Rural America remains deeply under-represented in clinical trials. St Lawrence Health (SLH) was the sole rural site and one of the top recruiters in the Accelerating COVID-19 Therapeutic Interventions and Vaccines (ACTIV)-1 trial, which was a large international trial that studied the efficacy of three immune modulators in hospitalized patients with COVID-19. In this article, we analyze the structural and clinical factors that enabled SLH’s success in the context of previously described barriers to research participation in rural areas. We conclude with lessons learned from the SLH experience and offer a broader replicable model for developing clinical research capacity in rural areas. SLH’s success in ACTIV-1 can be attributed to early and sustained support from the ACTIV-1 network, a small and integrated inpatient COVID-19 treatment team, regular and consistent communication between this team and the clinical research team at SLH, and SLH’s ongoing support and development of its clinical research department. SLH was, in turn, able to overcome several known barriers to implementation of clinical trials at community sites, including lack of provider time and a lack of trained research and clinical staff, and its experience in ACTIV-1 offers a replicable model for developing clinical research capacity in rural communities.

In this paper, I investigate how parents should talk to their children about injustice. In doing so, I use the non-ideal theory debate in political philosophy to show how the questions traditionally asked there can give substantive guidance to parents. I also contribute to that debate by showing how attention to injustice conversations (a) leads us to ask new questions and develop new modelling tools; (b) can help us to resolve the questions traditionally asked in the debate in a more direct way; and (c) can serve as a model for bringing together substantive and methodological questions in non-ideal theory.

Low political trust disengages citizens from mainstream politics, stimulating anti-establishment voting and even electoral abstention. However, existing scholarship has largely overlooked the temporal dynamics of political trust. Next to high versus low trust, our study identifies two additional components of political trust: its long-term variability and its short-term variation. We employ fifteen waves of the Dutch LISS panel (2008–2023) to systematically test the impact of these three components of political trust on electoral behavior. We find that there are systematic and meaningful differences between stable and variable (dis)trusters. While trust levels are the strongest predictor of both support for anti-establishment and abstention, trust variability has an additional effect on electoral behavior. Short-term declines in political trust increase the chances of anti-establishment voting and abstention, independent of individuals’ overall trust levels and variability. These findings have important implications for our understanding of democratic alienation and critical citizenship.

This article rethinks the political project of transforming sexual desire and the norms that regulate it, aiming to reduce oppression and marginalization in intimate life. In the wake of recent feminist revivals of this project, such as Amia Srinivasan’s The Right to Sex (2021), I analyze the limitations of two dominant frameworks: ‘disciplinary’ models, which overestimate our capacity to regulate desire, and ‘liberatory’ models, which assume the existence of an authentic, pre-political core of desire that can be freed from power. I argue that both models are flawed, promoting respectively the illusion of total control and prelapsarian fantasies. To move beyond them, I turn to Theodor W. Adorno’s concept of natural history, which challenges the fixity of desire without assuming its infinite malleability. Specifically, drawing on Adorno and his interpreters, I show the natural history provides a framework for conceptualizing agency and transformation that neither negates the constraints shaping desire nor forecloses the possibility of its active reconfiguration. This approach, I suggest, offers a critical foundation for feminist efforts to rethink and reshape desire.

Low enrollment of racial/ethnic minorities in clinical trials is a persistent problem. This study explores community health workers’ (CHWs) potential to increase research participation by Black people. We interviewed 12 CHWs and 12 Black community members, and after multidisciplinary analysis, held a CHW focus group to refine themes and make recommendations. Most participants mistrusted research, but many valued its potential for generativity. CHW involvement in research was seen as an opportunity to bring community relationships and context to all aspects of research, including recruitment. Participants proposed steps to build trustworthy research experiences and develop CHWs as full research team members.

