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The COVID-19 pandemic exacerbated psychological distress, but limited information is available on the shifts in mental health symptoms and their associated factors across different stages. This study was conducted to more reliably estimate shifts in mental health impacts and to identify factors associated with symptoms at different pandemic stages.
Methods
We performed a national repeated cross-sectional study at stable (2021), recurrence (2022), and end-of-emergency (2023) stages based on representative general national population with extensive geographic coverage. Anxiety, depression, post-traumatic stress disorder (PTSD) and insomnia symptoms were evaluated by GAD-7, PHQ-9, IES-R and ISI scales, respectively, and their associated factors were identified via multivariable linear regression.
Results
Generally, 42,000 individuals were recruited, and 36,218, 36,097 and 36,306 eligible participants were included at each stage. The prevalence of anxiety, depression and insomnia symptoms increased from 13.7–16.4% at stable to 17.3–22.2% at recurrence and decreased to 14.5–18.6% at end of emergency, while PTSD symptom continuously increased from 5.1% to 7.6% and 9.2%, respectively (all significant, P < 0.001). Common factors associated with mental health symptoms across all stages included centralized quarantine, frontline work and residence in initially widely infected areas. Centralized quarantine was linked to anxiety, depression, PTSD and insomnia during the stable, recurrence and end-of-emergency stages. Frontline workers exhibited higher risks of anxiety, depression and insomnia throughout these stages. Individuals in initially widely infected areas were more likely to experience depression and PTSD, particularly during the stable and recurrence stages. Stage-specific risk factors were also identified. Lack of outdoor activity was associated with anxiety, depression and insomnia during the stable and recurrence stages. Residents in high-risk areas during the recurrence stage correlated with increased anxiety and insomnia. Suspected infection was tied to anxiety and insomnia in the recurrence and end-of-emergency stages, while the death of family or friends was linked to PTSD during recurrence and to depression, PTSD and insomnia at the end-of-emergency stage.
Conclusions
Mental health symptoms increased when pandemic recurred, and could remain after end-of-emergency, requiring prolonged interventions. Several key factors associated with mental symptoms and their variations were identified at different pandemic stages, suggesting different at-risk populations.
This article investigates how early modern migrants articulated identification with their host society in the context of the late eighteenth-century Dutch Republic, a period preceding modern nationalism. Drawing on a unique dataset derived from the Prize Papers – a collection of testimonies from captured sailors interrogated by British Admiralty courts – we analyze migrants’ declarations of sovereign allegiance. We assess how factors such as duration of residence, local citizenship (poorterschap), occupational rank, and marital status influenced migrants’ identification with their adopted polity. Using logistic regression, we find that civic institutional embeddedness, reflected in city citizenship, and occupational rank, especially among ship captains, significantly predicted identification with the Dutch Republic. In contrast, duration of residence and marital status had weak and statistically insignificant effects. Our findings highlight that pre-national forms of identification were deeply embedded in civic and institutional contexts rather than simply reflecting modern nationalist sentiments. By combining quantitative analysis with targeted archival research into individual biographies, this study demonstrates the complex interplay between institutional opportunities and personal networks in shaping migrants’ allegiances, thereby offering a nuanced historical perspective relevant to contemporary debates on civic integration.
Healthcare has deleterious impacts on the environment through production of massive amounts of waste leading to generation of greenhouse gas (GHG) emissions. Single-use materials used for preparation and administration of intravenous (IV) medications are a large component of hospital waste. Transitioning medications from the IV-to-oral (PO) route, called switch therapy, may be a means of decreasing unnecessary waste and associated emissions arising from hospital care.
Methods:
This was a retrospective cohort study involving adult patients receiving IV antimicrobials with a highly bioavailable PO equivalent at a large academic medical center. For a randomly selected subset of patients, the mean number of IV days of therapy (DOT) for which PO therapy could have been administered based on our institution’s policy was determined for each antimicrobial. This proportion was applied to the full cohort to estimate the total unnecessary IV DOT. A GHG emissions estimation tool was used to estimate the emissions generated from the excess antimicrobials.
Results:
During the study period, 15,037 IV DOT were administered, of which 9,694 DOT (64%) were estimated to be unnecessary. This was estimated to have generated 2,049 kilograms of total waste and 0.353 metric tons of carbon dioxide equivalents, equivalent to 904 miles driven.
