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Continuous glucose monitoring (CGM) has revolutionized diabetes management by providing real-time data on blood glucose fluctuations. Unlike traditional methods, CGM systems offer continuous feedback, enabling individuals to better regulate glucose levels in response to lifestyle factors such as diet, exercise, and stress. This technology has been shown to improve glycemic control and stabilize HbA1c levels. Beyond its primary role in diabetes management, emerging research highlights the relationship between metabolic health and mental wellbeing. Glucose dysregulation has been implicated in mood instability, and fluctuations in blood glucose levels may directly influence emotional states. Notably, some researchers have proposed reclassifying major depressive disorder (MDD) as “Metabolic Syndrome Type II” due to shared pathophysiological mechanisms involving glucose homeostasis and inflammation. Given these connections, CGM technology may offer mental health benefits by promoting glucose stability. For individuals with diabetes who also experience psychiatric conditions such as MDD or generalized anxiety disorder (GAD), CGM use may contribute to improved mood regulation and reduced psychiatric symptoms. By addressing both metabolic and mental health concerns, CGM holds promise as a valuable tool in enhancing overall wellbeing. Further research is warranted to explore the full potential of CGM in supporting mental health outcomes in individuals with metabolic disorders.
The utility of routine environmental sampling to monitor the airborne fungal load (AFL) in healthcare settings is uncertain.
Methods:
AFL was measured by monthly cultures at a tertiary-care pediatric hospital from November 2018 through October 2023 on eleven units caring for patients at risk for invasive mold infection (IMI). Surveillance for healthcare-associated IMI was conducted for all patients in the healthcare system using locally developed definitions for possible, probable, and definite hospital-onset infections. Poisson regression was used to analyze the association between AFL and monthly IMI rates.
Results:
78 cases of IMI were identified during the period of AFL monitoring. Of these, 51 infections were classified as healthcare-associated probable or proven IMI and were tested for association with AFL measurements. There was not a significant facility-wide association between the average monthly AFL and the overall IMI rate. On units where hematology/oncology patients were treated, however, an increase in average monthly local AFL for opportunistic fungal pathogens of 1 CFU/m3 was associated with a 1.48-fold increase in the IMI rate for these patients (95% CI 1.00–2.19, P = .05). The AFL for Aspergillus species on these units showed a particularly strong association with the hematology/oncology IMI rate (15.9-fold elevation for an increase of 1 CFU/m3 [95% CI 2.8–90.7, P = .002]). Neither hematology/oncology nor facility-wide IMI rates showed comparable associations with changes of the AFL in outdoor air.
Conclusions:
Regular monitoring of AFL on targeted hospital units may identify periods when hematology/oncology patients are at increased risk for IMI.
In recent scholarship on the Ottoman Mediterranean, it has become commonplace to challenge narratives of heroic discovery and cultural superiority expounded in publications by European travellers. Rather than taking a polished, published account as its starting point, this paper discusses the travels of Edward Falkener (1814–96), a lesser-known Victorian architect and writer whose extensive tour around Anatolia (1844–5) was never communicated to a broader audience. If Falkener is remembered today, it is usually as the author of the first anglophone monograph on ancient Ephesus and editor of the first British academic journal devoted to classical art and architecture. This paper reviews Falkener’s career, but instead of these publications, the focus is on his remarkable personal archive of diaries, sketchbooks, watercolours, contracts and notes for an incomplete book about his tour of Anatolia. Drawing on this collection, it explores his fluctuating interests in heritage from different periods of Anatolia’s history and well-documented interactions with a variety of local actors who helped or hindered his meandering tour. Representing the first attempt to study Falkener’s journey, this paper explores the utility of his archive for understanding the challenges and contingencies of Victorian travel in the Ottoman Empire.
Public service internships are a staple in contemporary political science curricula. Research shows that internships produce better thinkers, employees, and citizens. Yet, political science interns are on the frontlines in observing the firsthand trauma, stress, and mental health challenges of many people seeking support and services from government. In turn, students may internalize this stress and trauma, a phenomenon recognized as secondary traumatic stress (STS). This study addresses a significant gap in the discipline’s understanding of the frequency and severity of STS experienced by political science interns in their fieldwork. We relied on surveys and written assessments from students enrolled in internship courses at two public universities. We find that interns report increased exposure to STS at the end of the semester. Furthermore, STS vulnerability varies among interns, with higher incidence rates among those with a history of primary trauma, older students, and women. We outline coping strategies for students, propose adaptations to experiential learning to enhance support, and emphasize the need for further research on this issue.
