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Meta-analysis is a widely used statistical tool for estimating the diagnostic accuracy of tests across multiple studies. Existing methods and available R packages primarily focus on a single diagnostic test, typically under the assumption that all studies include a gold standard. Greater efficiency can be achieved by modeling multiple diagnostic tests together and drawing on studies with or without a gold standard reference test across diverse designs. To address this challenge, recent work has extended both the Bayesian hierarchical model and the Bayesian hierarchical summary receiver operating characteristic model to the framework of network meta-analysis of diagnostic tests, enabling simultaneous comparison of multiple tests when some data are missing. Despite the importance of these methods, their computational complexity has limited their broad application. This article introduces NMADTA, an R package that implements these models with user-friendly functions. The package allows researchers to evaluate the accuracy of multiple diagnostic tests simultaneously and provides comprehensive graphical displays of the results.
This article examines how the devolved legislatures of Scotland, Wales and Northern Ireland have developed distinct institutional, normative and conflict-based constitutional identities that position them as constitutional actors within the UK’s territorial order. Moving beyond analyses focused solely on competence allocation and the Sewel Convention, it argues that devolved identity is articulated through institutional design, claims to democratic legitimacy and episodes of contestation with Westminster. Disputes arising from Brexit, the UK Internal Market Act 2020, rights-based legislation and the Northern Ireland Protocol reveal how devolved institutions frame authority in terms of popular sovereignty, civic nationhood, consent and parity of esteem. While parliamentary sovereignty remains legally intact, these developments expose a widening gap between doctrinal hierarchy and constitutional practice. The article contends that the UK now operates as a differentiated constitutional system in which authority is legally centralised yet politically dispersed across multiple constitutional sites.
The gut–liver axis represents a bidirectional communication network for maintaining metabolic and immunological homoeostasis. Alterations in this axis allow bacterial products to reach the liver via the portal vein, promoting inflammation, oxidative stress and lipid accumulation. In this scenario, the consumption of bioactive compounds has become prominent due to its antioxidant and anti-inflammatory effects. This study aimed to investigate the effects of camu-camu (Myrciaria dubia) extract, an Amazonian fruit rich in phenolic compounds, on intestinal morphology, barrier-related gene expression and hepatic outcomes of chicken (Gallus gallus) embryos exposed to dextran sulfate sodium (DSS). Fertile eggs were divided into three groups (n 20/group): water (control), DSS (1·5 %), and camu-camu (10 %) + DSS (1·5 %). On the seventeenth day of embryonic development, treatments were injected into the amniotic fluid, and samples were collected at hatching (twenty-first day). Results showed that camu-camu was associated with changes in intestinal histomorphology, increasing villus height, surface area and the number of goblet cells, along with increased expression of selected barrier-related genes (MUC2, CLDN-1 and ZO-2). In the liver, camu-camu significantly reduced NF-κB expression compared with the DSS and water-treated groups, consistent with modulation of inflammatory-related gene expression. Furthermore, the decreased expression of iNOS, CAT and SOD-1 indicates modulation of oxidative stress-related gene expression markers. Histological analysis indicated alterations in hepatic morphology, including reduced lipid droplets and inflammatory infiltrates. These findings indicate that camu-camu is associated with changes in intestinal histomorphology, selected barrier-related gene expressions, hepatic histology and inflammatory- and oxidative stress-related gene expression markers.
Whether the Lambert–Amery glacial system (LAGS) will remain near mass balance this century while adjusting to geometric change remains an open question. We couple the ice-flow model Úa to the PICO sub-shelf melt parameterization for 2020–2100 under ten high-emissions scenarios, two control experiments and targeted pinning-point perturbations. By 2100, unperturbed absolute trajectories across the twelve applied forcings contribute $-11.4$ to $1.9$ mm to sea level relative to the common 2020-relaxed state; member-specific transient-minus-2020-constant diagnostics isolate the response to post-2020 forcing evolution, which spans $-3.84$ to $+4.66$ mm. With SMB held time-invariant over the model domain, using time-evolving rather than time-invariant 2020 basin-mean ocean conditions increases the 2100 contribution by $1.50$ mm. Minimizing the dynamic buttressing contribution of all pinning points adds an almost forcing-invariant $0.82$ mm. Across ten single-point experiments, the 2100 sea-level response is proportional to grounding-area loss. Paired perturbed–unperturbed simulations have nearly identical shelf-integrated basal melt but distinct sea-level contributions, showing that the additional response is driven primarily by reduced buttressing rather than melt-forcing changes. Overall, LAGS remains close to mass balance under the applied forcing protocol, while time-evolving ocean forcing and pinning-point weakening modulate the magnitude of the 2100 sea-level response. Dynamically important pinning points are priorities for long-term monitoring.
