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Existing research on post-traumatic stress disorder (PTSD) development over time covers brief periods predominantly among military personnel, rather than civilians, and baseline measurements from before traumatic experiences are rarely available. This longitudinal study examined PTSD trajectories among Israeli civilians before and after the October 7, 2023, terror attack, exploring their associations with current and previous trauma.
Methods
Data included 1,231 Israeli Jewish adults from a quasi-representative sample surveyed at four time points: January 2018, April 2022, December 2023, and March 2024. Participants completed self-report measures, including the PTSD Checklist for DSM-5 (PCL-5), exposure to the October 7 attack and subsequent war, and trauma in childhood and adulthood. Latent growth mixture modeling identified PTSD trajectories.
Results
Four trajectories were identified: resilience (70.4%), trauma recovery (9.4%), trauma vulnerability (16.8%), and chronic PTSD (3.5%). The chronic PTSD group exhibited persistently high symptoms, associated with greater childhood trauma and war-related exposure. The trauma vulnerability group showed low-medium pre-attack PTSD levels that escalated post-attack, associated with higher war-related stressors. The trauma recovery group had high pre-attack PTSD severity related to high trauma exposure, but showed significant symptom reduction post-attack.
Discussion
This study, the first to examine PTSD trajectories in civilians after large-scale trauma, highlights diverse impacts. Most participants demonstrated resilience, while some exhibited chronic symptoms. Two trajectories – trauma vulnerability and trauma recovery – were event-responsive, suggesting that collective trauma can both exacerbate and paradoxically alleviate symptoms. Findings emphasize the need for targeted interventions and suggest future research using machine learning to refine PTSD trajectory prediction.
Generative artificial intelligence (GenAI) applications in job scheduling are expected to help schedulers embed their requirements into scheduling models in a more user-friendly way to generate customized scheduling results. However, there are still very few such applications, while using existing general-purpose GenAI services is inconvenient and prone to data leakage risks. To solve these problems, this study established a GenAI job scheduling system. By hosting the GenAI job scheduling system locally, schedulers can avoid the leakage of order- or recipe-related information that may occur when uploading to the cloud-based GenAI service. In the GenAI job scheduling system, a user interface is designed for users to enter queries in natural language. The user’s query is then analyzed to extract his/her requirements related to the scheduling task, thereby building an extended three-field notation (ETFN) of the scheduling problem. A customized genetic algorithm (GA) is generated to help solve the mathematical programming (MP) model corresponding to the ETFN, thereby updating invalid code or adding new code to the basic GA application. The effectiveness of the GenAI job scheduling system has been tested in a flexible job shop case.
Qualitative data and analysis can enrich our understanding of key questions in behavioural public policy. In this perspective, I make the case for incorporating qualitative approaches better and more often into our research. I offer practical ideas on how to do this, and a call for action from researchers, reviewers, editors, policy makers and our Higher Education and funding institutions.
Tarkhan is a cemetery in Egypt’s Nile Valley, best known for its pivotal late Predynastic and Early Dynastic remains. Despite its importance for understanding state formation in Egypt, the site saw limited modern investigation until 2024, when a new Egyptian-Polish archaeological project was launched to provide a reassessment of Tarkhan.
Sharing, harmonizing, and analyzing participant-level data is of central importance in the rapid research response to emerging pathogens. Individual participant data meta-analyses (IPD-MAs), which synthesize participant-level data from related primary studies, have several advantages over pooling study-level effect estimates in a traditional meta-analysis. IPD-MAs enable researchers to more effectively separate spurious heterogeneity related to differences in measurement from clinically relevant heterogeneity from differences in underlying risk or distribution of factors that modify disease progression. This tutorial describes the steps needed to conduct an IPD-MA of an emerging pathogen and how IPD-MAs of emerging pathogens differ from those of well-studied exposures and outcomes. We discuss key statistical issues, including participant- and study-level missingness and complex measurement error, and present recommendations. We review how IPD-MAs conducted during the COVID-19 response addressed these statistical challenges when harmonizing and analyzing participant-level data related to an emerging pathogen. The guidance presented here is based on lessons learned in our conduct of IPD-MAs in the research response to emerging pathogens, including Zika virus and COVID-19.
