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We aimed to investigate the effects of the COVID-19 pandemic on the education and professional development, working conditions, and wellbeing of early career psychiatrists (ECPs) in Europe, as well as their attitudes to telepsychiatry.
Methods
A questionnaire comprising 24 items was designed by the Early Career Psychiatrists Committee of the European Psychiatric Association. Data were collected online from June 2020 to September 2021. A series of multiple regression analyses were conducted to determine variables that could predict the dependent variables.
Results
Data were obtained from 517 early career psychiatrists from 39 different countries. Men were more confident than women in their knowledge of COVID-19 symptoms and management, including in managing patients with a comorbidity of COVID-19 and a mental disorder. Providing specific recommendations during the COVID-19 pandemic, access to additional educational activities for ECPs, following COVID-19-related recommendations and access to protective equipment were the significant predictors of a higher confidence in managing patients with comorbidity of COVID-19 and mental disorders. The obligation to change the place of work predicted a decreased satisfaction with telepsychiatry as well as a decreased willingness to use telepsychiatry after the COVID-19 pandemic, while a diagnosis of COVID-19, having recommendations for telepsychiatry and access to dedicated platform for telemedicine were predictors of an increased satisfaction with telepsychiatry.
Conclusions
The COVID-19 pandemic has affected ECPs in Europe to varying degrees. The results point to areas where decision-makers can improve the working conditions for ECPs.
The Dogmatism Paradox begins with the claim that I know some proposition p and uses apparently good reasoning to draw a seemingly irrational dogmatic conclusion: that I should therefore dismiss any new evidence against p. A standard solution to this paradox is to note that when I acquire new evidence against p, that evidence defeats my justification for believing p. As a result, I no longer know that p, and so the reasoning used to generate the paradox begins with a false premise.
By appealing to recent work in social epistemology by Endre Begby and C. Thi Nguyen, I develop a new, stronger version of the Dogmatism Paradox that is immune to this standard solution. This version of the Dogmatism Paradox has significant consequences for contemporary polarized political disagreements, in which subjects on both sides of the disagreement have reason to distrust new evidence against their beliefs. So, unless the paradox can be solved, many political disagreements in sufficiently polarized communities will turn out to be rationally intractable in the sense that agreement can only be reached by one side irrationally revising their beliefs.
The utilization of carbon dioxide (CO2) has garnered significant attention as a strategy to mitigate anthropogenic emissions. Within this field, the conversion processes of CO2 through photocatalytic systems have emerged as a particularly noteworthy area of research. This approach leverages solar energy for the reaction and is considered a promising and environmentally friendly alternative to traditional thermally driven catalytic systems. This article aims to summarize recent advancements in several key photo-conversion pathways, including the synthesis of methane, methanol, C2 hydrocarbons, dimethyl carbonate, and glycerol carbonate. Additionally, potential configurations for the development of processes aimed at producing various chemicals will be proposed. Current insights indicate that the photocatalytic conversion of CO2 could be effectively integrated with chemical absorption methods, provided that appropriate separation and process intensification strategies are developed. From an economic perspective, the photocatalytic reduction of CO2 minimizes the reliance on green hydrogen as a hydrogen source, thereby significantly improving overall economic viability. Environmentally, it is essential to enhance the reaction conversion and product selectivity of the photocatalytic conversion processes to maximize their decarbonization potential. Overall, this paper is particularly suited for readers who are new to this field and are interested in transitioning from experimental work to process development.
How might the affective work of politics be accessed through the fragments of material culture that we recover as archaeologists? This paper considers how political identities can be formed and shaped affectively through engagement with the qualities of craft objects and the connected world of experience that they index. Taking up a case study from nineteenth-century highland Madagascar, I explore how political affects are caught up with the making and using of everyday things and how the transposed qualities of objects and the metonymic connections they evoke offer a means to tie changes in material culture to shifts in political affects over time.
