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The establishment of state authority over the movement of people and goods across borders became a key marker of statehood after decolonization. In South Asia, India and Pakistan gradually and unevenly asserted territorial and fiscal sovereignty along their new borders. This article examines how the early Pakistani state confronted border anxieties through the bureaucratic practices and discourses of local officials, who embodied state authority at the frontier. This article further explores how the state attempted to regulate and classify cross-border movement and how borderland communities responded—sometimes complying, sometimes negotiating, and at times subverting these controls. Using archival sources and oral histories, the article argues that categories such as “regional” and “national,” “self” and “other” were not fixed or natural, but were produced through contingent interactions between state functionaries and local populations. In doing so, this article highlights the complex and negotiated nature of sovereignty in Pakistan’s borderlands.
Postnatal depression (PND) affects up to one in four mothers. However, they may experience barriers to access to conventional treatments, indicating a need for alternatives such as arts-based interventions. A previous trial showed that a 10-week singing intervention could alleviate symptoms of PND.
Aims
To evaluate, in a larger sample and across a longer timeframe than previously, the clinical effectiveness, implementation effectiveness and cost-effectiveness of the Melodies for Mums (M4M) singing intervention for symptoms of PND.
Method
One-hundred and ninety-nine mothers experiencing symptoms of PND (Edinburgh Postnatal Depression Scale score ≥10) and their babies were randomised to 10 weeks of in-person singing sessions (M4M, n = 133) or an active control (existing community-based mother–baby activities, n = 66). Mothers were re-assessed at weeks 6, 10, 20 and 36 for depression, healthcare use for themselves and their babies, and health-related quality of life according to the EQ5D-3. The perceived acceptability (Acceptability of Intervention Measure), appropriateness (Intervention Appropriateness Measure) and feasibility (Feasibility of Intervention Measure) of the activity were also assessed at week 6. Trial registration number: NCT04834622.
Results
Mothers in both groups experienced attenuation of depressive symptoms by week 10; however, those in the singing group maintained lower EPDS scores than those in the control group at week 20 (10.7 v. 12.2 (mean difference 95% CI [−2.96, −0.22]), P = 0.023) and week 36 (9.85 v. 11.4 [−2.93, −0.19], P = 0.026). Mothers in the singing group were also more likely to remain in the study (77 v. 57%, χ2(1) = 12.92, P < 0.001) and found their programme more acceptable (4.75 v. 4.0 [0.25, 0.83], U = 2436.5, P < 0.001), appropriate (4.25 v. 3.88 [0.12, 0.62], U = 2241.5, P < 0.001) and feasible (4.75 v. 4.0 [0.41, 0.91], U = 2568.0, P < 0.001). Finally, M4M was associated with 15 extra days of health and was found to be cost-effective (£126–539 per dyad).
Conclusion
M4M had a long-lasting effect on symptoms of PND and was perceived to be more suitable than existing activities; thus, M4M represents a worthwhile investment for healthcare systems as an intervention for mothers experiencing symptoms of PND.
We assessed the impact of an oral care initiative on non-ventilator-associated hospital-acquired pneumonia (NV-HAP) risk using two different measurement strategies.
Methods:
We evaluated changes in NV-HAP events among all patients admitted to 17 VA Medical Centers (1) across the period 10/01/2015–12/31/2019, and (2) one-year pre- vs post- each hospital’s oral care initiative start date. We modeled and compared observed versus predicted NV-HAP events per hospitalization using (1) an electronic clinical definition and (2) diagnosis codes, adjusting for patients’ demographics, vital signs, and laboratory results at presentation.
Results:
Among 333,257 hospitalizations, 1,922 (0.58%) met NV-HAP electronic clinical criteria and 2,386 (0.72%) diagnostic coding criteria. The risk of NV-HAP defined by electronic clinical criteria was 0.62% in October 2015 and 0.54% in December 2019 (estimated difference –0.084% [95% CI: –0.17%, 0.0056%]; the risk of NV-HAP defined by diagnostic coding decreased from 1.0% to 0.48% (estimated difference –0.53% [–0.63%, –0.43%]). In the one-year pre- vs post-analysis, there was no evidence of effect of the implementation on NV-HAP using either electronic clinical criteria (adjusted risk difference –0.078% (95% CI: –0.25%, 0.091%) or diagnostic coding criteria (adjusted risk difference –0.021% (95% CI: –0.18%, 0.14%).
Conclusions:
In a large multi-center study of hospitalized patients, we were unable to identify a clear effect of an oral care initiative on NV-HAP using electronic clinical criteria or diagnostic coding criteria.
This study investigated coping mechanisms among neurosurgeons responding to earthquake-related stress following the February 6, 2023, Kahramanmaraş earthquake in Turkey. Given the extreme challenges faced by neurosurgical teams, the study aimed to illuminate their stress-coping strategies under crisis conditions.
Methods
A cross-sectional study was conducted in 2023 with 64 neurosurgeons engaged in earthquake relief efforts. The Coping with Earthquake Stress Questionnaire (CESQ), covering Religious Coping, Positive Reappraisal, and Seeking Social Support dimensions, was administered. Convenience sampling was used. Data analysis employed IBM SPSS 25.0, applying descriptive statistics, Chi-square, t-tests, ANOVA with Bonferroni correction, and Pearson correlation (α = 0.05). Power analysis confirmed sufficient sample size.
Results
Neurosurgeons showed notable psychological resilience despite personal and material losses. Positive reappraisal was the most common coping strategy, consistent across experience levels. Although not statistically significant, less experienced neurosurgeons (1-5 years) showed a higher tendency toward seeking social support. A positive correlation was observed between Religious Coping and Positive Reappraisal.
