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We investigate the consequences of periodic, on–off glucose infusion on the glucose–insulin regulatory system based on a system-level mathematical model with two explicit time delays. Studying the effects of such infusion protocols is mathematically challenging yet a promising direction for probing the system response to infusion. We pay special attention to the interplay of periodic infusion with intermediate-time-scale, ultradian oscillations that arise as a result of the physiological response of glucose uptake and back-release into the bloodstream. By using numerical solvers and numerical continuation software, we investigate the response of the model to different infusion patterns, explore how these patterns affect the overall levels of glucose and insulin, and how this can lead to entrainment. By doing so, we provide a road-map of system responses that can potentially help identify new, less-invasive, test strategies for detecting abnormal responses to glucose uptake without falling into lockstep with the infusion pattern.
In the early months of 2020, governments faced the rapid spread of COVID-19. To navigate the storm of conflicting information about the danger posed by this new disease, countries sought guidance about when and how to respond to it. We argue that the World Health Organization (WHO) played a central role in the diffusion of policies against COVID-19 by exercising leadership. We develop the concept of leadership as a diffusion mechanism to explain how the WHO influenced governments to close schools and workplaces and cancel public events within weeks, despite its lack of strong enforcement mechanisms. Results from five event-history models show the significance of the WHO’s pandemic declaration on March 11, 2020 that mobilized countries to adopt the measures recommended by the organization. However, that declaration did not affect the diffusion of policies that the WHO advised against adopting.
Comprehensive cognitive remediation improves cognitive and functional outcomes in people with serious mental illness, but the specific components required for effective programs are uncertain. The most common methods to improve cognition are facilitated computerized cognitive training with coaching and teaching cognitive self-management strategies. We compared these methods by dismantling the Thinking Skills for Work program, a comprehensive, validated cognitive remediation program that incorporates both strategies.
Methods
In a randomized controlled trial we assigned 203 unemployed people with serious mental illness in supported employment programs at two mental health agencies to receive either the full Thinking Skills for Work (TSW) program, which included computerized cognitive training (based on Cogpack software), or the program with cognitive self-management (CSM) but no computer training. Outcomes included employment, cognition, and mental health over 2 years. To benchmark outcomes, we also examined competitive work outcomes in a similar prior trial comparing the TSW program with supported employment only.
Results
The TSW and CSM groups improved significantly on all outcomes, but there were no differences between the groups. Competitive work outcomes for both groups resembled those of the TSW program in a prior trial and were better than the supported employment-only group in that study, suggesting that participants in both groups benefited from cognitive remediation.
Conclusions
Providing facilitated computerized cognitive training improved neither employment nor cognitive outcomes beyond teaching cognitive self-management strategies in people receiving supported employment. Computerized cognitive training may not be necessary for cognitive remediation programs to improve cognitive and functional outcomes.
Complex, knowledge-intensive projects present challenges in terms of defining the work and determining roles. Time pressure makes these challenges more acute. External leadership can provide necessary direction and shape, giving the work a clear focus guiding the team’s efforts. With hackathons and rapid product prototyping more feasible than they ever have been, collaborations that fast-track innovation by drawing together teams of unfamiliar experts are more common than ever.
Method
Drawing on the process perspective on creative action, we seek to understand the generation of new ideas and solutions when teams are working within an extremely brief time frame of one week. The influence of mentors on these interactions has received limited attention. We fill this gap through a study of fifteen case teams who participated in a week-long boot camp where they generated proposals for public health studies, guided by mentors who were experts in the field. The teams’ proposals were evaluated by independent panels, and the evaluations provided metrics for team success.
Results
Our results suggest that even in short-term teams, the timing of mentor interventions is critical to team success.
In mammals, pregnancy and lactation are marked by maternal calcium stress and bone resorption, leading to reduced bone mineral density. In humans, these periods may partly explain the higher prevalence of osteoporosis in older women compared with men, but lactation patterns in modern humans may reflect cultural influences rather than natural conditions. The extent to which these findings apply to wild-living mammals remains unknown. We measured urinary C-terminal crosslinking telopeptide of Type I collagen (CTX-I) levels, a bone resorption marker, during pregnancy in wild and zoo-housed bonobos (Pan paniscus) and during lactation in wild bonobos. Studying wild-living primates such as bonobos can provide insights into ancestral reproductive adaptations. We found an increase in CTX-I levels towards the end of pregnancy in zoo-housed and primiparous wild females. Contrary to expectations, CTX-I levels during early lactation are lower than in other reproductive phases. This pattern diverges from the assumption that lactation increases bone resorption. Our findings suggest that wild bonobos may rely on a combination of physiological and behavioral strategies to modulate bone metabolism during lactation. Bone resorption may serve as a physiological back-up when behavioral or dietary strategies cannot fully meet calcium demands. These flexible responses, shaped by fluctuating environmental conditions and prolonged maternal investment, provide insight into evolutionary pressures on skeletal health and may inform strategies to mitigate bone loss in humans.
