Incarceration has vast and unequal impacts on public health beyond prison walls. Research from the United States documents these collateral consequences, including elevated mental illness and morbidity for the children and partners of incarcerated individuals, alongside community-level effects such as increased rates of teenage pregnancy and multidrug-resistant tuberculosis. In Latin America, however, these broader health impacts remain critically understudied. A significant barrier is the absence of data collection efforts or theoretical frameworks for mapping how Latin America's prisons affect the health of families and surrounding communities. This scoping review synthesises existing evidence on the collateral health consequences of incarceration in Latin America by conducting a comprehensive search in 2025 that included English, Spanish and Portuguese language peer-reviewed studies. From 17 included documents, prisons emerge as epicentres for tuberculosis transmission to visiting families and surrounding communities. The evidence reveals significant mental and physical health burdens on families. Women with incarcerated partners experience depression and anxiety whilst managing economic strain and expanded caregiving responsibilities, often neglecting their own health. Children of incarcerated parents show marked emotional distress, and incarcerated mothers alongside their young children face severely inadequate healthcare access within detention spaces. Despite collecting demographic data, most studies overlook how these burdens fall unequally across racialised populations. Future research must centre ethnoracial disparities and situated knowledge. Incarceration in Latin America has far-reaching effects on partners, children, families, and communities beyond prisons walls. While we know prisons’ health impacts on incarcerated people, we know far less about these broader impacts on families and communities. Most research comes from the United States, but Latin American prisons face different challenges, from severe overcrowding to limited healthcare access. In this study, researchers searched for all available evidence on incarceration’s health consequences for people outside prison walls in Latin America, finding 17 studies published in English, Spanish, and Portuguese examining impacts on partners, children, families, and communities. The evidence reveals that Latin American prisons act as amplifiers of infectious diseases, particularly tuberculosis, which spreads to families during visits and to communities after release. Beyond infectious diseases, the research shows troubling patterns for families, especially women. Female partners of incarcerated men experience high rates of depression and anxiety, and some studies found elevated stress hormones and increased cardiovascular disease risk among these women. Many neglect their own healthcare while managing financial strain, emotional burden, and increased caregiving responsibilities for children and family. Children and families experience significant emotional distress, intensified during events like COVID-19 visitation bans. The review also identified inadequate prenatal and child healthcare for pregnant women and young children living with their mothers in prison due to poor detention conditions. Understanding incarceration’s impacts on family and community health is essential for developing effective public health policies. A significant limitation appeared in how studies handled ethnoracial diversity: although some collected this information, it rarely informed health impact analysis. This oversight is particularly troubling in a region with diverse Indigenous and Afro-descendant populations, where robust evidence demonstrates pervasive racial inequalities across health, criminal justice, and other socioeconomic metrics. Future research must compile ethnoracial data informed by Latin American and locally-situated knowledge.
Research increasingly points to well-being as a public priority, integral to the health of individuals and communities. In response to pressing societal challenges, many researchers seek to produce scientific knowledge that advances understanding and cultivation of well-being. Academic culture rightly uplifts the products of well-being research-the knowledge that improves people's lives. However, relatively less attention is paid to fostering well-being in the process of conducting such research. Indeed, recent research indicating high rates of anxiety and depression (20%-50%) amongst graduate students and postdocs, suggest a troubling paradox: that the prioritization of well-being research outcomes may come at the expense of researchers' own wellbeing. Early-career scholars, who assume substantial demands within the scientific enterprise, are especially impacted by this tradeoff. Yet, they are uniquely positioned to re-envision a praxis for research that embeds well-being in both its products and processes. Developed by an interdisciplinary coalition of early-career scholars, this perspective paper identifies key barriers to fostering well-being in research, and in turn, proposes four guiding principles and corresponding practices: 1) cultivate belonging, 2) center communities, 3) question cultural systems, and 4) embody cultural change. In turn, these principles aim to advance the societal impact of well-being research through community-based, participatory approaches that promote solidarity between researchers and communities historically excluded from the research enterprise.