Current efforts to reduce the incidence of non-communicable disease (NCD) are slow, but increasing evidence highlights the microbiome as a potential target for prevention. The majority of microbial development occurs in the first 1,000 days of life, presenting opportunities for strategic intervention to reduce the prevalence of future NCDs. In this review, we explore the social, structural, and political barriers that may hinder physiological gut microbial development in the first 1,000 days in the context of current scientific knowledge, focusing on nutritional factors in pregnancy, and during the exclusive breastfeeding and complementary feeding periods. We summarise emerging evidence and explore obstacles to nutritional choices affecting microbial development, and unpack the rhetoric that healthy eating to develop a microbiome that supports optimum health is an individual choice. As evidence on the role of the microbiome in health and disease grows, specific attention must be applied to existing social, structural, and political barriers that may hinder optimal microbial development. Addressing the role of corporate actors and social determinants influencing dietary choices and barriers surrounding breastfeeding must be prioritised, alongside efforts to advance basic scientific research. Until a wider public health perspective is taken, the success of interventions and recommendations will be limited.
This study investigates structural abnormalities in hippocampal subfield volumes and shapes, and their association with plasma CC chemokines in individuals with major depressive disorder (MDD).
Methods
A total of 61 patients with MDD and 65 healthy controls (HC) were recruited. All participants underwent high-resolution T1-weighted imaging and provided blood samples for the detection of CC chemokines (CCL2, CCL7, and CCL11). Comparisons of hippocampal subregion volumes, surface shapes, and plasma CC chemokine concentrations were conducted between the MDD and HC groups. Furthermore, partial correlation analysis was performed to assess the relationship between structural abnormalities (hippocampal subfield volume and shape) and plasma CC chemokine levels.
Results
The MDD group exhibited a significant reduction in the volume of the left hippocampal tail compared to the HC group (F = 9.750, Bonferroni-corrected p = 0.026). No significant outward or inward deformation of the hippocampus was detected in MDD patients relative to the HC group (all FWE-corrected p > 0.05). Additionally, plasma CCL11 levels were elevated in the MDD group compared to the HC group (F = 9.982, p = 0.002), with these levels showing a positive correlation with the duration of the illness (r = 0.279, p = 0.029). Partial correlation analysis further revealed a negative correlation between the smaller left hippocampal tail volume and plasma CCL11 levels in MDD patients (r = −0.416, p = 0.001).
Conclusion
Abnormally elevated plasma CCL11 in MDD patients may mediate damage to specific hippocampal substructures.
Direct numerical simulations of a uniform flow past a fixed spherical droplet are performed to determine the parameter range within which the axisymmetric flow becomes unstable. The problem is governed by three dimensionless parameters: the drop-to-fluid dynamic viscosity ratio, $\mu ^\ast$, and the external and internal Reynolds numbers, ${\textit{Re}}^e$ and ${\textit{Re}}^i$, which are defined using the kinematic viscosities of the external and internal fluids, respectively. The present study confirms the existence of a regime at low-to-moderate viscosity ratio where the axisymmetric flow breaks down due to an internal flow instability. In the initial stages of this bifurcation, the external flow remains axisymmetric, while the asymmetry is generated and grows only inside the droplet. As the disturbance propagates outward, the entire flow first transits to a biplanar-symmetric flow, characterised by two pairs of counter-rotating streamwise vortices in the wake. A detailed examination of the flow field reveals that the vorticity on the internal side of the droplet interface is driving the flow instability. Specifically, the bifurcation sets in once the maximum internal vorticity exceeds a critical value that decreases with increasing ${\textit{Re}}^i$. For sufficiently large ${\textit{Re}}^i$, internal flow bifurcation may occur at viscosity ratios of $\mu ^\ast = {\mathcal{O}}(10)$, an order of magnitude higher than previously reported values. Finally, we demonstrate that the internal flow bifurcation in the configuration of a fixed droplet in a uniform fluid stream is closely related to the first path instability experienced by a buoyant, deformable droplet of low-to-moderate $\mu ^\ast$ freely rising in a stagnant liquid.
Trust judgments involve rapidly evaluating others’ appearance and are critical in psychosocial development. Trust biases may be linked to psychopathology risk, particularly in vulnerable, adversity-affected populations, but very little is known about trust perception in refugee context. Here, we measured trust perception of Syrian refugee children (N = 324, Mage = 6.32 years) displaced in Jordan, using a validated trust task with computer-generated faces varying in perceived trustworthiness (data collection: May-August 2021). Mothers (N = 324, Mage = 32.59) reported on child and mothers’ mental health, and mother-child relationship. Child trust perception was not associated with child or mothers’ mental health, or mother-child relationship (all p > .10), but we found age-related changes in perceived trust, with older children reporting faces as less trustworthy than younger children (B = .32, p < .001). Although children’s social judgments might be associated with socio-emotional functioning in non-refugee populations, our results suggest that refugee children’s mental health does not seem to be linked to their perception of trust, and that trusting others might diminish with age in displaced, at-risk children.
