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Syrian refugee women face numerous obstacles that impact their reproductive health. The aim is to assess prevalence and predictors of miscarriage and induced abortion among Syrian refugee women in Türkiye.
Methods
This study is a cross-sectional analysis based on data from 1886 Syrian refugee women aged 15-49 who have a history of marriage, obtained from the 2018 Türkiye Demographic and Health Survey – Syrian Migrant Sample. Univariate Chi-square, independent t-test, and multivariate logistic regression were performed to determine predictors of abortion and miscarriage.
Results
Among ever married Syrian refugee women, 27.3% (n = 514) experienced at least 1 miscarriage, 5% (n = 95) reported having at least 1 abortion. Mean maternal age was predicted with miscarriage and induced abortion (OR = 1.06 [CI: 1.04-1.08; P < 0.001] and OR = 1.08 [CI: 1.04-1.12; P < 0.001] respectively). Women in the southern/eastern region of Türkiye experienced 4.24 times (95% CI = 1.50-12.02; P < 0.01) more abortions than in the western/central region. Women who are related to their spouses had an abortion 1.91 times (95% CI = 1.06-3.43; P < 0.05) more frequently than non-related couples.
Conclusions
The rate of miscarriages and induced abortions is high among Syrian refugee women in Türkiye. Regional differences, maternal age, and marriage between relatives have been identified as important variables that need to be taken into consideration. Interventions concentrating on those elements by the bodies concerned may thereby lessen the burden and effects of abortion and miscarriage.
There are significant welfare concerns regarding the plight of working donkeys (Equus asinus) in developing countries. To-date, however, there has been limited work assessing the welfare of donkeys in many parts of Africa, including Kenya. This study aimed to characterise the unique welfare concerns of working donkeys in Meru County, Kenya. Baseline information was gathered, concerning challenges with feeding, working conditions and disease faced by owners and drivers with differences between pack and cart donkeys investigated. To this end, 102 donkeys underwent evaluation using a Standardised Equine Based Welfare Assessment Tool (SEBWAT) and 58 owners were surveyed. Important welfare concerns, including low body condition scores (BCS) (median [IQR] 2 [1.5, 2.5 out of 5]), hobbling (81/102; 79%) and mutilation wounds (49/102; 48%) were identified in all donkeys. The following categories registered significant physical differences between cart and pack donkeys: signalment (cart 100% male, pack 21% male); BCS (median cart 2.0, pack 1.5); and presence of skin wounds on the neck (cart 30%, pack 0%). Behaviour was assessed with differences noted in chin contact avoidance (cart 56%, pack 97%), tail tuck presence (cart 46%, pack 97%), number of donkeys owned (median cart 2, pack 1), reported administration of de-worming medication by owners (cart 95%, pack 17%), and occurrence of reported illness (cart 81%, pack 38%). This initial survey addresses welfare concerns related to the Meru County donkey population and will serve as a useful benchmark for future assessments as well as targeted interventions, including the introduction of modified carts to the region.
Driving enables older adults to maintain independence and community mobility. Driving plays a pivotal role in the ability to engage in activities, socialize, run errands, and access health care services; yet many people eventually stop driving. This study investigates factors that contribute to transitions from driver to non-driver (i.e., driving status) using data from the Canadian Longitudinal Study on Aging (CLSA). Among participants aged 45–85 who reported driving at baseline (n = 30,901), 1.65 percent (n = 510) had stopped driving at follow-up (three years later). Logistic regression identified predictors of this transition, including older age, female sex, lower income, urban residence, poorer self-rated health, difficulties with activities of daily living, low memory scores, and vision problems. These findings highlight the interplay of physical, cognitive, and environmental factors in driving cessation. This research advances understanding of mobility transitions in later life and informs targeted strategies to support older adults as they plan for driving retirement.