This perspective article invites readers to (re)imagine research as a means of practicing right relations with the places we inhabit and descend from. We anchor our work in a Kanaka Hawaiʻi, a Native Hawaiian cosmogeny and epistemology, one that recognizes all life as kin. We begin with the central question, “Where have the sand turtles gone?” to explore how a Kanaka Hawaiʻi-informed perspective, grounded in the genealogical creation chant, ke Kumulipo, can guide plastics research in Hawaiʻi. We elaborate this perspective through a moʻolelo, a story of a collaboration between a Kanaka Hawaiʻi cultural practitioner and a French and Swedish plastics researcher along the shores of Kapua, Waimānalo. By tracing the transformation of a conventional scientific study, we aim to grow entry points for research that is accountable to the place and the genealogical descendants of those specific lands, who have inherited the privilege and responsibility to steward them. We conclude by discussing how this perspective might offer critical insights for global environmental policy, such as the UN Plastic Treaty, urging a shift from treating Indigenous Peoples as stakeholders to honoring them as rights-holders. Ultimately, this work is a call to research in ways that honor the original peoples of the places where we are blessed to live, work, and research, particularly in ways that amplify the knowledge traditions and lifeways birthed from those specific lands. We write this piece for and with Waimānalo as a living, reciprocal co-author. We hope the experiences shared here return to and strengthen those places and people.
Outpatient providers at a large urban academic tertiary care referral center were surveyed regarding their current antibiotic prescribing practices and views on antimicrobial stewardship in their practice setting. Many clinical and non-clinical factors shape providers’ decision-making regarding antibiotic prescribing. Electronic medical record based interventions were a favored stewardship strategy.
The experience of human trafficking is associated with a high prevalence of mental health problems, particularly post-traumatic stress disorder (PTSD), anxiety, and depression, for which cognitive behavioural therapy (CBT) would be indicated as an evidence-based intervention. However, lack of knowledge about trafficking survivors’ psychosocial needs, and the complexity of their presentation and circumstances can deter clinicians and impact on survivors’ access to evidence-based care. This article aims to offer guidance for clinicians working therapeutically with adult survivors of human trafficking. It draws on existing CBT evidence-based interventions, and highlights survivors’ holistic needs. This article proposes the use of an existing three-phased approach to treatment and draws upon cognitive behavioural principles. The psychological impacts of exploitation, key assessment topics, and safeguarding concerns are discussed. Considerations for psychological formulation and intervention are described, with a focus on trauma reactions, including PTSD. The integration of a survivor’s social and cultural context into treatment is also explored. CBT interventions can be adapted and applied effectively to address the mental health needs of survivors of trafficking alongside other support to meet their holistic needs.
Key learning aims
(1) To outline potential impacts of trafficking-related experiences on mental health.
(2) To increase clinicians’ confidence in engaging survivors of trafficking in assessment and evidence-based CBT interventions.
(3) To apply a phased model framework to planning and delivering effective interventions where there may be additional or complex psychosocial needs.
This article tackles the paucity of research conducted on indoor relief in the countryside during the Old Poor Law by examining ten parish workhouses in Lincolnshire. It argues that parish workhouses developed into institutions which were circumstantially targeted at the poor. The workhouse boundary was permeable as paupers often experienced indoor and outdoor relief across a life-cycle of need, alongside other support strategies distinct from the poor law. Apart from providing relief for a range of paupers, the workhouse played a deterrent capacity in the negotiated process of relief. To make this effective, workhouse life underscored a loss of independence through a reduced material life and regimented daily routines which saw work as a centrality. All this was overseen by management regimes frequently led by workhouse masters and mistresses, crucial yet understudied personalities in the administration of the Old Poor Law.
Depression rates are higher in women, especially during periods of hormonal fluctuation. Reproductive system disorders (RSDs), which often disrupt hormonal balance, may contribute to this mental health burden. Despite their prevalence and significant health implications, the link between RSDs and depression remains underexplored, leaving a gap in understanding these women’s mental health risks.