Through examining three areas of focus within public mental health; prevention, healthy environments and reducing inequalities, we consider how interventions in these domains also have the potential to create a more sustainable healthcare system.
Results
We show how psychiatrists and mental health professionals alongside the wider health and social care system can be involved in advocating for this change.
Clinical implications
We aim to empower individuals working within mental health to advocate for change and consider how public mental health approaches can be integrated into their practice to improve outcomes.
In Antimicrobial Stewardship and Infection Prevention and Control, programmatic goals often strive to achieve clinical benefit by practice change in the direction of doing less. Practically, this may include reducing the number of tests ordered, encouraging shorter and more narrow courses of antimicrobials, or discontinuing practices that are no longer contextually appropriate. Because promoting practice change in the direction of doing less is a critical aspect of day-to-day operations in Antimicrobial Stewardship and Infection Prevention and Control, the goals of this Society for Healthcare Epidemiology Research Committee White Paper are to provide a roadmap and framework for leveraging principles of implementation and de-implementation science in day-to-day practice. Part II of this series focuses on some practical case studies, including real-world examples of applied de-implementation science to promote discontinuation of practices that are ineffective, overused, or no longer effective.
An increasing number of studies have sought to explore the applicability of scalable mental health interventions to bridge the adolescent mental health treatment gap. This study aimed to adapt the World Health Organization’s mental health intervention Early Adolescent Skills for Emotion (EASE) for urban communities in New York City (NYC). Following the mental health Cultural Adaptation and Contextualization for Implementation framework and in collaboration with three Brooklyn community-based organizations and the NYC Mayor’s Office of Community Mental Health, the intervention was intensively workshopped through eight weekly sessions with adolescents (n = 18) and caregivers (n = 12). Documentation of the process followed the Reporting Cultural Adaptation in Psychological Trials criteria. Surface adaptations involved revising the storybook to reflect key challenges faced by adolescents and caregivers of these communities, such as social media usage, economic stressors, and racial diversity. Deep adaptations addressed cultural concepts of distress by incorporating topics such as identity exploration, socioemotional learning, and the mind–body connection. Feedback from stakeholders indicated that the basic components of EASE are relevant for members in their communities, but additional changes would foster greater engagement and community building. These findings will inform upcoming program implementation across NYC and may guide adaptation work in other contexts.
This article presents the results of archaeological research of the post-Second World War mass grave site of Jama pod Macesnovo gorico in Slovenia. The surroundings of the killing site and the mass grave have been the subject of various investigations, including the exhumation of human remains in 2022. In addition to the human remains of approximately 3450 individuals, the results of metal detector surveys, and the excavation of the grave itself have yielded thousands of artefacts associated with the victims and perpetrators, shedding light on the events of the post-Second World War period and mass murder of opponents of the communist-oriented national liberation movement and new Yugoslavian regime. The study represents the results of the most extensive exhumation of war victims’ remains in Slovenia and demonstrates the significant role of archaeology in the reconstruction of historically poorly documented events in modern conflicts.
The Tomb of the Scipios is a multigenerational patrician tomb outside Rome dating from the early third to mid-second century b.c.e. The tomb is perhaps most famous for its verse epitaphs, which have traditionally been identified as echoes of the lost elite family domestic archives that informed the first Roman histories. In dialogue with the recent turn towards considering the role of non-literary methods of recording the past in the development of Roman historical thought, this paper proposes a reinterpretation of these epitaphs within their archaeological context. Ultimately, this paper argues that the Tomb of the Scipios and its epitaphs should be understood not simply as lost echoes of other types of family history, but as a site where the family experienced history through an ongoing dialogue with the dead.
The Mediterranean and the Middle East represent unique biogeographical regions that significantly shaped the evolutionary history and particular diversity of their associated organisms. However, knowledge on the copepods parasitizing freshwater fishes in these regions is limited. This study aims to investigate the diversity and phylogeny of parasitic copepods in freshwater fishes across the Mediterranean and the Middle Eastern regions. A total of 169 freshwater fish species from the Mediterranean and Middle East were examined for metazoan parasites, yielding over 1000 parasitic copepods. A thorough morphological evaluation combined with molecular analyses of partial fragments of rDNA (18S and 28S) and mitochondrial cytochrome c oxidase subunit I (COI) led to the identification of 7 species of Ergasilidae and 3 species of Lernaeidae. These findings include the descriptions of 2 new species: Ergasilus italicus n. sp. parasitizing South European nase, Protochondrostoma genei (Bonaparte, 1839), in Italy and Pseudolamproglena zahrziensis n. sp. found in yellow barbel, Carasobarbus luteus (Heckel, 1843), in Iraq. New host and geographical records, along with molecular data are provided for 8 previously described species – Ergasilus barbi Rahemo, 1982, Ergasilus briani Markevich, 1933, Ergasilus lizae Krøyer, 1863, Ergasilus rostralis Ho, Jayarajan & Radhakrishnan 1992, Neoergasilus japonicus (Harada, 1930), Paraergasilus longidigitus Yin, 1954, Lamproglena pulchella von Nordmann, 1832 and Lernaea cyprinacea Linnaeus, 1758.