Selectivity, the ability to kill weeds without killing the crop, is a challenge for in-row mechanical cultivation, especially in slow-growing crops like carrots [Daucus carota L. ssp. sativus Hoffm. ‘Bolero’]. To gain insight into the optimal tool type and timing for in-row cultivation of different weed species, we adapted an existing model (“Kurstjens model”) to predict “potential efficacy” (PE)—the greatest weed mortality attainable at a given level of crop mortality—based on weed anchorage force and height data, which serve as proxies for tolerance to uprooting and burial. We parametrized the baseline model using data for carrots and five weed species at early growth stages and used the model to predict the PE of idealized tools that bury or uproot in combination with various cultural practices. Under baseline model assumptions, tools that bury had greater PE for grass weeds, and tools that uproot had greater PE for broadleaves. Combining or “stacking” tools that uproot with those that bury had minimal impact on predicted PE for individual weed species, but increased PE on mixed grass–broadleaf weed communities compared with single-tool mechanisms of action. Cultural practices (e.g., stale seedbedding and cultivar choice) that increased carrot anchorage force and height relative to weeds at the time of cultivation greatly increased PE for both mechanisms of action. Our model provides a useful method for predicting the optimal tool mechanism of action and timing for any weed–crop combination.
The Great Ordovician Biodiversification Event (GOBE) records a global increase in marine biodiversity that reached maximum diversification rates during the Middle Ordovician. The degree to which the causes of the GOBE are regional or global is a question that must be addressed through analysis of regional data. In this study, stratigraphically constrained field-based data from the Middle Ordovician Simpson Group of Oklahoma were collected to identify temporal trends in body volume and determine whether body volume trends are more closely associated regional or global environmental and diversity changes. Anteroposterior–transverse (AT) volume estimations were produced for rhynchonelliform brachiopods at a bedding-plane level of resolution. Time-series analysis was used to establish temporal trends in brachiopod volume. Volume data were then analyzed alongside paired δ18O, Δ13C, 87Sr/86Sr, taxonomic diversity, and lithologic data using a boosted regression model to identify their relative influence on shell volume through time. Results of these analyses indicate that (1) a rapid pulse of brachiopod volume increase occurred coincident with the main diversification pulse in Simpson Group strata and (2) volume increase was not coupled with an increase in brachiopod volume variance. Volume increase was primarily associated with global-scale factors such as age, δ18O (temperature), 87Sr/86Sr (tectonics), and taxonomic diversity trends; whereas local-scale factors of Δ13C (carbon cycle) and lithologic trends were more weakly associated with local volume trends. Notably, all factors had a nonzero influence over brachiopod volume, indicating that local diversification was influenced by multifaceted interactions among abiotic and biotic controls. These results support the argument that Ordovician diversification included a substantial biotic shift during the Middle Ordovician and support the hypothesis that global factors were dominant, influencing diversification patterns during the main phase of the GOBE.
This article explores how pedagogy focused on affective possibilities of narrative genres can suggest new directions for climate fiction, potentially challenging the dystopian dominance in the climate crisis imaginary. We analyse a corpus of work produced by first year creative writing students. The students were given the task of “mashing” climate fiction with another genre (romance, horror, crime or any other genre of their choice) and asked to reflect on how this changed the emotional affect and tone of their narrative. Many students were still drawn to dystopian visions, reflecting how climate fiction has become entangled with this particular mode of storytelling, but the focus on reader affect resulted in the students adding layers of hope and agency. Many made use of the possibilities offered by genre: the whimsical allegory of fantasy, the critical thinking of realism, the active fear of horror and the comic potential of satire. By giving students the freedom to embed climate change into their preferred genre, and by asking them to consider the affective consequences of their choices, we offer challenges to the dominance of dystopian climate fiction, suggesting a different path to narratively engage with the climate crisis without descending into hopelessness.
To evaluate changes in dietary consumption and weight status of Brazilian adolescents.
Methods:
Data from the Brazilian National Dietary Survey (NDS) of 2008–2009 and 2017–2018 were analyzed, including food consumption and anthropometric data from 7,425 adolescents (ages 10–19) in 2008–2009 and 8,264 in 2017–2018. Foods were categorized into 17 groups. Weight status was estimated using BMI-for-age-and-sex classification. Differences in mean consumption were assessed using linear regression adjusted for caloric intake and sex. Consumption was analyzed by sex and income level, with analyses conducted in SAS, accounting for the sample design.
Results:
Among boys aged 10–14, underweight rose from 2.3% to 4.5%, obesity from 7.4% to 15.1%, and severe obesity from 0.7% to 2.1%; normal weight fell from 67.4% to 50.7%. Among girls, overweight increased (19.7% to 28.0%) and normal weight decreased (69.5% to 57.5%). Rice intake declined in all groups (e.g., –66 g/day in older boys). In younger boys, fruit (–18 g/day), coffee (–34 mL/day), and sweets (–21 g/day) decreased. Older boys showed reduced dairy (–55 g/day) and increased fast food (+22 g/day). In older girls, fruit (–20 g/day), dairy (–59 g/day), and sugary drinks (–90 mL/day) declined. Fast food rose only among those earning ≤0.5 minimum wage (+17 g/day).