Conclusions:
Optimizing IV-to-PO antimicrobial switch policies may be an effective way to decrease hospital environmental impact through reduction of single-use supply waste and associated emissions. Future work should prioritize evaluating other potential antimicrobial stewardship interventions as a means to reduce GHG emissions.
Clostridioides difficile infection (CDI) is common among patients undergoing hematopoietic stem cell transplantation (HSCT). Oral vancomycin prophylaxis may effectively prevent CDI in certain populations. We investigated the effectiveness of oral vancomycin primary prophylaxis in preventing CDI in HSCT patients.
Methods:
We searched six databases from inception to March 21, 2025, for studies comparing the incidence of CDI in HSCT patients who received oral vancomycin primary prophylaxis versus those who did not. We built a Bayesian random-effects model for meta-analysis. The primary outcome was the incidence of CDI. Secondary outcomes included incidence of positive vancomycin-resistant Enterococcus cultures, blood stream infections, graft-vs-host disease, and length of hospital stay. We also assessed for heterogeneity and publication bias using Robust Bayesian Meta-Analyses.
Results:
Six studies met inclusion criteria with a total of 1,236 patients. Four of the studies were of fair to good quality. Oral vancomycin primary prophylaxis reduced the incidence of CDI during hospitalization (OR 0.31; 95%CrI 0.16–0.59). Studies were weakly heterogeneous but had strong publication bias. Oral vancomycin primary prophylaxis reduced the odds of CDI by 12% after accounting for publication bias (OR 0.88; 95%CrI 0.32–1.16), although this reduction was not statistically significant. Secondary outcomes were similar in both groups.
Conclusion:
Oral vancomycin primary prophylaxis prevented CDI in HSCT patients without significantly affecting secondary outcomes. However, after controlling for publication bias, these findings were no longer significant. Further studies are needed to provide stronger evidence for or against this intervention, assess long-term safety, and assess potential effects on antimicrobial resistance.
Cultural transfers between metropolitan cores and colonial peripheries, have been a constant feature of the history of modern nationalism. Anti-colonial movements also influenced to some extent the development and strategies of European national movements before 1939. After 1945, and with particular intensity following the Algerian War of Independence, claims for national self-determination from the colonial possessions of the European empires also influenced the development of regional and national movements within Western Europe. This was flanked by the adoption of Marxist-Leninist and New Left doctrines by the post-war generation leading Western European minority nationalisms. The article deals with the reformulation of national self-determination in Europe under the influence of anti-colonial thought, particularly since the adoption of the theories of “internal colonialism”, and the new dimension given to the theory of national liberation by authors such as Frantz Fanon. It also looks at the emergence of radical ethno-nationalist parties in the 1960s and their commitment to this new wave of anti-colonial self-determination. Finally, the attempts of some of these movements to articulate a transnational programme will be analysed.
Disability and inclusivity are progressive topics that have evolved in response to societal experiences, as evidenced by the social model of disability, which has been endorsed as a replacement for the conventional individual model of disability. However, many still regard disability as an individual rather than an environmental problem, which fosters stigmatization of people with disabilities. Addressing this requires deeper knowledge to inform experience design that raises awareness of disability and the importance of social inclusion. The authors conducted a co-design experiment focusing on how to fill the communication gap between deaf and hearing people. Six teams, each comprising one deaf and two hearing participants, were observed to identify the salient characteristics of two contrastive approaches: LESS, a deaf-oriented audio environment with decreased audio stimuli, and MORE, a hearing-oriented audio environment with no decreased auditory stimuli. The results were cross-analyzing quantitative and qualitative data with interaction mapping. The analysis found that the LESS approach helps people feel no barriers, while the MORE approach enables them to challenge prior understandings of the issue. This study will contribute to designing an experience-based awareness-raising activity, suggesting where the gap exists and how it should be filled in the context of diversity, equity and inclusion.
Musica Elettronica Viva (MEV) enjoys cult status in the history of avant-garde music in the second half of the twentieth century. Founded in Rome at the turn of 1966 and 1967 on the initiative of the American composer and pianist Frederic Rzewski, MEV, together with the Gruppo di Improvvisazione Nuova Consonanza (GINC), introduced free improvisation to the European continent. However, many aspects of the group’s early years remain obscure, particularly with regard to their first performances and their transition to improvisation. Drawing on previously unpublished archives, in particular those of Frederic Rzewski preserved in Brussels, this article clarifies these aspects by establishing a precise chronology from 1966 to 1968. Far from following the aesthetics of GINC, MEV seems to have been more influenced by the Living Theatre, whose Artaudian and political approach encouraged its shift towards musical spontaneity and audience participation. This study thus offers a new perspective on the origins of MEV and its place within the Italo-American avant-garde of the period.