This article constructs an approach to analyzing longitudinal panel data which combines topological data analysis (TDA) and generative AI applied to graph neural networks (GNNs). TDA is deployed to identify and analyze unobserved topological heterogeneities of a dataset. TDA-extracted information is quantified into a set of measures, called functional principal components. These measures are used to analyze the data in four ways. First, the measures are construed as moderators of the data and their statistical effects are estimated through a Bayesian framework. Second, the measures are used as factors to classify the data into topological classes using generative AI applied to GNNs constructed by transforming the data into graphs. The classification uncovers patterns in the data which are otherwise not accessible through statistical approaches. Third, the measures are used as factors that condition the extraction of latent variables of the data through a deployment of a generative AI model. Fourth, the measures are used as labels for classifying the graphs into classes used to offer a GNN-based effective dimensionality reduction of the original data. The article uses a portion of the militarized international disputes (MIDs) dataset (from 1946 to 2010) as a running example to briefly illustrate its ideas and steps.
We aimed to present the hospital presented age-specific rate ratio of Traveller women with self-harm or suicide-related ideation and further explore their experiences when attending hospitals in Ireland with thoughts of suicide.
Methods:
A sequential mixed method analysis was adopted. National presentation data from 24 Irish Emergency Departments (EDs) for suicidal thoughts or self-harm, between 2018–2022 and qualitative interviews were conducted. Descriptive statistics, Poisson regression and rate ratios (95% confidence intervals), were used. Interpretative Phenomenological Analysis (IPA) was conducted on interviews with Traveller women presenting to EDs with suicidal thoughts in 2023. We involved lived experience women in the research.
Results:
693 Traveller women presentations were assessed in the 5-year period. Traveller women between 40–49 years of age had 7·81 (95% CI 6·39– 9·55) times higher risk of ideation presentation and those 50+ had 6·41 (95% CI 5·04–8·15) times higher risk of self-harm, when compared to White Irish females. One in four Traveller female presentations, requested no next of kin involvement when discharged. The ‘Power of human connection’ theme emerged from two Traveller women interviewed, reflecting the powerfulness of support in the participants experiences of suicidal ideation.
Conclusions:
Results highlight the potential suicide risk of Traveller women over the age of 40 and the significant issue of social isolation when all forms of interpersonal support – family, Traveller organisations, and public health services – are lacking, but crucial for a collaborative safety plan upon ED discharge.
Political economists continue to imagine the twentieth century in terms of three interlocking transformations: the neoclassical revolution in economics, the political triumph of neoliberalism, and the financialisation of the world economy. In his new book, The Sexual Economy of Capitalism, Noam Yuran tells a completely different story, identifying an obscene financial kernel already present at the dawn of modern capitalism and tracing the effects of its later blooming across a wide range of contemporary settings. In this essay, I develop an exaggerated version of Yuran’s narrative, drawing particular attention to the theoretical and philosophical implications of an obscene perspective on financial life today.
This article concerns the economy of one of the few fortified settlements of the Late Bronze Age–Early Iron Age on the northern coast of the Black Sea, the Uch-Bash settlement, and its satellite settlement, Sakharna Holovka, in the Inkerman Valley in south-western Crimea. Archaeological excavations from the 1950s onwards have yielded much information on the cultivation of plants from the settlement, including charred grains and their impressions on pottery, tools for harvesting and processing the crops, storage containers, and other objects. Data were also obtained on the crops that were grown in the Inkerman Valley. Together, this evidence shows that the production of cereals was a major aspect of its economy at the turn of the Bronze Age to the Iron Age.
This study compares the uses of the acronym wtf (‘what the fuck’) in digitally mediated text-based interactions in three typologically distinct languages: American English (source language), and Finnish and Chilean Spanish (recipient languages). The data consist of tweets extracted from the social media platform X. Interactional Linguistics and Digital Conversation Analysis are employed to examine the functions performed by wtf in different positions in a tweet and interaction. Instances of wtf were annotated to describe its uses in the source language and to compare them with those observed in the recipient languages. The study shows that in all three languages, wtf is used in various tweet-internal and sequential positions. These uses expressed the writer’s disbelief, astonishment, and a problem in acceptance towards prior content. The analysis concludes that the pragmatic functions of wtf in American English undergo a narrowing when it is used in Finnish and Chilean Spanish.