Methods
Using Danish nationwide health registers (2005–2018), we conducted a cohort study of 2,295,824 women aged 15–49, examining depression outcomes in 265,891 women diagnosed with 24 RSDs, including endometriosis, polycystic ovary syndrome, and pain-related diagnoses. For each RSD, age-matched controls were selected. We calculated incidence rates, incidence rate ratios, and prevalence proportions of depression diagnoses or antidepressant use around RSD diagnosis.
Results
Across all RSD subtypes, women demonstrated higher rates of depression both before and after diagnosis, with a peak within the year following diagnosis. Incidence rate ratios within 1 year of RSD diagnosis ranged from 1.15 (95% confidence interval [CI] 1.06–1.25) to 2.09 (95% CI 1.98–2.21), depending on RSD subtype. Elevated depression prevalence was observed 3 years before diagnosis, suggesting mental health impacts may have preceded clinical RSD identification.
Conclusions
This study reveals a striking association between RSDs and depression. Women with RSDs are more likely to suffer from depression, before and after RSD diagnosis, highlighting the need for integrated mental health screening and intervention. With over 10% of women affected by RSDs, addressing this overlooked mental health burden is imperative for improving well-being in a significant portion of the population.
Let $\{X_{i}\}_{i\geq1}$ be a sequence of independent and identically distributed random variables and $T\in\{1,2,\ldots\}$ a stopping time associated with this sequence. In this paper, the distribution of the minimum observation, $\min\{X_{1},X_{2},\ldots,X_{T}\}$, until the stopping time T is provided by proposing a methodology based on an appropriate change of the initial probability measure of the probability space to a truncated (shifted) one on the $X_{i}$. As an application of the aforementioned general result, the random variables $X_{1},X_{2},\ldots$ are considered to be the interarrival times (spacings) between successive appearances of events in a renewal counting process $\{Y_{t},t\geq0\}$, while the stopping time T is set to be the number of summands until the sum of the $X_{i}$ exceeds t for the first time, i.e. $T=Y_{t}+1$. Under this setup, the distribution of the minimal spacing, $D_{t}=\min\{X_{1},X_{2},\ldots,X_{Y_{t}+1}\}$, that starts in the interval [0, t] is investigated and a stochastic ordering relation for $D_{t}$ is obtained. In addition, bounds for the tail probability of $D_{t}$ are provided when the interarrival times have the increasing failure rate / decreasing failure rate property. In the special case of a Poisson process, an exact formula, as well as closed-form bounds and an asymptotic result, are derived for the tail probability of $D_{t}$. Furthermore, for renewal processes with Erlang and uniformly distributed interarrival times, exact and approximation formulae for the tail probability of $D_{t}$ are also proposed. Finally, numerical examples are presented to illustrate the aforementioned exact and asymptotic results, and practical applications are briefly discussed.
The district of Realejo in Granada, Spain, was a renown centre for the production of fine silk cloth from the medieval period onwards. During the excavation of a building on the south side of the square of Campo del Principe, two cesspits were identified that dated to the 17th–18th century. Historical evidence suggests this building might have been associated with the guild of silk workers, or might have been a residential property. Samples of sediment from each cesspit were taken at the time of excavation. Optical microscopy identified the eggs of Ascaris sp. (roundworm), Trichuris sp. (whipworm), probable Fasciola sp., Spirometra sp. and Capillaria sp. The presence of Ascaris and Trichuris likely reflect infection of the population by these helminths, and indicate ineffective sanitation. However, the eggs of Fasciola, Spirometra and Capillaria are more likely to reflect infection of animals rather than humans. The eggs could have been deposited in the cesspit if humans ate the organs of infected herbivores (Fasciola), if the faeces of companion animals such as cats or dogs were discarded in the cesspits (Spirometra), or if rodents defecated inside the cesspits as they explored the waste discarded there (Capillaria). While we cannot be sure if those who used these toilets were involved in silk manufacturing, merchants who traded in silk, or other members of society, the pattern of parasite species recovered help provide a vivid picture of life in the people who lived and worked in the silk district of Granada 300–400 years ago.
