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Fungal contamination of healthcare environments is increasingly recognized as a potential contributor to healthcare-associated infections, yet standardized environmental surveillance strategies remain poorly defined. Culture-based methods are widely used but have limitations including low sensitivity and prolonged turnaround time. Molecular approaches such as quantitative PCR (qPCR) may improve detection but have not been extensively evaluated in real-world hospital environments.
Methods:
We conducted a longitudinal observational study across three inpatient units at a tertiary academic medical center from September 2023 through June 2024. Environmental samples were collected monthly from patient rooms and shared unit areas, including air, bathroom floors, HVAC components, patient bedrails, and linen storage areas. Samples were analyzed using direct-from-sample 18S qPCR and culture-based detection followed by 18S or ITS sequencing.
Results:
Among 742 samples collected, 474 (64%) were positive for fungi by qPCR compared with 213 (29%) by culture (P < .01). qPCR showed higher detection rates across most sample types, including air (35% vs 3%), bathroom floors (86% vs 42%), HVAC exhaust vents (72% vs 41%), and patient bedrails (78% vs 10%). Culture methods identified a broader diversity of fungi, including Talaromyces, Candida, and Penicillium, while qPCR detections were dominated by Malassezia.
Conclusions:
Molecular and culture-based methods provide complementary insights into hospital fungal contamination. qPCR demonstrated greater sensitivity, while culture identified a broader range of viable fungi. Future surveillance strategies may benefit from leveraging qPCR sensitivity using targeted primers for clinically important fungi, reducing the need for broad sequencing and bioinformatic analysis.
Readers associate the generic masculine (e.g., in German, die Zuschauer, for a gender-mixed group) more with men, whereas they associate the German gender star form (e.g., die Zuschauer*innen) more with women. However, the stability or malleability of these gender biases is unclear. In the present study (N = 272), we examined whether increasing the salience of the gender star form’s inclusiveness (by anaphoric references to an equal number of women and men) in a first task influences gender representations in ensuing tasks. We observed no influence of the salience manipulation on two measures, but for a third measure, response speed, the female bias of the gender star form was neutralized by the salience manipulation. Thus, for some—though not all—measures, experiences in a previous task seem to influence how easily representations of men compared to women are available, indicating that gender representations elicited by language forms are malleable.
Why did Chile’s think tank sector become more concentrated even as supply and demand for expert opinion expanded? This article examines nine organizations between 2011 and 2022, tracking 18,948 public interventions and conducting sixty-six interviews with think tank members and stakeholders to understand this apparent paradox. While political crises, from student movements to the 2019 social “outbreak” offered opportunities for new voices to emerge, established think tanks systematically consolidated their advantages. This article develops the concept of intellectual infrastructure—the material, institutional, technological, and network conditions enabling expert interventions—to explain how advantages in funding and media access become self-reinforcing. In a middle-income country where international funding dried up without the emergence of domestic philanthropy, organizations with larger, more flexibly allocated resources could effectively crowd out competitors. This challenges assumptions about expertise democratization, revealing how intellectual authority becomes concentrated even during periods of apparent openness.
Scholarly work on the politics of immigration in the U.S. has focused primarily on the influence of local demographics. Less understood are the ways in which local governments respond to demographic changes beyond the city limits. We hypothesize that local governments anticipate future influxes of immigrants from neighboring localities and adjust policies ex ante in order to constrain their movement before it can occur. We predict variation in anti-immigrant legislation as a function of proximity to nearby immigrant populations and find that a 10 percentage point increase in the share of the foreign-born population in a city’s surrounding areas doubles the likelihood that a city considers a restrictive policy. The effect is more pronounced when neighboring immigrants originate from Latin America than from other regions. We also find suggestive evidence that knowledge of adjacent foreign-born populations is transmitted via commuting patterns as neighboring populations commute into cities for work. Our research highlights the importance of spatial networks in local politics and how local political units influence one another and engage in an anticipatory strategic response.
It remains unclear which patient and treatment characteristics are associated with greater cognitive and functional gains from individualised occupational therapy (IOT) in schizophrenia.