Conclusion:
Over the decade, dietary quality worsened and anthropometric indicators deteriorated. Income influenced consumption shifts, notably among low-income adolescents. Policies should promote healthy eating and limit ultra-processed food, especially for lower-income groups and boys.
Recent times have been hard for global governance, not least for formal intergovernmental organizations (FIGOs). Given changing conditions and their inability to adapt, many observers argue that FIGOs are drifting and losing ground to low-cost institutions (LCIs). We argue that this widespread perception is incomplete and that it dismisses too quickly the durability of FIGOs. We begin by pointing out that not all FIGOs are drifting and that some may even thrive amid transnational crises and power shifts. We then highlight the possibility that in a densely institutionalized global environment, states can substitute one FIGO for another. Thus, even as one FIGO is drifting, other FIGOs, rather than or alongside LCIs, can take the mantle. We identify and exemplify three key motivations for FIGO substitution: overcoming gridlock, enhancing ideological alignment, and policy laundering. During crises and power shifts, some members might paralyze a FIGO, leading to gridlock and prompting other members to cooperate in another FIGO. Power shifts and crises can also motivate dissatisfied FIGO members to pursue parallel activities in a FIGO that better fits their ideological outlook. Policy laundering occurs when members use one FIGO over another to signal political intent. We conclude by exploring the normative implications of FIGO substitution.
Repetitive transcranial magnetic stimulation (rTMS) has gained regulatory approval as an adjunctive treatment for obsessive–compulsive disorder (OCD) in adults. However, its application in adolescents remains largely untested. This editorial examines the limited evidence available, focusing on choice of target, stimulation depth and methodological variation. Ethical challenges surrounding the use of rTMS in vulnerable populations, including informed consent and the unknown long-term effects on neurodevelopment, are also discussed. Although rTMS holds promise for treatment-resistant adolescent OCD, a cautious and ethically rigorous approach is essential before wider clinical adoption can be considered.
Amiodarone is a frequently used medication in paediatric patients to manage atrial and ventricular arrhythmias, but its acute haemodynamic effects, particularly in children, remain underexplored. This retrospective, single-centre study aimed to characterise the clinical impact of amiodarone intravenous infusions on heart rate, blood pressure, oxygen delivery, and transaminase levels within the first 48 hours of amiodarone initiation in paediatric cardiac ICU patients.
Methods:
Single-centre, retrospective study of patients receiving amiodarone infusions, with measurements taken at baseline and at various intervals up to 48 hours after initiation. The primary outcome was the effect on heart rate, while secondary outcomes included blood pressure, arterial saturation, near-infrared spectroscopy values, central venous pressure, and transaminase levels. Several types of analysis models were employed to assess the results.
Results:
Data were collected from 87 paediatric patients. No significant changes in liver enzymes, blood pressure, or renal oxygen extraction were observed. These findings provide novel insights into the acute haemodynamic effects of amiodarone infusions in paediatric patients, suggesting that while amiodarone significantly lowers heart rate, it does not substantially affect oxygen delivery or necessitate increased vasoactive support.
Conclusion:
Amiodarone infusions are associated with a significant decrease in heart rate without greatly impacting oxygen delivery or requiring increased vasoactive support. Heart rate decreases most until a cumulative dose of 30,000 mcg/kg, and heart rate decrease is most pronounced in those with ventricular tachycardia.
International organisations (IOs) hold important governance functions and power. Yet, they are several steps detached from the constituencies that have entrusted them with functions and resources to carry them out, even as accountability expectations remain significant for their legitimacy. This article presents a broadly generalisable theoretical framework for understanding the variable accountability of IOs, seeking to advance the understanding of international accountability in three new ways. First, it elaborates on the concept of the scope of IO accountability, which can vary across organisations, over time, and across contexts. The idea of a scope of accountability moves beyond the dichotomy of accountable versus non-accountable power holders and advances an understanding of accountability as a multi-layered phenomenon, whereby both the expectations and practices of accountability can evolve over time and with respect to different audiences. Second, the article identifies three political factors – namely the formal and informal excercise of power, institutional structure, and public salience – that can shape, in important ways, the variable scope of IO accountability. Finally, it critically explores the tensions and contradictions between these political dynamics, and the implications for access to and the efficacy of accountability systems.