Translational science methods often fall short due to the complexity of the healthcare delivery environment. We developed a methodology that involves multiple interest holders working within a pre-competitive consortium to develop solutions to translational barriers. The methodology supports innovative collaboration in a stepwise fashion: elucidating challenges, designing solutions, enabling implementation, monitoring, learning, disseminating, and catalyzing. Cases that benefit most from a structured collaborative methodology are those where diverse needs require elucidation and alignment. Application of the methodology to develop regulatory, clinical, and business innovations has shown the importance of an innovation facilitator and the capacity-building potential of collective skill enhancement.
Sub-Saharan Africa (SSA) is currently undergoing rapid urbanisation, a transition that is closely linked to the adoption of sedentary lifestyles and Westernised dietary habits. This shift has contributed to a substantial rise in obesity and diet-related non-communicable diseases (DR-NCDs), placing a significant strain on already burdened healthcare systems. Among the key modifiable risk factors driving this epidemiological transition are changes in dietary patterns. Western-style diets have been shown to promote inflammation and trigger metabolic and immune dysregulation, factors that underlie the development of DR-NCDs. Conversely, many Tanzanian heritage diets incorporate a diverse array of nutrient-rich foods prepared using techniques that minimise the use of oils, sweeteners and preservatives. These diets predominantly use whole grains, legumes and fruits, foods high in dietary fibre and nutraceuticals. Nutraceuticals are known to have both immunomodulatory and metabolic benefits and could potentially counteract the negative effects associated with Western-style diets. However, the limited scientific documentation of these heritage diets endangers future research into their potential health benefits. This underscores the need for targeted efforts to preserve and promote traditional dietary practices. In this review, we summarise the diversity of heritage diets from four distinct tribes in Northern Tanzania – the Maasai, Chagga, Pare and Hadzabe – who have historically exhibited low rates of DR-NCDs but are now experiencing rapid urbanisation and lifestyle changes. We briefly describe the dietary patterns of these tribes and examine the potential links between the declining usage of traditional dietary practices and the rising prevalence of DR-NCDs in Tanzania.
Clozapine is the only medication specifically recommended for treatment-resistant schizophrenia, but research suggests that it is universally underprescribed, particularly among children and adolescents. This article discusses clinicians’ reluctance to prescribe clozapine for all age groups, and outlines its benefits for treatment-resistant schizophrenia in young people. It summarises guidelines on clozapine therapy for adults, including initiation, monitoring and adverse and side-effects, and describes how they can be applied to a younger population. Psychiatrists who care for younger people have consistently highlighted a wish for more learning opportunities focusing on clozapine, such as the content of this article.
We investigate the impact of corruption on female leadership in Brazil using cross-sectional municipal-level data. Our findings suggest that corruption significantly reduces the proportion of working women in leadership roles. Additionally, corruption decreases female representation in leadership relative to men, though this effect is less robust. When examining sectors most vulnerable to corruption, the results remain largely consistent, but we also note that women tend to avoid these sectors entirely. Our findings suggest that corruption acts as a significant barrier to female leadership.
A spherical cap, lined internally with a surfactant-laden liquid film, is studied numerically as a model of lung alveoli. Large-amplitude oscillations are considered (deep breathing), which may lead to collapse of the surfactant monolayer during compression, with formation of a sub-surface reservoir that replenishes the monolayer during re-expansion. Independent conservation equations are satisfied for the monolayer and the total surface concentration of surfactant and a novel kinetic expression is introduced to model the two-way internal transport with the reservoir. Marangoni stresses, which drive shearing flow, are not significantly hindered by the collapse of the monolayer, unless the latter is singularly stiff. However, volumetric flow rate and wall shear stress exhibit abrupt changes with monolayer collapse, mainly because of the strong modification of capillary stresses. These changes induce complex temporal variability in the epithelial shear, a condition known to stimulate enhanced surfactant secretion. The effect may counterbalance the predicted increase with amplitude in surfactant drift from the alveolar opening, thereby contributing to homeostasis. Nano-particles deposited on the liquid layer are slowly transported by the flow towards the alveolar rim, with exit half-time in order-of-magnitude agreement with in vivo data. Thus, Marangoni stresses are proposed as a key mechanism of alveolar clearance. Both particle displacement speed and surfactant drift from the alveoli are found to vary with solubility, with the former increasing monotonically and the latter exhibiting maximum at intermediate solubilities.