This paper analyzes the impact of product-market fit on firms’ export performance, focusing specifically on the case of wineries. To this end, we use a representative sample of Spanish wineries and data on 49 export markets. The empirical analysis is based on a firm heterogeneity model that integrates both macroeconomic and firm-level factors influencing wine export performance. Our findings indicate that a good product–market match facilitates export activity and can mitigate traditional barriers to international trade, such as geographic or political distance. When a winery conducts effective market research and identify markets where consumer preferences align closely with the characteristics of its products, its export performance improves significantly.

The Indonesian government has alternately ignored and respected the customary land rights of local people in its land policies since colonial times. Since the start of democratisation at the end of the 1990s, the trend to uphold customary land rights has become apparent at the national level. This study examines their status in the field, using the case of land grabbing on Padang Island, Riau Province, Indonesia. The findings include the company’s continued practice of purchasing land areas from local people at a lower price, not as compensation, because the company has not yet recognised the customary land rights. However, the local people contest the negotiation for a higher price through the newly introduced transparent practice of land transactions, involving village officers. The recommendation by the Mediation team to respect customary land rights is thus still a work in progress.

Alpha-ketoglutarate (AKG) is a well-known intermediate of the tricarboxylic acid cycle and plays an important role in the catabolism of branched-chain amino acids (BCAAs: leucine, isoleucine, and valine). While previous study suggested that AKG enhances glucose metabolism, its effect on the adaptation of muscles and adipocytes has not been well studied in diabetic condition. This study aimed to determine whether AKG improves glucose metabolism in the skeletal muscles and adipose tissues in diabetic mice. Male institute of cancer research mice were divided into control, diabetic, and diabetic + AKG groups. Diabetes (DM) was induced by a high fat diet consumption and streptozotocin (STZ) injection. Mice in the DM + AKG group were administered 1% AKG in drinking water for 6 weeks. The non-fasting plasma glucose level was significantly higher in the diabetic group than that in the control and DM + AKG groups (P < 0.05). No significant difference was observed in glucose transporter 4 (GLUT4) protein levels in the muscles between the DM and DM + AKG groups. AKG supplementation attenuated the decrease in peroxisome proliferator-activated receptor γ coactivator 1 alpha and GLUT4 protein levels in inguinal and epididymal adipose tissues in diabetic condition. In conclusion, the study findings suggested that AKG supplementation increased protein levels related to mitochondrial biogenesis and glucose transporters in adipocyte tissue accompanied with improved whole-body glucose metabolism in STZ and high-fat diet-induced diabetic mice.

Although the Mixteca region has witnessed a long period of human occupation from before village societies were established to the present, traditional archaeological narratives tend to simplify this history by emphasizing singular points of origin and radical moments of change. Based on decolonial perspectives, we examine how persistence may be a more suitable framework for understanding the long history of human occupation in the region. Using information from three archaeological projects, this article analyzes the enduring histories of household practices at the site of Etlatongo in the Nochixtlan Valley. We focus on the construction of domestic spaces over three different periods in the long occupation of the site: during the latter half of the Early Formative (1400–1000 BC), the late Middle Formative (500–300 BC), and the Postclassic (AD 900–1500s). By analyzing the changing continuities of domestic practices at Etlatongo, this study contributes to scholarship examining the persistence of Indigenous communities in Mesoamerica.

Cognitive problems represent one of the most common symptom dimensions in functional neurological disorder (FND; >80% of patients) and are frequently associated with distress, disability, and difficulties engaging in evidence-based treatments such as psychotherapy. Cognitive difficulties occur across the FND subtypes (eg, seizures, movement disorders, dizziness) but are largely underrecognized and undertreated by healthcare providers. That is, although a variety of interventions are available for primary functional symptoms and mental health comorbidities, there have not been any systematic efforts to date to specifically target cognitive functioning in FND, leaving an important gap in the literature.

