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Clinical Neuroendocrinology: An Introduction, second edition, is thoroughly updated and continues to fulfil the continued need for a concise, introductory description of the human neuroendocrine system in health and disease. The clinical implications of basic human neuroendocrinology are described and presented along with real clinical case studies and a selection of review questions in each chapter to help cement readers' knowledge. Recent important advances are revealed in new figures and up-to-date references from the clinical literature, such as the discovery of kisspeptin, its use in the treatment of amenorrhea and its application in IVF. The authors also describe the development of GLP-1 agonists, which are now available for the treatment of obesity. This is a key text for senior medical students deciding on a specialty, as well as residents and clinical fellows who are embarking on their chosen fields. The book also provides crucial clinical context for biomedical science graduate students and clinicians.
Compared to the 1980s and '90s, Sub-Saharan Africa (SSA) has experienced a resurgence of economic growth, though this growth hasn't led to structural transformation. Additionally, SSA has underperformed in translating growth into positive development outcomes like poverty reduction. These patterns challenge standard growth theory, which predicts that growth at the top of the distribution will trickle down and benefit everyone. In We Are the World, the authors enrich and update research conducted over the last ten years, adding new evidence to recast the socio-economic narrative and pave the way for a candid and non-ideological debate on how to help SSA get on track. Challenging a widespread mainstream interpretation, the authors illuminate the nature, evolution, and consequences of SSA losing ground in the development race, offering a bold reform agenda to promote inclusive growth and sustainable development across the continent.
This Element advances the Scalar Deictic Space approach as a cognitive–discursive framework for analysing how political discourse constructs, differentiates, and dynamically reorganises identity, agency, urgency, and legitimacy. Building on the primacy of spatial cognition, SDS conceptualises political meaning-making as a scalar configuration anchored in a deictic centre, organised across proximal, medial, and distal zones of positioning. These zones reflect graded relations of intentionality, dependency, and symbolic alignment rather than fixed group memberships. By moving beyond binary Us–Other models, SDS reveals how political discourse internally stratifies the in-group, redistributing power and responsibility through shifting spatial, temporal, and modal configurations. Drawing on variety of examples including US, Iranian, and Ukrainian political discourse, the Element demonstrates how scalar positioning enables actors to legitimise action and project future while maintaining ideological coherence. As a dynamic analytical tool for tracing diachronic change in political worldviews, SDS critically examines cognitive foundations of political persuasion.
This chapter explores the multifaceted nature of AI transparency. First, a general introduction first presented by Haresamudram et al. is given on what transparency entails in AI, distinguishing between algorithmic, interaction, and social transparency. Algorithmic transparency concerns the technical dimension of AI, including explainability techniques and the disclosure of other technical aspects. Interaction transparency allows users to recognize their interactions with AI systems, while social transparency concerns organizational governance structures. In a second step, we outline challenges to transparency, such as technical complexity, proprietary constraints, and potential conflicts with privacy regulations. Subsequently, this chapter provides an overview of the practical application of transparency, followed by real-world examples of transparency initiatives, highlighting both successes and failures. The final section argues that effective transparency requires strong regulatory frameworks, international standards, and AI literacy among stakeholders to ensure meaningful transparency beyond superficial disclosure.
This chapter explores the psychological impacts of automation that have received insufficient attention in safety frameworks. We examine how AI safety extends beyond technical robustness to encompass protection from psychological harms including manipulation, over-reliance, and exploitation of vulnerability. The chapter presents established methodologies for addressing psychological safety risks and identifies critical gaps in current approaches. We argue that comprehensive AI safety requires not only technical safeguards but also robust frameworks for protecting human agency, autonomy, and wellbeing. As AI systems become more integrated into everyday life in more sensitive ways, including companions and advanced assistants, psychological safety considerations become essential for responsible development. We conclude by outlining key priorities for further research and contend that a critical window of opportunity exists to establish effective guardrails. As we develop these technologies, they are simultaneously shaping us in ways that may prove undesirable and difficult to reverse.
