Large language models (LLMs) like OpenAI’s ChatGPT, Google’s Gemini and Anthropic’s Claude can be useful tools in psychiatric practice, helping with tasks such as searching for information, managing administrative work and supporting education. This article demystifies how these tools work by explaining their core operational principles and noting their key limitations, including the risks of confabulation (fabricating information), sycophancy and knowledge cut-offs. It provides practical guidance on mitigating these risks through structured ‘prompt engineering’ and offers a safety framework for integrating LLMs into low-risk administrative and educational workflows. The article stresses the importance of approaching these technologies with caution by independently verifying information, adhering to UK data protection laws and upholding the principles of best practice in patient care. The goal is to help clinicians use these powerful but fallible technologies wisely, ensuring that patient safety and professional responsibility remain paramount as they explore these new tools.

Cenobamate (CNB) has shown efficacy in reducing seizures in drug-resistant epilepsy (DRE) in clinical trials. We conducted a retrospective study at the Centre hospitalier de l’Université de Montréal epilepsy clinic to assess CNB’s real-world efficacy and safety. Among 109 patients, follow-up data were available for 68 at 3 months, 53 at 6 months and 54 at 12 months. Median seizure frequency reduction was 50.0%, 57.3% and 73.3%, respectively. Seizure freedom at 12 months was 25.9%. CNB was discontinued in 8.3% of individuals due to adverse events (non-serious) or treatment inefficacy. Our findings support CNB’s effectiveness in a DRE population.

We introduce a method to determine the investor’s optimal portfolio size that maximizes the expected out-of-sample utility under parameter uncertainty. This portfolio size trades off between accessing investment opportunities and limiting the number of estimated parameters. Unlike sparse methods such as lasso, which exclude assets during the optimization step, our approach fixes the optimal number of assets before optimizing the portfolio weights, which improves robustness and provides greater flexibility in practical implementations. Empirically, our size-optimized portfolios outperform their counterparts applied to all available assets. Our methodology renders portfolio theory valuable even when the data-set dimension and sample size are comparable.

This article examines the relational self-care practices of migrant Chinese women working as massage workers in the United States (hereinafter referred to as Chinese massage workers). Threading both the bodily and the intimate, Chinese massage workers offer care and relaxation for their clients through the modality of touch and quiet comfort. A wealth of scholarly work highlights the complexities of migrant massage workers’ daily lives and their paid labor of care. Thus far, the study of migrant massage workers focuses mainly on their romantic, familial, and work relationships. Little is known about the relational self-care practices that migrant massage workers engage in. Drawing on 20 months of ethnographic fieldwork, this article examines the practice of Chinese massage workers caring for one another through the intellectual genealogy of self-care in Black feminist scholarship. Through an examination of relational self-care performed by and for Chinese massage workers, this article shifts the focus from analyzing the expected performances of care-giving by migrant women massage workers within the economy of racial capitalism to a reconceptualization of self-care as a relational practice.

Emerging evidence has led to an interim review of the existing 2022 Canadian Stroke Best Practice Recommendations (CSBPR) for Acute Stroke Management, 7th edition, recommendations for endovascular treatment of acute ischemic stroke. This manuscript presents an update of the recommendations for endovascular treatment, addressing the issues of posterior circulation stroke, stroke with a large core and stroke with medium vessel occlusion (MeVO). These recommendations are a timely opportunity to reassess current processes to ensure efficient access to acute stroke diagnostics, treatments and management strategies, proven to reduce mortality and morbidity. These updated recommendations supersede the endovascular thrombectomy recommendations included in the 2022 publication of the CSBPR acute stroke management module. Additional materials to support timely implementation and quality monitoring of these recommendations are available at www.strokebestpractices.ca

Longitudinal qualitative inquiry from a social gerontological perspective can offer unique insights into older adults’ wellbeing and home care service trajectories. This temporal case study of 12 older home care clients analysed 136 interviews over three time points with 53 home care network actors in Manitoba and Nova Scotia. Many clients and families grappled with service changes almost daily, even if the level or type of service appeared officially stable. The pandemic added further disruption, shaping clients’ lives, wellbeing, and relationships, as well as their access to and use of service. Notably, changes in clients’ wellbeing and needs for help were not necessarily straightforward nor always apparent to case coordinators, especially when these were tied to social, emotional, or relational wellbeing, or to clients’ living arrangements, housing, family, and community integration. Findings can enhance theorizing of change for older adults receiving home care and guide equity-informed policy and practice.

Do economic sanctions negatively affect democracy and human rights in targeted countries? Although often intended to improve these outcomes, their record of doing so has historically been mixed at best. Most canonical studies cover the 1980s–1990s, but sanctions practice has since undergone major innovations following debates on humanitarian harm. Given this move toward ‘targeted’ sanctions, it stands to reason that sanctions may today be achieving their intended purposes. I take up policy and methodological innovations to re-examine the effects of Western sanctions seeking to improve democracy and human rights from 1990 to 2021. I find that negative effects persist, offering an important update to the empirical literature. Beyond this contribution, I present a template for replicating and extending country-year research in international relations (IR).