In many economies, youth unemployment rates over the past two decades have exceeded 10 percentage points, highlighting that not all youth successfully transition successfully from schooling to employment. Equally disturbing are the high rates of young adults not observed in employment, education, or training, a rate commonly referred to as “NEET.” There is not a single pathway for successful transitions. Understanding these pathways and the influences of geographic location, employment opportunities, and family and community characteristics that contribute to positive transitions is crucial. While abundant data exists to support this understanding, it is often siloed and not easily combined to inform schools, communities, and policymakers about effective strategies and necessary changes. Researchers prefer working with datasets, while many stakeholders favor results presented through storytelling and visualizations. This paper introduces YouthView, an innovative online platform designed to provide comprehensive insights into youth transition challenges and opportunities. YouthView integrates information from datasets on youth disadvantage indicators, employment, skills demand, and job vacancy at regional levels. The platform features two modes: a guided storytelling mode with selected visualizations, and an open-ended suite of exploratory dashboards for in-depth data analysis. This dual approach enables policymakers, community organizations, and education providers to gain a nuanced understanding of the challenges faced by different communities. By illuminating spatial patterns, socioeconomic disparities, and relationships between disadvantage factors and labor market dynamics, YouthView facilitates informed decision-making and the development of targeted interventions, ultimately contributing to improved youth economic outcomes and expanded opportunities in areas of greatest need.
Kongolandsbyen was an ‘ethnographic village’ staged in Oslo as part of Norway’s Jubilee Exhibition of 1914. The ‘village’ housed and displayed a troupe of eighty Senegalese performers including musicians playing kora, balafon, and other instruments. Examining music’s performance and reception in Kongolandsbyen demonstrates how colonialist practices and beliefs influenced even European nations, such as Norway, that were nominally non-imperialist. Kongolandsbyen’s promoters mimicked exhibitions common in France and Germany at which audiences sought both to learn about unfamiliar societies and to be entertained by sensationalized, ostensibly ‘primitive’, performances. By demonstrating fluency in the tired but familiar genre of the ‘ethnographic village’, Norwegians emulated the prestige of European imperial powers to challenge Norway’s marginal status as a newly independent, small country with limited geopolitical influence. Kongolandsbyen’s Senegalese performers pushed back against colonialist, racist representations through both thoughtful presentations of their musical traditions and an insistence on their own modernity.
This study presents a comparative evaluation of sentiment analysis models applied to a large corpus of expert wine reviews from Wine Spectator, with the goal of classifying reviews into binary sentiment categories based on expert ratings. We assess six models: logistic regression, XGBoost, LSTM, BERT, the interpretable Attention-based Multiple Instance Classification (AMIC) model, and the generative language model LLAMA 3.1, highlighting their differences in accuracy, interpretability, and computational efficiency. While LLAMA 3.1 achieves the highest accuracy, its marginal improvement over AMIC and BERT comes at a significantly higher computational cost. Notably, AMIC matches the performance of pretrained large language models while offering superior interpretability, making it particularly effective for domain-specific tasks such as wine sentiment analysis. Through qualitative analysis of sentiment-bearing words, we demonstrate AMIC’s ability to uncover nuanced, context-dependent language patterns unique to wine reviews. These findings challenge the assumption of generative models’ universal superiority and underscore the importance of aligning model selection with domain-specific requirements, especially in applications where transparency and linguistic nuance are critical.
Root water transport has been viewed as primarily limited by the radial component, with the axial pathway considered highly conductive and non-limiting. This is supported by theoretical estimates of axial conductance using the Hagen–Poiseuille equation. However, increasing evidence indicates that actual axial conductance is often nearly an order of magnitude lower than predicted, challenging assumptions that it does not limit water uptake. In this review, we discuss how recent model inversion approaches, guided by root hydraulic conductance measurements, have revealed that water transport can be co-limited by radial and axial conductance. We explore possible explanations for this co-limitation, with particular attention to root topology. Finally, we highlight how drought-induced adjustments in xylem vessel traits can reduce axial conductance, contributing to water conservation and cavitation resistance, thereby supporting drought adaptation strategies. Leveraging this overlooked limitation opens new avenues for breeding crops with improved water-use efficiency and resilience to drought .