Islamic Intellectual History in the Mughal Era brings together new scholarship on the rich and varied intellectual life of the Mughal world, challenging long-standing narratives of decline and dichotomies such as orthodoxy versus heterodoxy. Spanning disciplines including philosophy, logic, poetics, mysticism, law, and medicine, the chapters collectively illuminate the infrastructures, languages, and actors that shaped Muslim scholarly production in South Asia between the sixteenth and nineteenth centuries. Drawing on Arabic, Persian, and vernacular sources, the essays situate the Mughal scholarly enterprise within wider transregional currents across West, Central, and South Asia. With critical attention to genres, networks, and conceptual debates, the volume offers fresh perspectives on how knowledge was produced, circulated, and contested in early modern South Asia. It will be of interest to scholars and students in Islamic studies, South Asian history, religious studies, and global intellectual history.
It was aimed to determine the competencies of Family Medicine residency students regarding the treatment planning of diseases coded with diagnosis-treatment in the ‘National Core Education Programme’ (NCC) in Turkey. We aimed to identify areas where residents feel less competent, which can inform curriculum improvements to better address gaps in treatment planning skills for core diseases.
Methods:
The study was conducted with Family Medicine residency students from one medical school selected from each geographical region of Turkey. Students were asked to assess themselves at the time of graduation from medical school and currently during their residency training, in terms of ‘appropriate drug selection’, ‘prescribing’, ‘non-drug treatment planning’ and ‘processing treatment management and giving information’ competencies for 59 diseases in the NCC.
Results:
The rate of Family Medicine residency students who felt competent in treatment planning/management when they graduated from medical school was very low; although this rate increased to a certain extent with residency training, it could not reach an acceptable rate. Despite partial improvements after graduation, the results suggest potential gaps in achieving the desired competency levels, even after 1–3 year of residency training. The residency students’ competency perceptions ranged from 10–30% to 60–80% across different diseases.
Conclusion:
It is important to review and reconstruct the six-year medical education and Family Medicine residency training programs, based on the framework drawn by NCC, focusing on rational treatment planning/management to reconceptualize treatment planning/management and decision-making.
Kindness, empathy and compassion are fundamental to effective mental healthcare and are associated with reduced emotional strain and greater professional satisfaction among practitioners. However, most interventions designed to foster these virtues have not sufficiently addressed cultural adaptation, despite its critical role in ensuring care that is relevant and inclusive for diverse populations.
This rapid review aimed to synthesise evidence on empathy-, kindness- and compassion-focused training interventions in mental health and healthcare settings, with particular attention to cultural adaptation, facilitator characteristics and outcome measurement.
A rapid review was conducted to identify culturally informed interventions designed to enhance kindness, empathy and compassion among mental health professionals. Searches were performed in PubMed/MEDLINE and PsycINFO for studies published between 2014 and 2025 using key terms related to ‘mental health professionals’, ‘empathy’, ‘compassion’ and ‘kindness’. This review was prospectively registered on the Open Science Framework (OSF; DOI: https://doi.org/10.17605/OSF.IO/U6H32).
Results
The initial search identified 690 records. Following title, abstract and full-text screening, four studies met all inclusion criteria. The interventions were: (a) a 90 min empathy workshop (USA); (b) a 14-session, cross-cultural, competence course (Sweden); (c) an 8-session, trauma-focused cognitive–behavioural therapy (CBT) programme (Ukraine); and (d) a 4-day emotionally focused therapy externship (6 Spanish-speaking countries). All interventions reported positive outcomes. Significant increases in empathic awareness were observed in the USA (p = 0.019), with qualitative improvements in empathy reported in Sweden. In Ukraine, 69% of participants rated the programme as ‘very’ or ‘extremely helpful’, and 92% reported professional benefit. The Spanish-speaking cohort demonstrated significant gains in perspective-taking (p < 0.001) and empathic concern (p < 0.001).
Clinical implications
Culturally informed approaches to enhancing kindness, empathy and compassion show promising outcomes among mental health professionals. These findings highlight the importance of integrating cultural responsiveness into virtue-based interventions to foster inclusive, intelligent kindness in global mental health practice.
Major depressive disorder is a leading cause of disability worldwide, yet its clinical presentation varies substantially across cultural contexts. In many low- and middle-income settings, including Pakistan, depression is frequently expressed through somatic rather than psychological symptoms, contributing to under-recognition in general medical settings.