Cognitive rehabilitation is a flexible approach utilizing diverse techniques aimed at improving cognition and enhancing functional independence in people with neuropsychiatric disorders. Cognitive rehabilitation can have positive impacts (moderate effect sizes) on cognition and everyday functioning across a variety of conditions, including traumatic brain injury, mild cognitive impairment, long COVID, PTSD, and others. Given the transdiagnostic clinical utility of cognitive rehabilitation, it has potential for benefit in many patients with FND if adapted and applied appropriately.

In this review, we highlight the utility of cognitive rehabilitation for FND, with a focus on clinically actionable advice and guidance. We describe fundamental principles of cognitive rehabilitation, evidence for its efficacy and effectiveness across neuropsychiatric disorders, and methods for avoiding potential pitfalls when applying it in FND. We then discuss a Case Vignette in order to emphasize the application of cognitive rehabilitation principles in an individual patient. We conclude with future directions for research and clinical care.

Workplace happiness has emerged as a strategic and ethical priority due to its impact on employee well-being, engagement, and sustainable performance. However, the construct remains conceptually fragmented, with existing measures often limited to affect or job satisfaction. This study addresses these limitations by proposing and preliminarily validating a multidimensional instrument that integrates hedonic and eudaimonic dimensions of workplace happiness: emotional well-being and purpose, work–life balance, and work relationships and support. Using a multi-phase research design, including expert content validation, a pilot study (n = 100), and large-scale psychometric testing (n = 354), the study applies exploratory and confirmatory factor analyses. Results provide initial evidence of strong structural validity, internal consistency, and convergent and discriminant validity (CFI = 0.971; TLI = 0.959; RMSEA = 0.078). Workplace happiness is conceptualised as a synergy of affective fulfilment, meaningful contribution, and supportive relationships. Despite cross-sectional and non-probabilistic limitations, the instrument offers a robust foundation for future validation and human-centred organisational research.

We present a critical survey on the consistency of uncertainty quantification used in deep learning and highlight partial uncertainty coverage and many inconsistencies. We then provide a comprehensive and statistically consistent framework for uncertainty quantification in deep learning that accounts for all major sources of uncertainty: input data, training and testing data, neural network weights, and machine-learning model imperfections, targeting regression problems. We systematically quantify each source by applying Bayes’ theorem and conditional probability densities and introduce a fast, practical implementation method. We demonstrate its effectiveness on a simple regression problem and a real-world application: predicting cloud autoconversion rates using a neural network trained on aircraft measurements from the Azores and guided by a two-moment bin model of the stochastic collection equation. In this application, uncertainty from the training and testing data dominates, followed by input data, neural network model, and weight variability. Finally, we highlight the practical advantages of this methodology, showing that explicitly modeling training data uncertainty improves robustness to new inputs that fall outside the training data, and enhances model reliability in real-world scenarios.

Many archaeological arguments are based on artifact identification, but to be replicable the categories must be well defined, with researchers able to consistently identify the relevant attributes. If data are to be compared across projects or researchers, the same training and reference material should be available. Standardized visual guides for specific artifact types and contexts are valuable tools for improving identification by individuals and reducing inter-operator variation. To standardize shell temper description within Pensacola Mississippian pottery, we describe the development of a visual guide based on replicated shell-tempered pastes. We created 98 unique fired clay briquettes, varying in measured ways across four variables: shell type, particle size, particle density, and whether shell was still present or leached. The resulting briquettes were imaged and arranged for quick comparison with archaeological materials. To test the utility of this guide, we conducted a survey among professional archaeologists, assessing their confidence in and success with identifying shell temper attributes with and without the guide images. The results of the survey demonstrate the effectiveness of such tools for collaborative archaeological research. We describe the general method for producing this type of guide, which may be adapted for different pottery temper types, and provide our own images for use by others studying shell-tempered pottery.