In this article, we focus on the systemic expected shortfall and marginal expected shortfall in a multivariate continuous-time risk model with a general càdlàg process. Additionally, we conduct our study under a mild moment condition that is easily satisfied when the general càdlàg process is determined by some important investment return processes. In the presence of heavy tails, we derive asymptotic formulas for the systemic expected shortfall and marginal expected shortfall under the framework that includes wide dependence structures among losses, covering pairwise strong quasi-asymptotic independence and multivariate regular variation. Our results quantify how the general càdlàg process, heavy-tailed property of losses, and dependence structures influence the systemic expected shortfall and marginal expected shortfall. To discuss the interplay of dependence structures and heavy-tailedness, we apply an explicit order 3.0 weak scheme to estimate the expectations related to the general càdlàg process. This enables us to validate the moment condition from a numerical perspective and perform numerical studies. Our numerical studies reveal that the asymptotic dependence structure has a significant impact on the systemic expected shortfall and marginal expected shortfall, but heavy-tailedness has a more pronounced effect than the asymptotic dependence structure.
The “EU Vaccines Strategy” launched by the European Commission in June 2020 aimed to ensure vaccine safety, equitable access, affordability, swift distribution, and global solidarity for COVID-19 vaccines. This study critiques the Commission’s centralized procurement approach, focusing on Advance Purchase Agreements (APAs) through a literature review, policy analysis, and a case study of the EU-AstraZeneca’s APA. It identifies critical challenges, including transparency deficits, accountability gaps, and anticompetitive practices by vaccine producers that undermine equitable access. Drawing on these insights, the study proposes the FACER Framework — Fairness, Accountability, Competition Law, Ethics of Innovation, and Resilience — a novel model integrating the Treaty on the European Union (TEU) and the Treaty on the Functioning of the European Union (TFEU) oversight with ethical principles. By embedding legal and moral accountability, FACER offers EU policymakers a robust tool to enhance vaccine strategy and equity in future health crises.
Gastrointestinal (GI) nematode infections represent a significant health burden globally, affecting both humans and livestock. Traditional in vitro models to study host–parasite interactions, such as immortalized cell lines, have limitations that hinder the full understanding of these complex relationships. Organoid technology has emerged as a promising alternative, offering a physiologically relevant platform to study host–nematode interactions in vitro. Organoids are three-dimensional structures comprising differentiated cell types that recapitulate features of the corresponding organ. Technological advances for growing, maintaining and manipulating organoids have increased their applications to model infections, inflammation and cancer. This review discusses recent work using GI organoids to advance understanding of nematode–host interactions and modulation of GI epithelial cells. Additionally, we review studies that co-cultured GI organoids with innate lymphoid cells to study epithelial-immune cell cross-talk in the context of nematode infection. By bridging the gap between reductionist cell culture systems and whole-organism studies, organoids offer a powerful platform for investigating complex host–nematode interactions, and for developing and screening novel therapeutics.
Research demonstrates that English- and French-speaking Canadians differ in a wide range of attitudes, including their political preferences, their vision of the Canadian federation and their national identity. In this article, we ask whether individual bilingualism is associated with a decrease in the attitudinal differences between anglophones and francophones. Using survey data collected in the summer of 2023, we attempt to determine whether knowledge of the French language is related to an increase in the responsiveness of English-speaking citizens toward issues that typically preoccupy French-speaking Canadians. Our analyses suggest that knowledge of French as a second language is strongly linked to the political preferences of Canadian citizens but does not bridge the attitudinal gap between Canada’s two main language groups. These results highlight the relevance of considering the different languages that people speak—and not just their mother tongue—to understand their political attitudes.
Providing psychotherapy at 50 sessions in a year (starting twice weekly) led to faster and greater improvements in depression and personality functioning compared to 25 sessions, starting weekly for patients with depression and personality disorder (PD). This study reports long-term dosage effects at 18 and 24 months.
Methods
In a pragmatic, double-randomized clinical trial, 246 outpatients with depression and PD were assigned to (1) 25 or 50 sessions and (2) Short-term Psychodynamic Supportive Psychotherapy (SPSP) or Schema Therapy (ST). Depression severity was assessed with the Beck Depression Inventory-II. Secondary outcomes included diagnostic remission of depression (MINI-plus), PD (SCID-II/SCID-5-P), and treatment-specific measures. Intention-to-treat analyses were conducted.