Aims
To estimate the prevalence of depression among patients attending a tertiary care medical clinic in Pakistan, and to characterise the somatic and psychological symptom patterns associated with depression severity.
Method
We conducted a cross-sectional study of 356 adult patients recruited from a general medicine out-patient clinic in Lahore, Pakistan. Depression and anxiety were assessed using Patient Health Questionnaire 9 (PHQ-9) and Generalised Anxiety Disorder 7 scales. For patient encounters with missing PHQ-9 scores, symptom-based prediction using a random forest model was applied. Clinical notes were analysed using natural language processing to extract somatic and psychological symptoms. Logistic regression models were used to identify predictors of moderate-to-severe depression.
Results
Sixty-three per cent of participants met the criteria for moderate-to-severe depression, with 42.4% having comorbid anxiety and depression. Psychological symptoms such as low mood and anhedonia were rarely documented, whereas somatic complaints predominated across all severity levels. Epigastric pain (odds ratio 2.31–2.50) and anxiety (odds ratio 5.87–5.95) were found to be strong predictors of moderate-to-severe depression, whereas male gender was associated with lower likelihood (odds ratio approximately 0.54). Constipation showed a borderline association with depression severity, whereas diarrhoea did not.
Conclusions
Depression in this clinical setting is predominantly expressed through somatic symptoms, particularly gastrointestinal complaints and pain syndromes. In general medical clinics in Pakistan, routine depression screening should be implemented for patients presenting with unexplained somatic symptoms.
Clozapine reduces overall mortality and suicide risk in schizophrenia, but the specific causes and clinical contexts of death among clozapine-treated patients remain less well characterised.
Aims
We aimed to characterise causes of death in clozapine-treated patients within a defined UK catchment area over 17 years (2009–2025); compare features across predefined mortality clusters (suicide, expected, unexpected); compare unexpected death cases with a clozapine-treated comparison cohort alive in 2019 and examine temporal mortality patterns.
Method
We conducted a retrospective, descriptive cohort study of all deaths among clozapine-treated patients within a UK mental health National Health Service Trust between 1 January 2009 and 31 December 2025. Deaths were classified into suicide, expected and non-intentional unexpected, using a previously established framework. Variables were compared across clusters and between unexpected death cases and a clozapine-treated comparison cohort alive in 2019.
Results
Of 87 deaths, 11 (12.6%) were suicides, 29 (33.3%) were expected and 47 (54.0%) were non-intentional unexpected. Malignancy was the most common cause (21/87, 24.1%), followed by cardiovascular (13/87, 14.9%) and respiratory or infective causes (9/87, 10.3%). Age differed across clusters (p = 0.005), with suicides at younger ages. Compared with the 2019 cohort, patients who died unexpectedly were older (55.0 v. 48.6 years, p = 0.006) and more likely to smoke (75.0 v. 34.6%, p < 0.001). Annual mortality peaked in 2021 and was not fully explained by direct COVID-19 deaths.
Conclusions
Mortality in clozapine-treated patients arises across diverse clinical contexts, with more than half classified as non-intentional unexpected. Findings support sustained physical health monitoring, closer attention to smoking and other modifiable risks, and continuity of care.
In this work, we propose interconnection structures for substrateless all-silicon dielectric waveguides, a platform for terahertz (THz) hybrid integration that currently relies on traditional tapered interfaces. We demonstrate two dielectric waveguide-to-waveguide interconnect approaches: a truncated termination and a quarter-wave-matched (QWM) slot termination. Both designs maintain a confined coupling point, enabling consistent coupling. Experimental results show maximum interconnection coupling losses of $5\,\mathrm{dB}$ and $2.5\,\mathrm{dB}$ for the truncated and QWM-slot terminations, respectively, across the 220–330 GHz band. The QWM-slot transmission coefficient remains above $-3\,\mathrm{dB}$ with a misalignment tolerance up to $100\,\mu\mathrm{m}$, representing a $2.5\times$ improvement over the truncated design. Offset characterization along three axes reveals smooth decoupling behavior over a 1 mm range, validating the potential for broadband, contactless interconnects between dielectric waveguide interfaces. These results establish a compact THz interconnect concept with substantially relaxed translational alignment tolerances, making it well-suited for deployment in scalable 6G multi-chip arrays and THz sensing modules.