After reviewing several stances in modern theology on the historicity of the resurrection of Jesus, this article argues that a common feature of the worldviews of Baroque Catholicism, classical Reformation theology, and the Enlightenment, namely, their separation of the supernatural and natural realms into ‘two orders’, explains the attractiveness of the apologetical strategy of affirming the reality of the resurrection as a non-historical, supernatural event. Drawing on the temporal and spatial imaginary of Henri de Lubac’s theology of grace, it concludes by pressing the case for a theological understanding of the resurrection of Jesus as a historical event that valorises the eschatological resonance of time.
Fossils and more recent remains of dead organisms serve as natural archives of Earth’s recent and ancient history. It is often the case that small or fragmented specimens, especially microvertebrate bones, go unstudied. Accurate identification of such remains to a specific taxonomic level can help address a wide range of questions spanning paleontology, paleoecology, zooarchaeology, ecology, conservation science, forensics, and biogeography. Geometric morphometrics demonstrates significant potential for identifying fragmented lizard fossils to at least the family level based on shape differentiation. Our proof-of-concept study using lizard maxillae of extant species within the Pacific Northwest, USA, accurately identified fragmented maxillae with as few as six comparative specimens per genus. These findings establish a framework for addressing taxonomic challenges in fragmented bone specimen identification for taxa whose curated comparative specimens are small in number and unequal in representation.
Fitting loss distributions in insurance is sometimes a dilemma: either you get a good fit for the small/medium losses or for the very large losses. To be able to get both at the same time, this paper studies generalisations and extensions of the Pareto model that initially look like, for example, the Lognormal distribution but have a Pareto or GPD tail. We design a classification of such spliced distributions, which embraces and generalises various existing approaches. Special attention is paid to the geometry of distribution functions and to intuitive interpretations of the parameters, which can ease parameter inference from scarce data. The developed framework gives also new insights into the old Riebesell (power curve) exposure rating method.
The objective of this study is to evaluate the feasibility of implementing Hospital-Based Health Technology Assessment (HB-HTA) within Ukraine’s healthcare system, focusing on its potential to strengthen evidence-based decision-making regarding clinical effectiveness, safety, cost-efficiency, and organizational and strategic impact of health technologies (HTs) in healthcare facilities (HCFs).
Methods
We collected and synthesized key initiatives implemented between 2021 and 2025, outlining the main steps involved in introducing HB-HTA in Ukraine.
Results
The article describes the landscape of the Ukrainian healthcare system and shares the experience of the initial steps of HB-HTA introduction amid tight budgets and increasing demands. Drawing on international models and adapting them to the national context, we outline key implementation strategies, the development of scientific and methodological approaches for HB-HTA, and the integration of a pilot HB-HTA project within a leading national HCF known for its high-level diagnostic and operational capabilities.
Conclusions
The conducted pilot laid the groundwork for integrating HB-HTA into Ukraine’s healthcare system and demonstrated its role in empowering HCFs to guide smarter budget allocation and procurement decisions, especially in the context of decentralization. With continued investment in expertise, legal integration, and streamlined methodology, HB-HTA can become a cornerstone of transparent, cost-effective decision-making across the HCFs of the National healthcare system. The experience gained in Ukraine provides valuable insights that can support other countries in effectively adopting and utilizing HTs at the hospital level.
Studying lobbying influence in politics has been confronted with the challenge of gaining insights into processes that usually take place behind closed doors and about which honest answers from participants are difficult to obtain. Therefore, innovative methods of indirect measurement of lobby success – via text analysis or interviews – have been used to get at the hidden politics of lobbying. In this research note, we propose an additional technique to study lobby influence much more directly, the randomized response technique (RRT). This method has been successfully used to study doping in elite sports, for instance, but has been almost absent from political research in the past. The note presents the method and illustrates its applicability with a study of lobby influence in German Parliaments. The study reached out to 2386 present and to 850 former MPs (Members of Parliaments). The response dataset added up to 273 present and 160 former MPs, equaling response rates of 11.4% and 18.8% respectively. Despite these low response rates, it was nevertheless possible to estimate rates of lobby-friendly behavior among German MPs at comparably low rates of instruction noncompliance. Although the results should be interpreted cautiously due to the low response rate, the study demonstrates the viability of RRT surveys as a means to study sensitive issues in politics.