Depression in individuals with type 2 diabetes mellitus (T2DM) is associated with worse clinical prognosis; however, evidence regarding the relationship between depression and hypoglycaemic risk remains limited and inconclusive.
Aim
Our study aimed to evaluate the association between depressive symptoms and hypoglycaemic events.
Method
Depressive symptoms were assessed in participants of the ACCORD-HRQL study at baseline and during follow-up visits at 12, 36 and 48 months using the nine-item Patient Health Questionnaire (PHQ-9). Symptom severity was categorised into three levels: none (0–4 points), mild (5–9 points) or moderate to severe (10–24 points). The primary outcomes included hypoglycaemia requiring any assistance (HAA) and hypoglycaemia requiring medical assistance (HMA).
Results
Over a median follow-up of 4.3 years, 220 individuals developed HAA (incidence rate: 27.0 per 1000 person-years) and 157 individuals experienced HMA (incidence rate: 18.8 per 1000 person-years). Depressive symptoms exhibited dynamic fluctuations during the study period, and participants with depression consistently demonstrated less effective glycaemic control compared to those without depression. However, each one-unit increase in PHQ-9 score was not associated with elevated risks of HAA (hazard ratio, 1.00; 95% CI, 0.97–1.03) or HMA (hazard ratio, 0.98; 95% CI, 0.95–1.02).
Conclusions
Depressive symptoms in individuals with T2DM are dynamic and correlate with suboptimal glycaemic control. However, no significant association was observed between depression severity and increased hypoglycaemic events. These findings highlight the importance of integrated clinical strategies for continuous mental health monitoring and glucose management in T2DM individuals.
This comment is the personal reflection of an early career historian on the challenges of working on Russian history during a time of geopolitical change and declining access. As libraries and archives in the Russian Federation become increasingly difficult to use following the invasion of Ukraine, early-career and younger historians are being forced to adopt remote or indirect methods of research due to formal and informal barriers. I reflect on some of the ethical, practical and epistemological dilemmas of conducting historical investigations at a distance, drawing chiefly on my own experiences working on the tsarist secret police during the First World War. I argue that this is not a return to Cold War constraints, but a new era that demands fresh strategies and a redefinition of expertise.
We construct a model for the (non-unital) S1-framed little 2d-dimensional disks operad for any positive integer d using logarithmic geometry. We also show that the unframed little 2d-dimensional disks operad has a model which can be constructed using log schemes with virtual morphisms.
There is limited analysis of the adoption of luxury tourism strategies in Africa. Such strategies promise lower ecological impact and higher tourism revenues. Through an analysis of economic data and secondary literature, as well as interviews conducted in Mauritius, Botswana, and Rwanda, this article examines why once luxury tourism strategies are adopted and do not deliver expected results, some countries reverse these strategies while others do not. Contrary to recent African political economy literature, this paper shows that “democratic” governments (Mauritius, Botswana) with shorter-term horizons have more flexibility in adapting their strategies compared to “authoritarian” governments with longer-term horizons (Rwanda).
We study new properties of generalised Harish-Chandra theory aiming at explaining the inductive local-global conditions for finite groups of Lie type in nondefining characteristic. In particular, we consider a parametrisation of generalised Harish-Chandra series that is compatible with Clifford theory and with the action of automorphisms on irreducible characters and we reduce it to the verification of certain requirements on stabilisers and extendibility of characters. This parametrisation is used by the author in a separate paper to obtain new conjectures for finite reductive groups that can be seen as geometric realisations of the local-global counting conjectures and their inductive conditions. As a by-product, we extend the parametrisation of generalised Harish-Chandra series given by Broué–Malle–Michel to the nonunipotent case by assuming maximal extendibility.
Butachlor is a herbicide extensively employed in rice (Oryza sativa L.) cultivation but historically under-investigated for its toxicological impacts on terrestrial vegetation. This study examines the dose-dependent effects of butachlor on the germination and antioxidant defense mechanisms in the seeds of Asian tape grass [Vallisneria natans (Lour.) H. Hara], an important submerged plant species widely distributed in the agricultural ponds. In a hydroponic setup, seeds were exposed to four concentrations of butachlor (0, 20, 200, and 2,000 μg ai L−1), and cultivated under controlled light conditions to quantify germination rates and assess oxidative stress responses. Our findings showed that butachlor concentrations up to 20 μg L−1 had no effect on the germination rate of V. natans seeds, while germination rates decreased by 6.0% and 8.7% at 200 and 2,000 μg L−1, respectively. At 2,000 μg L−1, malondialdehyde (MDA) content increased by 5.7 nmol g−1 FW, and catalase (CAT) activity declined by 21%, indicating oxidative damage. Additionally, the antioxidants proline (Pro) and glutathione (GSH) were upregulated under 20 μg L−1 butachlor treatment after 12 h, contributing to reactive oxygen species (ROS) scavenging and cellular stability. This study highlights the nuanced interactions between butachlor exposure and the antioxidant defenses in V. natans, providing valuable insights into the ecological impacts of herbicide pollution. Understanding these interactions is crucial for development of sustainable agricultural practices and management of herbicide resistance in aquatic systems.