Burning nettle (Urtica urens L.) and common groundsel (Senecio vulgaris L.) are widespread, economically important weeds in horticultural systems. This laboratory and glasshouse study evaluated the effect of temperature, photoperiod, salinity, osmotic stress, and pH on seed germination, and the effect of burial depth on seedling emergence of these species. A significant interaction between temperature and photoperiod showed that germination depended on combined thermal and light cues rather than either factor alone. Urtica urens germinated higher in complete darkness (53%) than in light/dark (3%) across three temperature regimes studied. Germination peaked at 90% at 25/15C in complete darkness, while no germination occurred for this species at 15/5C and 35/25C day/night temperatures. In contrast, S. vulgaris preferred light/dark conditions (52% germination vs 29% in darkness), reaching 96% at 25/15C under day/night conditions. Salinity and osmotic stress inhibited germination of both species in a non-linear, sigmoidal pattern. Urtica urens germination was completely inhibited at ≥200 mM of sodium chloride (NaCl) and at ≤−0.6 MPa osmotic potential. Senecio vulgaris showed greater tolerance, with complete inhibition at ≥250 mM NaCl concentration and at ≤−1.0 MPa osmotic stress. Urtica urens germination peaked at pH 6 (92%) and declined under more acidic and alkaline conditions, while S. vulgaris germinated >97% across all pH levels (4 – 10). Urtica urens showed overall low emergence with 11% from soil surface and <1% when buried at different depths. In contrast, S. vulgaris showed up to 90% and 38% emergence from surface in sand and soil, respectively, but its seeds could not emerge beyond 0.5 cm burial depth. These findings can help refine integrated weed management in baby leaf crops by identifying periods when emergence is most likely, supporting timely stale seedbed or pre-emergence interventions, avoiding unnecessary soil disturbance when conditions favor germination, and prioritizing surface-focused control tactics for S. vulgaris.
This systematic review and meta-analysis aimed to identify and synthesize evidence on risk factors for COVID-19 in incarcerated populations.
Methods
A systematic search of PubMed, Scopus, and Google Scholar was conducted for English articles until October 2025. Study quality was assessed using the PRISMA checklist and NOS tool. Meta-analysis was performed in Stata 17 using a random-effects model, with odds ratios as the primary effect measure and statistical significance set at P < 0.05. Heterogeneity was evaluated via I2 statistics.
Results
Twelve articles were ultimately included in the study. For the meta-analysis, only 5 articles were considered, which evaluated sex, age, and vaccination status as the risk factors of COVID-19. The total sample size was 176169, consisting of 169117 males and 7,726 females. In most studies, the average age was reported to be around 40 years. Fully vaccinated prisoners were less likely to contract COVID-19 than unvaccinated ones (OR: 0.38; 95% CI: 0.22, 0.67; P = 0.001), while no significant relationships were found regarding sex and age.
Conclusions
Our findings confirm that full vaccination significantly protects against COVID-19 in prisons. Prioritizing vaccination campaigns, along with measures like mask use and hand hygiene, is essential to protect incarcerated individuals and the wider community.
We use a series of global models to investigate the linear and nonlinear interactions between shock cells, Kelvin–Helmholtz waves, guided jet modes and other fluctuations in a screeching jet. First, we identify a set of lightly damped global eigenmodes of the Navier–Stokes operator linearised about the mean flow and show that they result from interactions with different shock-cell wavenumbers. Second, we use resolvent analysis to study the linear input–output behaviour of the jet and obtain a time-periodic representation of the screech mode, which compares favourably with experimental data. Third, we use harmonic resolvent analysis to study triadic interactions, including inter-frequency energy transfer, between the screech mode determined from resolvent analysis and other fluctuations in the jet. The components of the optimal harmonic resolvent mode at harmonics of the screech frequency are consistent with experimental observations that have not been previously predicted by global models. Fourth, we leverage a novel bilinear formulation of harmonic resolvent analysis to study the impact of the screech mode’s nonlinear self-interaction on other fluctuations in the jet. We show that the forcing provided by this nonlinear self-interaction of the screech mode, along with its triadic interactions with other frequencies embedded within the harmonic resolvent operator, is sufficient to explain the redistribution of energy to other frequencies and the associated experimental observations. In aggregate, these findings underscore the critical role of triadic and nonlinear interactions in shaping the screech dynamics and offer a promising workflow for studying similar interactions in other flows dominated by periodic motions.