In the introduction to this roundtable, we argue that global governance currently faces hard times because it is affected by a set of significant developments revolving around the changing distribution of state power, the rise of nationalist populism, and the frequent occurrence of transnational crises, while seeking to facilitate collective action on complex cooperation problems. Against this backdrop, the essay identifies two major institutional dynamics of global governance in hard times: first, the drift of formal intergovernmental organizations (FIGOs) that is caused by them being gridlocked in a period of significant changes in their social, (geo)political, economic, and technological environment. Second, the proliferation of various types of low-cost institutions. To help us think systematically about how these two interrelated institutional dynamics affect global governance, the essay develops the innovation thesis and the decline thesis. The “innovation thesis” suggests that by transitioning from a rather exclusive and hierarchical system revolving around FIGOs into a more inclusive and heterarchical system revolving around institutional diversity, global governance is currently being adapted to its new environment. The “decline thesis,” by contrast, argues that the two institutional dynamics undermine rules-based multilateralism and may lead to a shift back toward traditional (great) power politics that does not respect institutional constraints.
The rise of visually driven platforms like Instagram has reshaped how information is shared and understood. This study examines the role of social, cultural, and political (SCP) symbols in Instagram posts during Taiwan’s 2024 election, focusing on their influence in anti-misinformation efforts. Using large language models (LLMs)—GPT-4 Omni and Gemini Pro Vision—we analyzed thousands of posts to extract and classify symbolic elements, comparing model performance in consistency and interpretive depth. We evaluated how SCP symbols affect user engagement, perceptions of fairness, and content spread. Engagement was measured by likes, while diffusion patterns followed the SEIZ epidemiological model. Findings show that posts featuring SCP symbols consistently received more interaction, even when follower counts were equal. Although political content creators often had larger audiences, posts with cultural symbols drove the highest engagement, were perceived as more fair and trustworthy, and spread more rapidly across networks. Our results suggest that symbolic richness influences online interactions more than audience size. By integrating semiotic analysis, LLM-based interpretation, and diffusion modeling, this study offers a novel framework for understanding how symbolic communication shapes engagement on visual platforms. These insights can guide designers, policymakers, and strategists in developing culturally resonant, symbol-aware messaging to combat misinformation and promote credible narratives.
The patient, the first of twins, weighed 714 g at birth. On day 14, ultrasound revealed a large methicillin-resistant Staphylococcus aureus-induced atrial vegetation; the tumour grew to 6 mm by day 19. Percutaneous removal was selected due to the risk of pulmonary embolism. We used a three-loop EN Snare system. The procedure was safe and successful.
This article examines the process of drafting the authoritarian Portuguese Constitution of 1933, which took place during the military regime. The aim is to identify the powers involved, their objectives and the strategies they developed, and to find insights that shed light on the adoption of constitutions by authoritarianisms. The results suggest that conflict between political forces is endemic to the constitutional process, and that those who hegemonise support and aim to demilitarise the system are able to impose the new constitution even without guaranteeing the existence of democratic political parties. There is also a promising point of analysis: the emergence of an authoritarian constitution is based on path dependence, ie, it has many links with the material constitutionalism that precedes it, where there are already normalised authoritarian elements.
This article examines how subnational fiscal competition over foreign direct investment affects both the siting of new projects and the ability of local governments to raise tax revenue for social spending. We leverage a quasi-natural experiment, an unexpected declaration by the Brazilian Supreme Court in 2017 that reduced states’ ability to offer investors differentiated tax subsidies. Our results show that disadvantaged regions did not see a major shift in investment patterns after the change in investment law. We do not find a consistent relationship between the incentive law change and state revenue generation, but we do find that incentives are associated with less revenue. The results are consistent with arguments that investment incentives exacerbate inequality by reducing states’ capacity to collect revenue while doing little to affect investment location. Our results illustrate that economic agglomeration is difficult to reverse through tax policy and that fiscal federalism often cannot provide strong enough inducements to drive investment into less advantaged regions.