Aims
To explore predictors of changes in cognition and functioning and their maintenance among patients with schizophrenia who received IOT.
Method
This secondary analysis used data from a randomised controlled trial and its follow-up. Participants allocated to the group occupational therapy plus IOT arm who received IOT during their hospital stay and had available outcome data were included (n = 34; with follow-up data available for 32 participants). Changes in cognition (Brief Assessment of Cognition in Schizophrenia) and functioning (modified Global Assessment of Functioning – social functioning subscale) were examined. Linear mixed-effects models were used to evaluate patient- and treatment-related predictors of change and maintenance.
Results
Greater improvement in cognition was associated with lower baseline cognition (β = −0.40, p = 0.003). Maintenance of cognitive improvement was associated with fewer prior hospital stays (β = −0.21, p = 0.031) and better post-treatment quality of life (β = 5.61, p < 0.001). Greater improvement in functioning was associated with lower baseline functioning (β = −0.50, p < 0.001) and fewer physical comorbidities (β = −8.43, p = 0.004), whereas maintenance of functional improvement was associated with better post-treatment cognition (β = 2.27, p = 0.014) and greater engagement in self-monitoring (β = 0.27, p = 0.026).
Conclusions
Both patient characteristics and engagement in specific IOT components were associated with variability in changes in outcomes and their maintenance. These findings may inform more personalised occupational therapy strategies for schizophrenia.
This paper examines reflective judgement as a crucial aspect of the power of judgement in Kant’s third Critique. Following Ginsborg’s normative-regulative interpretation, it demonstrates how aesthetics and teleology emerge from a single principle of reflection, which takes the form of contingent contingency, or possible lawfulness, in both. This reading establishes a parallel between common sense and the intuitive intellect, and allows one to preserve the normative dimension of Kant’s work while making Kant’s more speculative legacy continuous with it.
This article examines the multifaceted nature of the rule of law. It primarily shows a way to measure how the meaning of the rule of law differs across countries, or across different contexts more generally, by analyzing parliamentary discourse on the rule of law. The findings point to a convergence in the conceptualization of the rule of law across diverse legal traditions despite ex ante differences between common law, French, German, and post-socialist legal traditions. The article also proposes a principled approach for deriving weights for rule-of-law indicators in order to assess the sensitivity of country rankings with respect to the adherence to rule-of-law principles.
Many guidelines recommend deprescribing benzodiazepines and z-drugs in most long-term users. Due to physical dependence in those using medication as prescribed (distinct from addiction), discontinuation can be difficult and is often unsuccessful, as withdrawal symptoms can be severe and long-lasting, especially after long-term use. There is a lack of clarity on how to taper patients in a tolerable manner that minimizes discomfort. Current guidelines vary with some suggesting linear reductions (e.g. 1 mg every 1–4 weeks) and some proportionate reductions (e.g. 5%–10% of the most recent dose per month, with smaller reductions as the dose decreases). The shape of the relationship between dose of benzodiazepine and activity at gamma-aminobutyric acid-A (GABA-A) receptors is hyperbolic: steeply inclining at low doses, flattening at higher doses. Consequently, linear dose reductions produce increasingly large changes in receptor occupancy, predicting escalating withdrawal effects, while hyperbolic or proportionate dose reductions produce linear reductions in pharmacological effect. Slower tapering (over months and years) may be more successful than tapering over days or weeks. In practice, rate of tapering should be adjusted according to severity of withdrawal effects. Final doses for some people will need to be very small (equivalent to as little as 0.2 mg of diazepam, or less) so that the last ‘step down’ to zero is not larger than prior tolerated reductions in terms of pharmacological effects. Liquids or compounded formulations of medication can be helpful at low doses to make small reductions. Guidelines should recommend hyperbolic tapering while awaiting randomized trials comparing linear with hyperbolic tapering.