Results
At 18 and 24 months, BDI-II means did not differ between dosage groups (19.0 for 25 sessions versus 19.1 for 50 sessions; d = −0.01; 95% CI = −0.35-0.37, p = 0.96). The lower-dosage group improved during follow-up (−2.6 BDI points, p = 0.031), which may be partly attributed to additional therapy received by a subgroup. Remission rates at 24 months were 66% for depression and 76% for PD, with no differences between conditions.
Conclusions
Higher psychotherapy dosage led to faster initial improvements, but long-term outcomes were not superior to those achieved with a lower dosage. These results should be interpreted with caution, as unregulated treatment during follow-up reduced the power to detect significant dosage effects. Both SPSP and ST provide viable alternatives to treatments focused solely on depression.
As artificial intelligence grows, human–robot collaboration becomes more common for efficient task completion. Effective communication between humans and AI-assisted robots is crucial for maximizing collaboration potential. This study explores human–robot interactions, focusing on the differing mental models used by humans and collaborative robots. Humans communicate using knowledge, skills, and emotions, while robotic systems rely on algorithms and technology. This communication disparity can hinder productivity. Integrating emotional intelligence with cognitive intelligence is key for successful collaboration. To address this, a communication model tailored for human–robot teams is proposed, incorporating robots’ observation of human emotions to optimize workload allocation. The model’s efficacy is demonstrated through a case study in an SAP system. By enhancing understanding and proposing practical solutions, this study contributes to optimizing teamwork between humans and AI-assisted robots.
To combat the decline in North American grasslands and prairies, innovative strategies to establish new native grass and forb plantings must be considered. Integrated vegetation management entails the use of many practices to cultivate desirable vegetation along roadsides, including mowing, applying herbicides, burning, and replanting. Currently, only a limited selection of postemergence herbicides are available to improve native plant establishment along roadsides. A greenhouse herbicide screen that included four postemergence herbicides registered for use on Conservation Reserve Program (CRP) acres and rights-of-way was conducted to test their safety for use on four native grasses (big bluestem, buffalograss, sideoats grama, and switchgrass) and seven forb species (ashy sunflower, black-eyed Susan, butterfly milkweed, desert false indigo, Illinois bundleflower, Mexican hat plant, and purple coneflower). Clopyralid (689 g ae ha−1), metsulfuron (4.18 g ai ha−1), and quinclorac (418 g ai ha−1) applied at labeled rates caused no injury to the native grass species or butterfly milkweed. However, florpyrauxifen-benzyl (38.4 g ai ha−1) caused significant injury to buffalograss and switchgrass. None of the herbicides tested were universally safe to use on all forb species evaluated in this trial, with each herbicide causing unacceptable injury (≥25%) to one or more forb species. None of the herbicides studied here would be completely safe for use on mixed stands of native grasses and native forbs at the seedling growth stage, indicating that prairie establishment must use alternative chemistries, plant mixes with fewer species, or avoid postemergence applications shortly after emergence of native forbs.
The openness of decision-makers to be influenced by and invest in proposals for policy reform is not constant. Timing is key, as are the diversity and depth of interests, levels of knowledge, and nature of the policy challenge itself; these can all affect how governments absorb information that might fall beyond the usual cost-benefit assessments of day-to-day policymaking. This essay explores how and when the policy environment provides opportunities to introduce a more nuanced discussion of competing moral values in migration governance and, critically, the new policy directions to which they might give rise. In doing so, it will utilize a range of examples from national, EU, and global debates of the past decade, to highlight moments when a dilemmas approach has been—or could have been—useful to effect policy change. Stressing ethical dilemmas can influence migration policymakers when the conditions are right.
Today’s controversies about territorial access and rights of refugees and the cohesion of the nation-state can be traced back to the Declaration of the Rights of Man and of the Citizen and Kant’s ideas about hospitality. Seyla Benhabib has argued that the resulting dilemma can be softened and bridged through “democratic iterations,” and that the EU deliberation offers a suitable perspective. However, the complex construction of the EU asylum framework has led to a paradox of highly regulated rights and closed borders, and to disappointment and opposition. The sudden opening of borders and free choice for the Ukrainian victims of Russian aggression open a new perspective to address the dilemma, in line with EU principles of free choice and openness.
