate level.
This article draws a comparison between US border policies in the 2020s and the policies implemented by the British colonial regime in 1940s ‘Aden to dissuade Jewish immigration. It makes an original argument, based on documents from the British colonial archives and Jewish philanthropic sources, that the plunder of Jewish migrants was a consequence of British policy, and not, as scholars have sometimes assumed, a vaguely-defined “anarchy” in the Aden Protectorate sultanates (today, southern, and eastern Yemen). The history of British immigration policy – and the unofficial incorporation of both environmental and human forces into the project of dissuading Jewish migration – bears a striking resemblance to American policies in recent years. The perils of the Darién Gap and other deadly routes and the concentration of migrants in dangerous conditions on the US–Mexico border de facto incorporate the jungle, the desert, and criminal syndicates into the border regime’s efforts to disincentivize migration. A look at the archival record of a parallel story in 1940s Yemen/‘Aden allows us to glimpse the construction of policies that utilize unofficial actors and factors (from bandits to the hot desert sun) in a border regime’s campaign of terror against (potential) migrants. The article demonstrates the value of historical comparative cases for understanding the policies of governments today. Scholars of current events lack access to the intelligence reports, correspondence, and other once-classified documents available to historians, which allow for a fuller understanding of the ways in which similar policies have been developed and implemented.
The development of new papaya cultivars with high genetic potential for production, combined with quality traits that meet the demands of emerging markets, facilitates the expansion of the genetic base, reduces production costs, and broadens papaya cultivation. This study continues the largest Brazilian papaya breeding program, a partnership of over 25 years between UENF and Caliman Agrícola S.A. The objective was to evaluate the ability of inbred lines to generate hybrids with market potential in Brazil and for export. A total of 62 hybrids were obtained through topcross strategy. The lines were evaluated based on their specific combining ability (SCA), and the hybrids were analyzed through estimates of functional and varietal heterosis (VH) using three widely cultivated commercial varieties in Brazil: ‘UENF/CALIMAN 01’, ‘Tainung 01’, and ‘UC10’. Promising lines were identified for both hybrid creation and use as commercial varieties, exhibiting desirable traits for domestic and international markets, such as high fruit firmness and elevated soluble solids content (the lines UCLA08-053 and UCLA08-087 with the ‘Intermediate’ pattern and the lines UCLA08-066, UCLA08-122, and UCLA08-080 with the ‘Formosa’ pattern). Several hybrids, including H23, H26, H51, and H89 from the ‘Intermediate’ type and H4, H9, H19, and H68 from the ‘Formosa’ type, outperformed their parental lines and commercial varieties. These genotypes demonstrated superior SCA and VH compared to commercial controls, highlighting their strong genetic potential for the production market, increasing the shelf life of the fruits during storage and transportation, and allowing them to travel long distances without compromising fruit quality.
Healthcare systems are increasingly exploiting the advantages of Internet of Things technologies: cloud-connected devices with perceptive sensors can gather very accurate health data from people even if they do not get to the hospital or private clinics. For potential innovators of new medical IoT devices, the legal framework applicable was until now limited to the application of the General Data Protection Regulation and the Medical Devices Regulation.
This paper will investigate what will happen when medical IoT-generated data are shared to create new products or services according to the framework now depicted by the Data Act and the European Health Data Space.
Given that the EHDS and the Data Act are both aimed at facilitating the secondary use of (health) data, the contribution will compare the two processes set up to establish a roadmap to solve health-data sharing theoretical and practical queries.