This work demonstrates the occurrence of travelling wave flutter instabilities on viscoelastic coatings in supersonic flows, which forms an important milestone towards developing viscoelastic materials for high-speed flow applications. The flow-induced travelling surface waves were generated by elevating the air speed such that the flow dynamic pressure and the material Young’s modulus are of the similar order, their ratio defined as the compliance parameter. Experimental investigations probed the critical compliance parameter corresponding to surface instability onset across different fluid-structural non-dimensional parameters. The results revealed a strong dependence of the critical compliance parameter on the flow Mach number in addition to other flow and structural parameters that were found to influence the instability onset in earlier studies with aqueous flows. A broader parametric sweep of these parameters was performed using linear stability analysis. Consistent qualitative comparisons were obtained between the experiments and stability calculations on the most amplified wave characteristics. Further investigations revealed that the interaction mechanisms are similar to incompressible flows.
A mutual influence between mood disorders and obesity has been reported. Maladapting eating behaviors associated with mood spectrum swings may play a pivotal role in the development and maintenance of obesity. Considering that, the aim of the present study is to investigate the relationship between problematic eating behaviors, namely emotional eating, grazing and night eating, with impulsivity and lifetime mood spectrum (mood, energy, cognition, rhythmicity and vegetative functions) in severe obese patients seeking bariatric surgery.
Methods
304 obese outpatients were recruited at the Psychiatric Unit of the University Hospital of Pisa. Participants completed psychometric tools including the Emotional Eating Scale (EES), the Italian-Night Eating Questionnaire (I-NEQ), the Grazing Questionnaire (GRAZ), the Barratt Impulsiveness Scale (BIS-11), and the Mood Spectrum Self-Report – lifetime version (MOODS-SR). Descriptive analyses and linear correlation were performed.
Results
The sample was predominantly female (71.4%), with a mean age of 47.5 ± 10.9 years and a mean BMI of 43.3 ± 6.3 kg/m2. Impulsivity was positively correlated with depressive and manic mood, energy, and cognitive MOODS-SR domains. Emotional eating, night eating, and grazing were significantly associated with the MOODS-SR total score (r=0.422, p=0.000; r=0.321, p=0.001; r=0.321, p=0.000, respectively) and with specific depressive and manic subdomains of the MOODS-SR.
Conclusion
Loss-of-control eating behaviors were positively associated with lifetime depressive and manic mood spectrum features in bariatric patients, highlighting the importance of assessing these dimensions to promote a tailored and integrated treatment.
The ‘left behind’, commonly defined by socio-economic factors such as rural residence, working-class status, and subjective perceptions of marginalization, have been repeatedly linked to support for populism and authoritarianism. However, it remains unclear whether the left behind are truly turning away from democracy and whether and how perceived marginalization (understood as a lack of recognition in different areas) is linked to fundamental democratic orientations (democratic attitudes, understandings, and governance preferences) that go beyond support for populist parties or specific policies. Using data from about 2,500 respondents in both the United States and Germany, I investigate how perceived societal marginalization is related to democratic orientations while accounting for traditional socio-economic factors. The results show that a lack of cultural recognition (feeling that one’s values are becoming less important or that one’s group cannot freely express its opinion in public) is associated with lower democratic support, an authoritarian and majoritarian understanding of politics, and higher support for authoritarian governance. Conversely, feeling unseen and unheard by politicians is associated with dissatisfaction with democracy and lower support for representative governance but also with high democratic support, a liberal understanding of politics, and support for citizen-centered decision-making in the form of referendums. These findings challenge simplistic portrayals of the left behind as inherently undemocratic. They also highlight the need for nuanced approaches to engage the left behind based on the dimensions in which they experience a lack of recognition to ensure democratic stability.
Games have the potential to engage a wider public with archaeology, but popular products also continue to perpetuate misconceptions about the past. One potential solution is for archaeologists, heritage professionals, and historians to act as consultants in the process of game design. However, there has been little published about what consultation involves, particularly with the understanding that games with archaeological themes often rely heavily on colonial narratives, as well as stereotypes that affect descendant communities. In this digital review, I draw on my experiences as an archaeologist and cultural consultant within the tabletop games industry to highlight how representation, expertise, and positionality are considerations for any scholar who is solicited for consultation on a commercial product. I also address the unpaid, underpaid, and emotional labor that lurks within an industry reliant on personal passions and work characterized as fun. I conclude with recommendations that focus on reducing harm in the present while playing with the past.