As governments prepare for the resumed session of the Intergovernmental Negotiating Committee on Plastic Pollution (INC-5.2), the urgency of agreeing on a legally binding global plastics treaty is more pressing than ever. This editorial introduces a collection of letters calling for systemic, science-based, and justice-oriented approaches to plastic governance delivered through an ambitious and effective global plastics treaty. The letters span environmental, health, and social disciplines, and highlight the shortcomings of fragmented policy and assert the need for coordinated and binding action. The letters advocate for reducing plastic production, implementing restrictions on toxic chemicals, incorporating the structural inclusion of affected communities, and ensuring robust scientific oversight. Taken together, the collection of letters reflects the scientific and ethical imperatives to act decisively in shaping a transformative and enforceable plastics treaty.
This article surveys reports of human helminth infection from geographical regions above latitude 60°N published in the period 2001–2024. We take a global approach encompassing the Americas and Eurasia. The helminth genera thus described herein include nematode (Trichinella, Toxocara, Anisakis, Pseudoterranova), cestode (Echinococcus, Dibothriocephalus) and trematode (Opisthorchis, Trichobilharzia). The primary reports identified infections principally by serology (community-based or individual, including imported cases) and outbreaks. There were also articles reporting national data compiled from official sources. Despite successful local control programmes, these pathogens pose an ongoing risk to human health in this region.
Gestational diabetes mellitus (GDM) is a common medical condition during pregnancy and is linked to short- and long-term complications for both mothers and offspring. However, there is limited information regarding poor glycaemic control in Malaysia. This study aims to determine the predictors of poor glycaemic control among women with GDM and to explore women’s perceptions and experiences in self-managing glycaemic control. An explanatory sequential mixed methods study was conducted among women with GDM in Northern Terengganu. A proportional-to-size stratified sampling method was used in quantitative research to obtain 238 samples. Logistic regression was applied to determine associations between factors and poor glycaemic control. Then, purposive sampling was done in qualitative inquiry to obtain 12 samples. Thematic analysis was applied to identify recurring themes. The data from both quantitative and qualitative inquiry were then combined to answer research questions. Dietetic counselling (AOR = 2.95; 95% CI: 1.41, 6.17; p-value=0.004) and diet self-efficacy (AOR = 0.78; 95% CI: 0.61, 0.98; p-value=0.040) were associated with poor glycaemic control. Six themes that emerged from the interviews were: fear and worry; knowledge and motivation; dietary preferences and beliefs; family factors; occupational factors; and availability and affordability. The findings provide useful evidence for healthcare providers in delivering comprehensive health education and providing care for women with GDM.
We study buoyant miscible injections of dense viscoplastic fluids into lighter Newtonian fluids in inclined closed-end pipes, at the high-Péclet-number regime. We integrate experiments involving camera imaging and ultrasound Doppler velocimetry, and computational fluid dynamics simulations, to provide a detailed analysis of interfacial dynamics, flow phases/regimes, velocity field, yielded and unyielded zones, and interfacial arrest mechanisms. The flow dynamics is governed by Reynolds ($Re$), Froude ($Fr$) and Bingham ($B$) numbers, the viscosity ratio ($M$), inclination angle ($\beta$), or their combinations, such as $\chi \equiv 2Re/Fr^2$. As the interface evolves, our results reveal a transition from an inertial-dominated phase, characterised by linear front advancement at the injection velocity, to a viscoplastic-dominated phase, marked by deceleration and eventual interfacial arrest governed by the yield stress. The critical transition length between these phases $(\mathcal{L} \approx 1.26 Fr^{0.14})$ is determined by a balance between inertial and buoyant stresses. Experimental findings confirm buoyancy-driven slumping in our flows, consistent with the theoretical yield number criterion ($Y \equiv B/\chi$), with maximum interfacial arrest lengths scaling as $L_s \sim 1/Y$. These results also classify arrested and unhalted interfacial flow regimes on a plane involving ${\chi \cos (\beta )}/{B}$ and $Y$. Furthermore, we demonstrate that the interfacial arrest mechanism arises from interactions between buoyancy, rheology and geometry, as diminishing shear stresses promote unyielded zone expansion near the interface, progressively encompassing the viscoplastic layer and halting flow when stresses fall below the yield stress.
Theories of liberal justice depend upon ideas of how much we can expect ordinary people to be motivated by the moral interests of others; there are limits to the motivational power of such notions as altruism and sympathy. This means, however, that the theories of justice we have may have difficulty in understanding how to rightly respond to the moral claims that might emerge in the face of widespread migration in response to climate change. This essay argues that liberal states may face a dilemma in response to this migration—one in which a state must do what cannot be justified toward either the migratory or the sedentary. This claim, further, might represent a new site of intergenerational injustice, in which future generations are given political problems to which our best theories of political justice can provide little assistance.