In this paper, we study a nonlinear free boundary problem modelling the growth of radially symmetric tumours. The tumour consists of a central necrotic core, an intermediate quiescent layer and an outer proliferating shell. The evolution of tumour layers and the movement of the tumour boundary are totally governed by external nutrient supply and conservation of mass. The three-layer structure generates three free boundaries with discontinuous nutrient consumption rates and cell growth rates. We develop a nonlinear analysis method to clarify the interactive relationships among free boundaries. By carefully studying the dependence of the critical-state tumour growth rate on the external nutrient concentration, we reveal the evolutionary mechanism in tumour growth and the mutual transformation of its internal structures. The existence and uniqueness of the radial stationary solution is proved, and its globally asymptotic stability towards different dormant tumour states is established.
We study the optimal stopping of an $\alpha$-dimensional Bessel bridge for the payoff $\phi(x)=x^n$, where $\alpha,n \in (0,\infty)$. As a special case we consider the Brownian excursion with the identity function as the payoff ($\alpha=3,n=1$). For the Brownian excursion we can give an explicit solution but in the general case we provide a complete solution via a power series expansion.
With nearly one in six children globally living in conflict zones, evidence-based mental health and psychosocial support (MHPSS) is crucial. This systematic mapping review with narrative synthesis followed the PRISMA 2020 guidelines to synthesize fifty-six studies examining in-country interventions for conflict-affected youth under 25 from 1990 to 2025. The studies were mostly conducted in the global South and utilized various methods, including Teaching Recovery Techniques, trauma-focused cognitive behavioural therapy, and school-based programmes.
The findings were mixed. While twenty-five studies reported positive outcomes regarding post-traumatic stress symptoms (PTSS), anxiety and social functioning, the effects often diminished over time, and long-term data (>6 months) remains scarce. The review identified three critical success factors: multilayered stepped-care models, task-sharing with trained lay workers, and family engagement. To be effective, cultural adaptation and age-appropriate tailoring were essential; efforts in this regard ranged from play-based interventions for younger children to structured therapies for adolescents.
The evidence base is limited by methodological heterogeneity and short follow-up periods. To bridge the research–practice gap, future efforts must prioritize longitudinal evaluations and stronger collaboration between researchers and humanitarian actors to ensure that interventions effectively mitigate the long-term impacts of conflict.
Face-to-face communication often involves multiple iconic cues (gestural, suprasegmental and segmental) to convey meaning. Previous research shows that gestural and suprasegmental iconicity cues, as well as gestural and segmental iconicity cues, often co-occur, suggesting that speakers combine visual and acoustic forms of iconicity to reinforce meaning. This study investigates whether listeners can simultaneously utilize both suprasegmental and segmental iconic cues in the same speech stimuli to associate sounds with meaning. Finnish-speaking participants were presented auditorily with pseudowords consisting of suprasegmental and segmental iconicity cues referring to shape-related concepts (Experiment 1) or magnitude-related concepts (Experiment 2). The study showed that these two dimensions of acoustic iconicity are processed relatively independently, yet in parallel, for linking the speech signal to meaning.
To explore the primary health care experiences of Indian immigrants living with chronic illnesses in Australia.
Background:
Primary health care is integral for managing health issues for people living with chronic illnesses. Despite Indian migrants being the largest overseas-born population in Australia to use primary health care services for their chronic illnesses, at this time, limited literature reports on their experiences in Australia.
Methods:
A qualitative exploratory approach was adopted for this study. Through purposive sampling, 11 participants were recruited, and data was collected using semi-structured interviews. The interviews were transcribed verbatim and thematically analysed.
Findings:
Three themes and six sub-themes emerged from the thematic analysis. The first theme ‘being a mix of experiences’ presented participants’ positive and negative experiences related to communication, compassion, quality of care and length of consultations. The second theme ‘facilitators to accessing primary health care services in Australia’ described the benefits of telehealth and having a common cultural background as that of the general practitioner. Meanwhile, the third theme ‘barriers to accessing primary health care services in Australia’ identified unavailability of preferred GPs and waiting times and delays for in-person appointments as barriers that hindered access to PHC services in Australia.
Conclusion:
Primary health care experiences of Indian immigrants with chronic illnesses in Australia were a mix of positive and negative experiences, similar to that of other immigrants. Faster accessibility and compassionate services among migrants were highlighted to be needing extra attention by way of further research and acknowledging the unique diversity of individuals.