Declining participation by family childcare home (FCCH) providers in the Child and Adult Care Food Program (CACFP) may stem from inadequate tiered reimbursements for nutritious foods. During the COVID-19 pandemic, federal waivers temporarily eliminated tiers and increased reimbursements. We evaluated provider, sponsor and family perceptions of CACFP benefits and challenges in general and regarding the temporary removal of tiers and increased reimbursement rates.
Design:
From September 2023 to February 2024, FCCH providers, CACFP sponsors and CACFP family recipients in California participated in semi-structured interviews about CACFP benefits and challenges, perception of tiers and the COVID-19 waiver, quality of food and business viability. Thematic analysis was conducted using the immersion crystallisation method.
Setting:
Virtual interviews with California providers, sponsors and families.
Participants:
FCCH providers (n 31), CACFP sponsors (n 10) and CACFP family recipients (n 6).
Results:
Providers and sponsors reported that the higher temporary reimbursement rate positively impacted food budgets and quality. Pandemic-era facilitators of CACFP participation included the higher reimbursement rate, tier removal and a hybrid model for monitoring visits. Benefits beyond the pandemic included nutrition education and supporting child food security. Families valued CACFP for providing a variety of high-quality foods. However, barriers to CACFP participation persist, including administrative burden, inadequate reimbursements, strict regulations and the impacts of the pandemic and inflation.
Conclusions:
Increasing CACFP reimbursements while reducing other participation barriers can better support FCCH providers’ and sponsors’ participation. Supporting FCCH CACFP participation and retention can enhance access to healthy and nutritious meals for children from families with low income.
Nutrition education plays a crucial role in improving the nutritional status of pregnant women, yet evidence of its impact in low-income settings like Ethiopia is limited. This study evaluated the effectiveness of facility-based nutrition education and counseling on pregnant women’s knowledge, dietary practices, and Fe-folic acid supplement use.
Design:
A cluster randomised controlled trial was conducted in Addis Ababa, Ethiopia, involving 683 pregnant women across twenty health centres assigned to intervention or control groups. Antenatal care providers in the intervention group received training on pregnancy nutrition and counseling, while the control group continued standard care per national guidelines. A total of 683 pregnant women were enrolled during their first and second antenatal care (ANC) visits. Mixed-effects linear regression was used to evaluate outcomes.
Study setting:
The study was conducted in Addis Ababa, Ethiopia, from August to December 2017.
Participants:
Pregnant women attending ANC follow-ups and healthcare providers working in ANC units.
Results:
The intervention group demonstrated significant improvements in knowledge, including iodised salt use (difference-in-differences (DID) 23 %), correct Fe-folic acid supplementation duration (DID 68 %) and the need for additional meals during pregnancy (DID 49·9 %). Dietary practices improved with higher dietary diversity (DID 32·3 %), increased dairy consumption (MD 1·2 v. –0·1; DID 1·2 per week) and higher Fe-folic acid supplementation (MD 4·9 v. 1·6; DID 3·2 per week).
Conclusion:
Nutrition education and counseling during ANC visits significantly improved pregnant women’s knowledge and dietary practices. Integrating and strengthening these interventions into routine ANC services could effectively enhance dietary intake and health outcomes.
Let M be an open Riemann surface and $n\ge 3$ be an integer. In this paper, we establish some generic properties (in Baire category sense) in the space of all conformal minimal immersions $M\to{\mathbb{R}}^n$ endowed with the compact-open topology, pointing out that a generic such immersion is chaotic in many ways. For instance, we show that a generic conformal minimal immersion $u\colon M\to {\mathbb{R}}^n$ is non-proper, almost proper, and ${\mathfrak{g}}$-complete with respect to any given Riemannian metric ${\mathfrak{g}}$ in ${\mathbb{R}}^n$. Further, its image u(M) is dense in ${\mathbb{R}}^n$ and disjoint from ${\mathbb{Q}}^3\times {\mathbb{R}}^{n-3}$, and has infinite area, infinite total curvature, and unbounded curvature on every open set in ${\mathbb{R}}^n$. In case n = 3, we also prove that a generic conformal minimal immersion $M\to {\mathbb{R}}^3$ has infinite index of stability on every open set in ${\mathbb{R}}^3$.