Transnational climate litigation has become a strategic tool to press state and non-state actors into action. An analysis of international and domestic cases shows how rights and obligations are being materially, subjectively, spatially and temporally stretched in judicial proceedings. This article focuses on three distinct grammars of climate justice activated in climate litigation. The analysis exposes a shift from a traditional to a progressive grammar that moves from actual to potential climate harms, from human to nonhuman rights, from territorial to extra-territorial obligations, and from present to future generations. Beyond a traditional liberal framing of rights-based approaches to climate justice, we witness here a progressive critical grammar that broadens the scope of who can be considered legally affected by climate change, where, and how. A more radical understanding of climate justice, however, exceeds the capacity of these registers to confer structure, order, and meaning to climate harms across matter, subjects, space and time. Against this backdrop, a reparative grammar of climate justice is envisioned, which reconfigures the material boundary from potential to entangled harms, the subjective boundary from nonhuman victims to more-than-human care, the spatial boundary from extra-territorial to terrestrial spatiality, and the temporal boundary from future to enduring temporalities. In doing so, the analysis opens up a register of political thought for climate justice that starts in the law yet vastly exceeds and disrupts it.
There is no recognised cure or specific biomarker for autism spectrum disorder (ASD). Exosomes are small vesicles that carry proteins, lipids and nucleic acids. They have been investigated for diseases such as Parkinson’s and Alzheimer’s. As the conclusions were on the biological utility of exosomes as a non-invasive brain biopsy, some animal, human and in vitro exosome studies have also been presented in the ASD field. The purpose of this review is to compile the studies that have established a relationship between ASD and exosomes so far and discuss their potential for linking the gap between the laboratory and clinic.
Methods:
In this systematic review, 31 PubMed articles were identified using the keywords ‘exosomal’, ‘exosome and ‘autism spectrum disorder’. After excluding 16 reviews, 4 irrelevant studies and 1 preprint, and adding 5 relevant articles, 15 research articles were included based on PRISMA criteria. The articles were investigated and reviewed by both authors. Their methodology and results are also discussed according to two main streams in studies.
Results:
Numerous studies have identified potential biomarkers, including mitochondrial DNA (mtDNA7S), cytokines including IL-1β, TNF-α and IL-6, and different types of RNAs by comparing the exosomal contents of ASD patients or models with controls. In studies that focused on treatment, behavioural improvements were shown in ASD model mice.
Conclusion:
Since there are presently no reliable biomarkers or effective treatments for ASD, exosome-based research offers a promising avenue for early diagnosis and the creation of tailored therapies.
Computer vision–based precision weed control has proven effective in reducing herbicide usage, lowering weed management costs, and enhancing sustainability in modern agriculture. However, developing deep learning models remains challenging due to the effort required for weed dataset annotation and the difficulty of identifying weeds at different stages and densities in complex field conditions. To address these challenges, this study introduces an indirect weed detection method that combines deep learning and image processing techniques. The proposed approach first employs an object detection network to identify and label crops within the images. Subsequently, image processing techniques are applied to segment the remaining green pixels, thereby enabling indirect detection of weeds. Furthermore, a novel detection network—CD-YOLOv10n (You Only Look Once version 10 nano)—was developed based on the YOLOv10 framework to optimize computational efficiency. Redesigning the backbone (C2f-DBB) and integrating an optimized upsampling module (DySample) permitted the network to achieve higher detection accuracy while maintaining a lightweight structure. Specifically, the model achieved a mean average precision (mAP50) of 98.1%, which is a 1.4% percentage-point increase compared with the YOLOv10n baseline, a relevant improvement given the already strong baseline performance. At the same time, compared with YOLOv10n, its GFLOPs (giga floating-point operations per second) were reduced by 22.62%, and the number of parameters decreased by 15.87%. These innovations make CD-YOLOv10n highly suitable for deployment on resource-constrained platforms.