In toroidal confinement systems, the scrape-off layer (SOL) magnetic field exhibits characteristics analogous to those of a magnetic mirror configuration, particularly in the edge plasma region. Therefore, linear plasma devices have advanced divertor simulation studies. To further promote divertor simulation studies, a new divertor simulator, ‘Pilot GAMMA PDX-SC (PGX-SC)’ has been developed, incorporating a pair of superconducting coils that generate a simple magnetic mirror configuration. An electrode-biasing system was installed on the PGX-SC to regulate the plasma potential. The system comprises three concentric basing plates installed at the east end of the main chamber of PGX-SC, in conjunction with a DC-stabilised power supplies for each basing plate. This system can also measure the floating potentials and electrode currents by connecting a resistor to each plate in the absence of an external power supply. Preliminary experiments were conducted to investigate the effect of plasma by applying a bias to the electrode plates. Applying a voltage to the inner electrode increased the plasma potential at the outer electrode. This result suggests the feasibility of controlling the peripheral plasma potential using concentric biasing plates. When voltage was applied to the outer electrode, the amplitude of the fluctuating current decreased. These results collectively indicate the capability of plasma control employing concentric biasing plates.
Australian government herbariums and museums are repositories of flora and fauna specimens collected from across Australia. This has occurred since before Australia was colonized and to the present time, often by explorers and researchers using Indigenous people’s traditional knowledge to identify and locate culturally significant species. The colonial legacy of Australia is embedded in ex situ collections of biological specimens and related data, which mostly predate international treaties promoting benefit-sharing with Indigenous peoples for using their traditional knowledge. Collections of culturally significant biological specimens and associated data should be recognized as cultural property and managed according to Indigenous data sovereignty principles including for attribution and nomenclature. This article presents an example of Australian native tobacco biodiscovery in Australia and pathways for integrating principles of Indigenous data sovereignty for decolonization of ex situ collections and for promoting a rights-based approach.
We classify the sets of natural numbers n for which certain dynamical systems $(X,f)$ on a compact metric space X have a periodic point of (least) period n. Interest in this question dates back to Sharkovskii’s theorem for continuous maps on intervals of the real line, but it also ties to checkable conditions for Krieger’s embedding theorem for symbolic dynamical systems. Given a system for which the logarithmic derivative of the Artin–Mazur zeta function is rational, we use the Skolem–Mahler–Lech theorem to classify for which n the system has a periodic point of (not necessarily least) period n. Moreover, we build on work on finitely presented (FP) systems and their relationship to symbolic dynamics to classify the set of least periods, that is, periodic orbit lengths, for arbitrary FP systems, extending a known classification for shifts of finite type. We also provide several constructions to realize any such least period sets.
Fungal feed additives offer a potential avenue to enhance dairy cattle health and productivity. This narrative review examines and consolidates literature investigating the effects of products containing, or derived from, anaerobic fungi (AF), obligately aerobic filamentous fungi and yeasts. There is a sparsity of research investigating supplemental AF in cattle, but existing literature demonstrates that AF can consistently increase the digestibility of feeds. Anaerobic fungal additives are limited by their oxygen vulnerability, although characterization of the resting stage of their lifecycle would aid in the development of products which could be used on farm. The majority of research investigating aerobic fungi in dairy cattle is based upon their fermentation products. These products often enhance digestibility variables in cattle, which sometimes benefits growth and production. Inconsistent responses, which are attributed to heterogenous product composition and rumen stability, hinder the industry utility of these additives, and further research is required to define the conditions required for efficacy. A large body of research exists examining the effects of active yeast and yeast derivatives in mature cattle and calves. In-depth examination of this research is beyond the scope of this review, but substantial evidence suggests that supplementing dairy cattle with yeast can be advantageous for gut health and development, production and stress tolerance. This review highlights the pathways through which exogenous fungi can enhance dairy production, and that further research is required to define the causes of inconsistent responses from treatments. This will increase the value of fungal additives to the dairy sector.
After the Occultation of the Twelfth Imam (al-ghaybah al-kubrā) in the fourth AH/tenth CE century, the applicability of divinely ordained punishments, ḥudūd, became a subject of theo-juridical controversies between two groups of Shiʿi jurists: pro- and anti-ḥudūd. In the aftermath of the Islamic Revolution of 1979 and the establishment of a Shiʿi theocracy, Iranian theocrats supported the pro-ḥudūd Shiʿi jurists, and as a result, ḥudūd punishments were incorporated into the Islamic Penal Code and have been applied by the state ever since. Some Iranian legal reformers, recognizing the challenges in applying ḥudūd punishments, have put forward two politico-juridical mechanisms (zarfiyat): the secondary ruling and the state order. These two mechanisms, the reformers assert, may be used by the Islamic Republic of Iran to suspend ḥudūd punishments. In this article, I examine both the arguments presented by reformers and the objections to these arguments raised by conservative and Shiʿi orthodox-minded jurists. These objections pose doctrinal challenges that impede the utilization of these mechanisms, thus obstructing the suspension of ḥudūd punishments.