The current study investigates farmers’ behavioral intentions toward adopting biopesticides in India, integrating the theory of planned behavior and health belief model. The models were further expanded by the inclusion of a control variable, Government Initiatives. A total of 468 responses from four districts (Patna, Bhagalpur, Purnea, and Saharsa) in Bihar were collected by face-to-face surveys and analyzed using the SmartPLS 4 software by structural equation modeling to assess the correlation between the constructs. The hypothesis testing employs a bootstrapping method with 5,000 iterations. The present study demonstrated a strong positive correlation between all variables derived in the integrated model. Perceived severity strongly influenced farmers’ attitudes toward adopting the use of biopesticide. Furthermore, subjective norms and government initiatives emerged as the most important factors influencing farmers’ intentions toward adopting biopesticide. Premium price, low effectiveness, and reduced crop productivity emerged as significant challenges to the adoption of biopesticides. To address these challenges, this study suggests providing farmers with affordable solutions and resources in collaboration with the government. The proposed study provides significant information and facilitates the understanding of farmers’ inclinations to utilize biopesticides. The government and policymakers can address key barriers to the adoption of biopesticides—such as income inequality—by offering subsidies for organic food production, developing an efficient and dedicated supply chain for input and output organic produce, and formulating strategies to optimize the use of biopesticides in order to promote long-term sustainability.
Sludge is one of the most important yet underappreciated problems in modern society. Examples of sludge include unnecessarily complex paperwork requirements, hard-to-navigate documents and websites, long waiting time, and unfriendly or confusing staff interactions. However, little is known about whether some people are more vulnerable to and less accepting of some types of sludge than others. Drawing on data from a nationally representative survey with 1,591 participants from Ireland, we show that people report being particularly vulnerable to outdated websites with broken links, unfriendly staff interactions, complex documents laden with jargon, and hard-to-navigate websites. These are also the types of sludge that are least acceptable. Less vulnerability is reported to long waiting times and requirements about having to provide private information. We find only minor differences in sludge perceptions depending on whether the sludge emerges in the public or the private sector. Moreover, people with poor mental health report being more vulnerable to and less accepting of sludge. Self-reported administrative literacy is related to less reported vulnerability, and the tendency to procrastinate and a lack of time and mental energy predict more reported vulnerability to sludge. Administrative literacy and a lack of mental energy also predict acceptability of sludge.
Surface roughness of fairly small (micron-sized) height is known to influence significantly three-dimensional boundary-layer transition. In this paper, we investigate this sensitive effect from the viewpoint that roughness alters the base flow thereby inducing new instabilities. We consider distributed roughness in the form of a wavy wall with its height being taken to be of $\mathit{O} (R^{-1/3 } \delta ^{\ast })$, where the Reynolds number $R$ is defined using the local boundary-layer thickness $\delta ^{\ast }$. Despite having a height much smaller than $\delta ^{\ast }$, the roughness is high enough to induce nonlinear responses. The roughness-distorted boundary-layer flow is characterised by a wall layer (WL) – a thin layer adjacent to the surface – the main layer and a critical layer (CL) – the vicinity of a special position at which a singularity of the Rayleigh equation occurs. The widths of both the WL and CL are of $\mathit{O} (R^{-1/3} \delta ^{\ast })$. Surface roughness alters the base flow significantly, leading to $\mathit{O} (1)$ vorticity distortions in these layers. We show for the first time that the nonlinearly distorted flows in these layers support small-scale local instabilities due to the roughness-induced $\mathit{O} (1)$ vorticities. Two types of modes, CL and WL modes, are identified. The CL modes have short wavelengths and high frequencies, with the spatial and temporal instabilities being governed by essentially the same equation. Thus, we focus on the former, which can be formulated as a linear generalised eigenvalue problem. The WL modes have short wavelengths but $\mathit{O} (1)$ frequencies. The temporal WL mode is governed by a linear eigenvalue problem similar to that for the CL modes, while the spatial WL mode is described by a nonlinear eigenvalue problem. The onset of these small-scale fluctuations could form a crucial step in the transition to turbulence.
To successfully recruit and retain faculty members from underrepresented backgrounds (URBs), we need to understand the factors that attract them to research careers in the first place. However, scholarship in this area has focused largely on students who are contemplating research careers rather than faculty members who are currently in such careers.