We derive asymptotic models for the ultimate regimes in horizontal convection (HC) and pure internally heated convection (IHC), in analogy with our recent (2024) extension of the ultimate-regime model for Rayleigh–Bénard convection (RBC). To derive the corresponding models for HC and IHC, we combine turbulent boundary-layer relations with the exact dissipation balances for these two systems. For HC, the resulting scaling relations are consistent with the rigorous transport bound of Siggers et al. (2004 J. Fluid Mech. vol. 517, 55–70). For pure IHC, they are consistent with the exact HC–IHC balance analogy of Wang et al. (2021 Geophys. Res. Lett. vol. 48, e2020GL091198) and with the rigorous bounds on the convective-flux asymmetry in the equal-temperature-plates configuration (Arslan et al. 2021 J. Fluid Mech. vol. 919, A15). The main difference between RBC and HC/IHC is that, in the latter two cases, the global kinetic-energy balance does not contain the additional response factor (dimensionless convective heat flux in HC or inverse bulk temperature in IHC), whereas it does in RBC. As a consequence, for fixed Prandtl number ${\textit{Pr}}$, the ultimate-regime scaling exponent is $1/3$ for both HC and IHC, rather than $1/2$ as in RBC.
This study reports mainly experimental findings on the evolution of confined axisymmetric gravity currents of non-Newtonian fluids within a gap of fixed height, focusing on the combined effects of rheology and surface tension. The inflow rate follows a power-law dependence on time, with the exponent related to the fluid behaviour index. Prior theoretical work, validated against axisymmetric experiments with Newtonian fluids, has shown that (i) surface tension acting primarily at the grounding line can significantly modify the structure of classical self-similar solutions and (ii) the presence of a meniscus at the grounding line can be incorporated into the similarity formulation through a parameter relating its height to the gap thickness, thereby preserving self-similarity. Here, this framework is extended to non-Newtonian fluids, adopting a power-law rheology for analytical convenience, which is appropriate since the tested shear-thinning and shear-thickening fluids behave as power-law fluids over the relevant shear-rate range. The influence of surface tension is confirmed through twenty-one axisymmetric experiments using Newtonian and non-Newtonian fluids. Good agreement between theory and experiments is obtained only when the grounding-line meniscus is included in the analysis. In addition, surface tension is found to play a central role in the hysteresis observed during the initial stages of current propagation, determining whether the current remains confined or transitions to an unconfined state. Finally, we show that the self-similar solution is robust, remaining valid even when the inflow rate deviates from the ideal power-law form, for example, in cases involving a delay in filling the experimental cell.
Entamoeba bovis is a common intestinal amoeba of ruminants, yet molecularly confirmed data from Europe remain limited. We investigated the occurrence, morphology and genetic variability of E. bovis in Italian domestic and wild ruminants and developed a rapid species-specific polymerase chain reaction (PCR) assay. Faecal samples from calves (n = 45), goats (n = 26), sheep (n = 11) and Italian red deer Cervus elaphus italicus (n = 25) were examined by sediment microscopy and iodine staining. Amoebic stages were detected in 57% of bovine, 61.5% of caprine, 100% of ovine and 56% of red deer samples. Across hosts, cysts were consistently uninucleate and displayed typical E. bovis morphology, including frequent chromatoid bodies and an iodophilic glycogen mass. Representative positives were sequenced at the 18S rRNA locus (∼800 bp), confirming E. bovis (98.6–99.8% identity; 100% query coverage). Maximum-likelihood phylogenetic analysis placed all Italian isolates within the E. bovis clade and indicated a shared lineage across domestic ruminants and red deer, with no segregation by host or ecological setting. A newly designed E. bovis-specific PCR (375 bp) consistently yielded a single amplicon in all sequenced positives, supporting its use for rapid screening without sequencing.