Conclusion
Positive reappraisal emerged as a key coping mechanism, underlining neurosurgeons’ resilience. Mental health support, especially for early-career professionals, remains vital. Broader CESQ applications and cross-cultural studies are encouraged to guide future psychological preparedness efforts in neurosurgery.
Baillie’s identity is (see [1] or [2], p. 240). Its integral analogue, , is not difficult to prove (see Lemma 1, below). In this Article, we prove a generalisation of the latter result (see Theorem 1). Theorems 2 and 3 are extensions, involving in addition, powers of cosines in the integrand. Theorem 4 answers a question raised after the proof of Theorem 1, and Theorem 5 collects together the preceding results in the form of three identities between trigonometric integrals. Theorem 6 gives a further generalisation.
Flows enabled by phoretic mechanisms are of significant interest in several biological and biomedical processes, such as bacterial motion and targeted drug delivery. Here, we develop a homogenisation-based macroscopic boundary condition that describes the effective flow across a diffusio-phoretic microstructured membrane, where the interaction between the membrane walls and the solute particles is modelled via a potential approach. We consider two cases where potential variations occur (i) at the pore scale and (ii) only in the close vicinity of the boundary, allowing for a simplified version of the macroscopic flow description, in the latter case. Chemical interactions at the microscale are rigorously upscaled to macroscopic phoretic solvent velocity and solute flux contributions, and added to the classical permeability and diffusivity properties of the membrane. These properties stem from the solution of Stokes advection–diffusion problems at the microscale, some of them forced by an interaction potential term. Eventually, we show an application of the macroscopic model to develop minimal phoretic pumps, showcasing its suitability for efficient design and optimisation procedures.
Early pregnancy diagnosis in buffaloes enhances reproductive efficiency and dairy production. This study aimed to develop and validate a duplex TaqMan-based RT-qPCR assay using two interferon-stimulated genes (ISGs), ISG15 and LGALS3BP, for early pregnancy diagnosis in buffaloes. Whole blood samples were collected from artificially inseminated buffaloes before (day 0) and after (days 20, 25 and 40) artificial insemination (AI). On 40 days, post-insemination ultrasonography was performed to categorize animals as pregnant or non-pregnant. RNA from peripheral blood mononuclear cells (PBMCs) was isolated and converted into cDNA. A duplex TaqMan-based RT-qPCR assay was developed to predict pregnancy based on the expression of ISG15 and LGALS3BP in PBMCs. Gene expression was evaluated in a test dataset at various time points. The assay's performance was validated using two additional datasets, under which blood samples were collected randomly at 20 ± 2 days to evaluate its utility for predicting pregnancy. Colour Doppler ultrasonography was utilized to confirm pregnancy at 40 days post-insemination for all the animals. Significantly different abundance of transcripts of ISG15 and LGALS3BP, in pregnant buffaloes, was observed on day 20 post-insemination. A statistically significant fold change (p < 0.05) of ISG15 and LGALS3BP transcripts was observed between pregnant and non-pregnant buffaloes. The receiver operating characteristic curve of validation datasets demonstrated the AUC = 0.95 and AUC = 0.90. The negative predictive value and positive predictive value range from 90% to 95% and 75% to 85%. In conclusion, the developed duplex RT-qPCR-based assay demonstrates high sensitivity and specificity in detecting early pregnancy in buffaloes.
We study constant Q-curvature metrics conformal to the the round metric on the sphere with finitely many point singularities. We show that the moduli space of solutions with finitely many punctures in fixed positions, equipped with the Gromov–Hausdorff topology, has the local structure of a real algebraic variety with formal dimension equal to the number of the punctures. If a nondegeneracy hypothesis holds, we show that a neighbourhood in the moduli spaces is actually a smooth, real-analytic manifold of the expected dimension. We also construct a geometrically natural set of parameters, construct a symplectic structure on this parameter space and show that in the smooth case a small neighbourhood of the moduli space embeds as a Lagrangian submanifold in the parameter space. We remark that our construction of the symplectic structure is quite different from the one in the scalar curvature setting, due to the fact that the associated partial differential equation is fourth-order rather than second-order.
Individual-level solutions, such as lifestyle changes, are often regarded as cost-effective complements to systemic policies like government regulations in addressing climate change. However, some argue that exposure to these solutions may shift focus away from systemic interventions, potentially crowding-out support for large-scale policies. Across two experiments in Iran (N = 303) and Australia (N = 308 and 625), we tested whether exposure to different numbers of individual and systemic policies would affect individuals’ perception of systemic climate solutions. Results showed that, regardless of country or exposure type, whether through daily life or experimental manipulation, participants consistently supported systemic policies and changes, attributed greater responsibility to the government, perceived minimal conflict between systemic and individual approaches, rated systemic policies as more effective than individual ones, and viewed individual actions as only moderately substitutable for systemic solutions. These findings challenge the crowding-out hypothesis, suggesting that exposure to individual solutions does not diminish support for systemic policies or structural reforms.
Maximising creativity requires an enriched imagination that uses all five senses. This study explored the effects of a reduced visual–auditory multisensory stimuli environment on creativity. Nineteen participants took the Alternative Uses Test (AUT) under the nine decreased visual–auditory multisensory stimuli conditions. Fluency and originality were evaluated as a part of the creativity assessment. The number of ideas from the AUT determined the fluency level, and the three judges’ evaluations determined originality. A study on associative conceptual network analysis explored the word associations of selected nouns from the AUT under nine reduced visual–auditory multisensory stimuli experimental conditions, revealing outdegree centrality scores to evaluate creative potential. The results suggest that the decreasing visual stimuli inhibit fluency whereas auditory stimuli do not, and that originality is enhanced when stimuli are reduced, whether visual or auditory, unless there is a notable divergence between the visual and auditory conditions. These results highlight the importance of perceptual focus and cognitive load regulation in fostering creative potential.