Chemical, biological, radiological, and nuclear (CBRN) incidents present escalating risks across the Middle East and North Africa (MENA) amid geopolitical instability, cross-border threats, and evolving non-state actor capabilities. This policy analysis examines why prevailing case-level and ministry-siloed governance is insufficient for population-level CBRN readiness, weighs alternative coordination models, and outlines an artificial intelligence (AI)-enabled, centrally coordinated public-health strategy adapted to the region’s heterogeneity and resource constraints. We propose a National Emergency Management Advisory Council to provide statutory inter-ministerial authority and stewardship for a National CBRN Dashboard that delivers decision support, inventory tracking, simulation, and rapid triage. We situate this within existing backgrounds and analyze legal authority, financing, data governance, and feasibility in low-resource settings. While prototype AI models report high accuracy for antidote optimization, agent classification, and triage, we argue these metrics reflect controlled research, not operational readiness, and require external validation, robustness testing, and cybersecurity safeguards. A phased, evidence-graded roadmap is proposed to move MENA CBRN management from reactive to predictive and adaptive models.
Elections are central to the study of politics. When studying parties’ vote shares across districts, scholars are encouraged to use compositional-outcome models in order to test their theories about what factors shape the dynamics of electoral support. Existing compositional modeling approaches incorrectly deal with scenarios in which not all parties compete in every electoral district. Because unobserved factors that affect a party’s decisions to contest a district are likely correlated with its performance in districts where the party fielded candidates, failing to account for partial contestation is likely to result in sample selection bias. Addressing sample selection in a compositional setting is challenging because the outcomes are in log-ratio form, and thus the errors often deviate from normality. To deal with these issues, we introduce a novel maximum likelihood approach which accounts for this type of sample selection and demonstrate through simulations that our method outperforms commonly used solutions, including the conventional Heckman correction. We illustrate the utility of our approach by analyzing the 2017 and 2019 U.K. parliamentary elections in English constituencies.
While first-order ethical norms and prescriptions appear to be universal, the same is not true for second-order ethics and moral philosophies. The contrast between various models of second-order ethics can be usefully explored through a comparative assessment of the ethics of a pre-modern Muslim scholar with those of a modern one. In this article, I critically compare and contrast the views of Khawaja Nasir al-Din Tusi with those of Abdolkarim Soroush.1 The former subscribes to a modified Aristotelian framework enriched by Islamic teachings, whereas the latter has developed a theory that, while also inspired by Islamic teachings, is informed by the views of a number of modern philosophers.
This essay reviews scholarship on mobilization and its various consequences for democracy and autocracy. It highlights how collective action can advance democratization, stall or reverse it, or reinforce authoritarian rule. The review synthesizes key themes in this literature, including organizational foundations, coalitions, diffusion, tactics, and discourse, as well as the long-term implications of mobilization for democratic consolidation and deepening. It also considers how authoritarian leaders and regimes actively mobilize their supporters, in both democratic systems and authoritarian contexts. The essay concludes by outlining directions for future research, emphasizing the need for multi-level approaches that bridge subnational findings and cross-national comparison.
The field of L2 research is going through a shift toward greater openness. However, many widely promoted open research practices, such as replication and preregistration, originated in response to the reproducibility crisis in psychology and map unevenly onto qualitative research. This critical review synthesizes literature from L2 research and neighboring fields to examine open research from a qualitative perspective. We organize the review around five key debates, including replication, preregistration, data sharing, data reuse, and publication policy. Taken together, these debates reveal the complexity of openness in qualitative inquiry and show both points of convergence and tension. We identify an emerging trend from principled resistance to principled engagement in the literature, with transparency standing out as a unifying principle. Building on these insights, we propose the situated-openness framework that serves as a heuristic for qualitative researchers to consider how to practice open scholarship in alignment with their own epistemological and ontological commitments.