In times of crisis, such as pandemics or social injustice, people often talk about the importance of solidarity, standing together for a common cause. However, this term, while powerful, can sometimes leave people out, especially those who do not fit neatly into shared identities or experiences. Our paper examines how the concept of solidarity can unintentionally exclude individuals, obscure power disparities, or even be exploited by political or corporate interests. Rather than abandoning the concept, we suggest adding a new term: convergence. This word captures the idea of people coming together from different backgrounds to work towards shared goals, without needing to be the same or agree on everything. By combining solidarity with convergence, we can build more inclusive, transparent, and dynamic ways of working together in today’s complex world. This shift in language may help us navigate global challenges more fairly and collaboratively.
What it means for a provision to be “incompatible” with Convention rights is crucial in determining whether courts with the power to do so ought to make a declaration of incompatibility under section 4 of the Human Rights Act 1998 (“HRA”). A clear understanding of incompatibility is also necessary for the proper operation of statements of compatibility under section 19 HRA. It is crucial for the devolved legislatures whose incompatible legislation is “not law”. And delegated legislation can be struck down, or declared incompatible, by a court for the same reason. Yet the test for determining incompatibility remains unclear and understudied. The lack of clarity threatens both rights protection and dialogue between the different branches, and layers, of the state. This article argues that the test currently favoured sets the bar inappropriately high and that the test must more clearly consider both the potential extent, and the likelihood, of the breach.
Gaming disorder (GD), i.e., persistent problematic gaming with clinically significant impairment, is a growing concern; however, estimates of GD in representative adolescent samples are limited. This study aimed to examine GD prevalence, incidence, persistence, and risk factors for different epidemiological parameters across 6 years, covering pre- to post-COVID-19 pandemic.
Methods
Population-based longitudinal data, including 3358 German adolescents, were collected annually from 2019 to 2024 using online surveys. GD prevalence estimates were assessed by standardized International Classification of Diseases (ICD-11)-based self-report questionnaires. Between-wave persistence and incidence of GD, sociodemographic data, gaming time, and stress perception were measured. Risk factors for incidence and persistence of GD were examined using generalized-estimating equation (GEE) models.
Results
GD prevalence doubled from 2.9% in 2019 to 6.5% in 2023 and remained above prepandemic levels in 2024 (3.9%). Males showed higher prevalence estimates compared to females across most waves, and prevalence peaked in 2023 (8%). For females, GD prevalence doubled between 2019 (1.7%) and 2020 (3.4%), peaked in 2022 (6.1%), and declined thereafter. The incidence of GD increased during the pandemic. According to GEE models, male sex, higher perceived stress, and longer gaming times were risk factors for GD incidence; older age and higher education were protective factors. The persistence of GD reached its peak in 2020 (36.2%). Significant risk factors for GD persistence were higher stress perception and longer gaming time.
Conclusions
Prevalence and incidence rates indicate that GD continues to be a significant concern, and pandemic-related increases affected both males and females. Prevention and intervention programs should target identified risk groups.
As protected areas increasingly compete with other land uses, their ability to generate economic value through tourism has become central to both public acceptance and long-term sustainability. However, the effects of tourism on wildlife remain understudied, particularly in African protected areas. Mole National Park, Ghana’s largest protected area, is critical for both biodiversity conservation and ecotourism. With plans to expand tourism into its less-visited areas, we assessed the impacts of tourism on medium- to large-sized mammals using multiple metrics. Camera traps were deployed across zones with low, medium and high tourism use, recording 24 mammal species over 6,050 trap-days. Although overall species richness and abundance were similar across zones, certain species showed higher relative abundance in high-use areas (e.g. kob Kobus kob, African buffalo Syncerus caffer) and others were more abundant in low-use areas (e.g. western hartebeest Alcelaphus buselaphus major, African savannah elephant Loxodonta africana). The most consistent effect of higher tourism levels was a shift in daily activity patterns towards more nocturnal behaviour, probably in response to human presence. Olive baboons Papio anubis and common warthogs Phacochoerus africanus, however, maintained peak activity around midday. Juvenile presence was highest in low-tourism zones, suggesting possible reproductive sensitivity to disturbance. These behavioural and demographic responses may have longer-term consequences for population dynamics. Our findings raise concerns about the expansion of tourism into currently undisturbed areas, as wildlife is already responding to existing pressure. We recommend designating no-access zones as wildlife breeding areas, implementing buffer zones based on species activity and educating tourists on responsible wildlife viewing. Finally, we highlight the need for broader research on tourism impacts across conservation landscapes in Africa.