Autistic high school students overwhelmingly have a poor experience of school. Research into this stage of life is limited, and researchers have tended not to talk to autistic students directly, instead hearing from non-autistic observers such as teachers and parents. This study aimed to address this gap in our knowledge by interviewing autistic students in mainstream high schools about their experience of school and their ideas for how this could be improved. Ten autistic students (13 to 20 years old) in Australian high schools were interviewed. Students overwhelmingly reported a negative experience. Most said their ideal school would be one where teachers and peers had greater understanding about autism and teachers had training in autism. By including the student voice, this research makes a valuable contribution to our understanding of autistic students’ school experience, adding depth and detail, and including what they would like to see changed. Importantly, the interview data also challenged misconceptions about what autistic students prioritised. The voice of autistic teens can make an important contribution to policies and practices aimed at improving their experience of school.
The growth of small perturbations in isotropic turbulence is studied using massive ensembles of direct numerical simulations. These ensembles capture the evolution of the ensemble-averaged flow field and the ensemble variance in the fully nonlinear regime of perturbation growth. Evolution equations for these two fields are constructed by applying the ensemble average operator to the Navier–Stokes equations and used to study uncertainty growth in scale and physical space. It is shown that uncertainty growth is described by a flux of energy from the ensemble-averaged flow to the ensemble variance. This flux is formally equivalent to the subgrid scale (SGS) energy fluxes of the turbulence cascade, and can be interpreted as an inverse uncertainty cascade from small to large scales. In the absence of information sources (measurements), the uncertainty cascade is unsteady and leads to the progressive filtering of the small scales in the ensemble-averaged flow, a process that represents the loss of predictability due to chaos. Similar to the kinetic energy cascade, the uncertainty cascade displays an inertial range with a constant average uncertainty flux, which is bounded from below by the average kinetic energy dissipation. Locally in space, uncertainty fluxes differ from the SGS energy fluxes at the same scale, but both have similar statistics and are significantly correlated with each other in space. This suggests that uncertainty propagation is partly connected to the energy cascade and that they share similar mechanisms. These findings open avenues to model uncertainty propagation in turbulence following an approach similar to the SGS models in large-eddy simulations. This is relevant not only to efficiently assess the reliability and accuracy of turbulence forecasts, but also to design uncertainty-robust reconstruction techniques for data assimilation or SGS modelling.
Each year, over 100,000 dogs are imported into Germany from other EU countries by animal welfare organisations, mainly from Romania. This study conducted a systematic content analysis of websites belonging to 241 animal welfare organisations that rehome dogs from southern and eastern Europe to Germany. Assessment included transparency, legal compliance, and availability of educational and medical information for adopters. The study shows that many organisations lacked information regarding dogs’ origins, transport methods, or health status which sometimes makes it difficult to distinguish between dog rescue and illegal dog trade. Photos were mainly used in adoption advertisements and behavioural descriptions were only included in two-thirds of the dog advertisements which poses a risk of increased dog relinquishment post-adoption due to behavioural unsuitability. Information on vector-borne diseases and typical behaviour of imported rescue dogs was not provided comprehensively. Few organisations violated legal standards, offering underage or banned breeds and failing to use the TRACES transport system. Most organisations relied upon private foster homes, while few had no temporary housing available in Germany. Although most claimed to conduct pre-adoption checks, comprehensive contract details were rarely published. The number of existing animal welfare organisations that rehome dogs from southern and eastern Europe to Germany is unable to be determined due to high fluctuation and the lack of central registry. Inadequate health disclosures and behavioural descriptions risk poor adoption matches and increased returns. Lack of legal compliance may endanger both animal and public welfare and opens the door to illegal dog trade. Sustainable animal protection requires better adopter education, reliable medical testing, and local engagement in source countries to reduce reliance upon transnational rehoming.