Cash transfer programmes have achieved widespread adoption across developing countries, yet evidence on their effectiveness in the Middle East and North Africa remains comparatively limited. This systematic review examines four central questions: whether transfer effectiveness shows threshold effects whereby modest amounts alter behaviour while substantial poverty reduction requires larger transfers; how supply-side service capacity constraints mediate the effectiveness of demand-side incentives; how conflict and displacement influence programme sustainability; and how programme design features interact with patriarchal structures to shape women’s empowerment. Database searches spanning 2000–2024 identified 270 experimental or quasi-experimental studies with quantitative outcomes. Narrative synthesis examined heterogeneity across transfer amounts, programme design, and contexts. Results indicate non-linear threshold effects: modest transfers (5–10 per cent of household income) alter behaviour through framing mechanisms, whereas meaningful poverty reduction requires transfers of 15–20 per cent or more. Demand-side incentives produce counterproductive outcomes when supply-side capacity binds. Humanitarian assistance improves consumption temporarily but effects dissipate within —four to ten months absent sustainable livelihood pathways. Financial resources alone do not guarantee women’s empowerment; complementary interventions addressing social norms and legal frameworks appear necessary. These findings suggest the imperative of calibrating transfer magnitudes to programme objectives while recognising empowerment requires interventions transcending monetary provision.

While animal welfare is a growing global concern, there has been very little research into how it is understood in Iran. Cultural, religious, and legal factors influence attitudes and practices in ways not addressed by existing research. This study provides culturally grounded insights for improvement of animal welfare in Iran. Utilising a validated survey tool, we investigated the attitudes of Iranians toward the welfare of farmed, companion, and wild animals. A total of 325 responses were collected. The findings indicate that animal welfare is considered important to Iranians, with the majority expressing interest in improving the welfare practices. Despite varying degrees of familiarity with different animal species, there was a consensus on the importance of enacting laws to protect animal welfare. Most participants agreed that chickens feel pain (92.9%) and emotions (79%), whereas fewer attributed these capacities to fish, with 63.6% acknowledging pain and 59.5% acknowledging emotions. Furthermore, most of the participants agreed that animals should not endure pain in the slaughter process (97.8% agreement). While the majority of participants agreed that pre-slaughter stunning was better for the animals (78.7%), only 51.7% agreed that they would prefer to eat meat from animals that had been stunned; reflecting the traditionally held views regarding the role of stunning in Halal meat production. The results of the current study support previous findings suggesting that concern for animals may be a universal human inclination, although, in Iran, attitudes towards specific species and agricultural practices are also shaped by religious perspectives.

Fire could be mapped into many target domains to construct metaphors. However, it is not yet known to what extent people’s experience of real-world fire affects the diversity of fire metaphors. The present study aims to explore the derivation of fire metaphors through the ecological perspective of affordances by analysing the collocational patterns associated with both metaphorical and literal uses of ‘fire’ in the Corpus of Contemporary American English (COCA). Results show that (1) metaphorical and non-metaphorical fire expressions are related to the ecological affordances of real-world fire, including ‘injury to the skin’, ‘warmth’ and ‘illumination’; (2) metaphorical fire expressions are more likely to evoke the ecological affordances and (3) ‘injury to the skin’ is more prominent than ‘warmth’ and ‘illumination’. The findings reveal that the interaction between humans and the environment is fundamental in the process of metaphorical understanding. Metaphorical uses of fire are strongly influenced by embodied interactions with the physical fire and are constrained by cognitive salience.

The proportionality between crime and punishment is made, and the way it is made makes for a certain kind of criminal law. By analyzing how punitive measures are justified in Swedish criminal law and crime policy through appeals to proportionality, the Article demonstrates how proportionality has been made and remade to legitimize an increasingly punitive crime policy, obscuring the reasons for these legislative changes. The Article thus calls for the principle of proportionality to be dismantled and employs a discursive approach to reverse-engineer claims of proportionality in Swedish legislative proposals. The purpose of this approach is to make visible the meanings and limits of the contemporary crime policy understanding of crime, punishment, and a just criminal law.