Methods:
This study explores the career motivations of early-career health researchers (faculty members and postdoctoral fellows) from URBs. It was conducted as part of a cluster randomized trial across 25 academic institutions investigating a support intervention. We conducted 1-hour semi-structured qualitative interviews with scholars from URBs in both the intervention and control arms of the trial. To our knowledge, this is the largest qualitative study of early-career faculty members from URBs to date.
Results:
Seventy-eight individuals were interviewed. Our analysis revealed six key themes pertinent to participants’ motivations to pursue research careers: (1) love of science; (2) making a larger impact; (3) happenstance and economic considerations; (4) family, community, and a path out of poverty; (5) the role of mentors and role models; and (6) support programs for scholars from URBs.
Conclusions:
Our results align with prior studies while offering new insights into the motivations of URB faculty members in research careers. These insights can and should inform the design of programs to both recruit and retain URM faculty members in research careers.
Thermal protective clothing (TPC) protects firefighters from physical threats associated with structural firefighting. However, it also limits the release of body heat generated, which can result in hyperthermia and dehydration. Despite the prevalence of winter structure fires in the United States, there is a paucity of cold-weather firefighting research.
Study Objective:
This study documented physiological responses to moderate-intensity exercise in a cold environment while wearing TPC with the hypothesis that while exercising in firefighting TPC, a cold environment would maintain normal core body temperature and decrease extremity temperature compared to a thermal neutral environment.
Methods:
Fourteen firefighters (two females; 30.9 [SD = 8.1] years) participated in both a thermal neutral (20°C) and cold (-8°C) condition simulation. Each subject was outfitted with a heart rate (HR) monitor, eight surface temperature sensors, and a core temperature (Tc) capsule prior to donning TPC. For each condition, subjects walked on a treadmill in an environmental chamber to simulate the common firefighting work intervals of two 20-minute sessions, with a short rest in between, followed by a 20-minute rehabilitation period. Body temperatures, HR, respiratory rate (RR), rate of perceived exertion (RPE), and thermal sensation, comfort, and preference were recorded during exercise and recovery.
Results:
Core temperature, HR, RR, and RPE increased during exercise in both conditions. Mean skin temperature (MST) rose during the thermal neutral condition but not during the cold condition. Overall, Tc (0.3 [SD = 0.4]°C; P = .0142), HR (26.3 [SD = 8.36] BPM), RR (3.56 [SD = 5.6] BPM), RPE (2.0 [SD = 1.9]), and MST (3.4 [SD = 1.2]°C) were all higher at the end of the neutral condition compared to the cold condition. During recovery, most measures returned to baseline after approximately five-to-20 minutes in both conditions, but they recovered more slowly in the thermal neutral condition.
Conclusion:
Moderate-intensity exercise in TPC increased physiological and perceptual measures more in a thermal neutral environment than a cold environment. Recovery was faster following the cold condition. This may allow firefighters to work for longer durations or recover faster, possibly allowing for fewer crews on scene. However, this study did not account for the risk of other cold induced conditions due to prolonged exposure, such as frostbite. Further investigations should be conducted on cold weather firefighting and its impact on firefighters to establish guidelines and standard operating procedures.
This article offers the first critical edition of and philological commentary on a previously unpublished prefatory text (Ἕτερον προοίμιον) transmitted under the name of Theophilos Korydalleus and found in over forty-five manuscripts of his Aristotelian Logic. It examines the status, content, and manuscript transmission of this brief philosophical treatise, which has hitherto been neglected in favour of the more extensive prologue printed in the 1729 edition. Drawing on new manuscript evidence, particularly a marginal scholion by Iakovos Argeios (Add MS 7143, British Library), the study argues that the Ἕτερον προοίμιον constitutes the authentic preface by Korydalleus himself, whereas the longer prologue should be attributed to his disciple and successor Ioannes Karyophylles. This attribution, if accepted, sheds light on the process of textual interpolation and ideological appropriation within the Patriarchal Academy of Constantinople during the late seventeenth century. The study situates the controversy over the two prologues within the broader intellectual and political conflict between the Korydallean tradition, represented by Karyophylles, and the faction aligned with Alexander Mavrokordatos. By highlighting the interplay between manuscript transmission, authorship, and institutional power, the article contributes to ongoing efforts to reassess the contours of post-Byzantine philosophical education and the editorial challenges posed by early modern Greek Aristotelianism.