Although some drugs have been approved for clinical treatment, early diagnosis and intervention remain the most effective strategies for managing Alzheimer's disease (AD) at present. With advances in deep learning and multimodal fusion, an increasing number of complex frameworks have been proposed. This paper systematically reviews multimodal deep learning-based models for AD diagnosis between 2020 and 2026. Beyond the technical survey, we explore how to deal with the heterogeneous modality integration and missing modality processing. From these experimental results, many models show impressive performance on public datasets. However, we have noticed a troubling problem that these "lab-perfect" results often falter when they face the chaos of the real-world. Because of the persistent black-box problem and the hidden traps of data leakage, the path to clinical use is still uphill. This work suggests that it is time to move beyond chasing tiny gains in accuracy and focus on building models that doctors can truly trust, understand, and use in real clinical settings.
Burnout remains one of the defining occupational hazards of healthcare in the United States, and it spares no one on the care team: physicians, nurses, trainees, and assistants all report it at high rates. When generative AI entered healthcare around 2023, it arrived quickly and carried a promise of relief from the administrative burden that so many clinicians identify as a reason for their exhaustion. This review asks one question about that promise: Does the current evidence from the United States indicate that AI alleviates or worsens clinician burnout, and under what implementation conditions? We approached this question through a structured thematic narrative synthesis, weighting evidence by study design. Randomized controlled trials carried the greatest interpretive weight, while non-randomized studies were considered lower-certainty supporting evidence. The first randomized trials of AI-assisted scribing, published in 2025-2026, are encouraging with respect to documentation time and, in some trials, well-being. Yet most of what has been published so far is non-randomized, single-center, and short-term. The more troubling pattern is that AI tends to displace work rather than reduce it. Tasks are not eliminated but moved: from production to oversight, and potentially from physicians to nurses and assistants. Where earlier commentaries offered the metaphors of a "double-edged scalpel" and a "productivity paradox," this review proposes "displacement of burden" as a framework that can actually be tested.
Bangladesh made substantial gains in child survival over two decades, with the under-five mortality rate falling from 94 to 30 per 1000 live births between 2000 and 2020. Recent data from the Bangladesh Bureau of Statistics, however, point to a troubling reversal. The infant mortality rate rose to 27 per 1000 live births in 2023, whereas neonatal mortality climbed from 16 to 20 per 1000 live births within a single year. More than 100,000 children under 5 died in 2023, with two-thirds of deaths occurring in the first month of life. Bangladesh also records around 63,000 stillbirths annually, representing a substantial public health burden and reflecting persistent gaps in maternal and antenatal care. Contributing factors include preterm birth, limited skilled attendance at delivery, pneumonia, malnutrition, and disruptions from the COVID-19 pandemic. Strengthening rural healthcare, expanding immunization, and improving maternal and neonatal care are essential if Bangladesh is to meet its Sustainable Development Goal (SDG) 3.2 targets by 2030.
Fatigue significantly impacts quality of life in lymphoma patients. Multiple patient-reported fatigue measures are used in lymphoma research, including FACIT-Fatigue and PROMIS Fatigue instruments, but direct comparisons of their responsiveness and ability to detect individual-level change in this population are lacking. This study evaluated the responsiveness and sensitivity to individual-level change of Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-Fatigue), Patient-Reported Outcomes Measurement Information System (PROMIS) Fatigue measures (4a, 7a, and 13a), and NFLyMSI-18 Lymphoma Symptom Index in patients with lymphoma. In a prospective observational study, 102 lymphoma patients at an academic cancer center completed FACIT‑Fatigue, PROMIS Fatigue 4a, 7a, and 13a, and NFLymSI‑18 at baseline and again at 3 months (n = 89). Responsiveness was evaluated using standardized response means (SRMs) for patients classified as improved or worsened via clinical anchors: Patient Global Rating of Change, Patient Global Rating of Severity, Patient Global Rating of Severity Interference, and PRO-CTCAE severity and interference fatigue items. Individual-level change was evaluated using Reliable Change Index (RCI) and Likely Change Index (LCI). SRM magnitudes varied by anchor and direction of change. For improvement, FACIT-Fatigue and NFLymSI-18 showed consistent responsiveness (SRMs 0.67-1.01 and 0.62-0.89, respectively), while PROMIS measures showed more variability (SRMs 0.31-1.58). For worsening, PROMIS measures, particularly 4a and 13a, demonstrated larger SRMs (0.75-1.71) than FACIT-Fatigue (0.73-1.24) or NFLymSI-18 (0.57-0.84) for most anchors. LCI analyses identified reliable improvement in 31.5% of patients using FACIT-Fatigue and 24.7-33.7% with PROMIS, and reliable worsening in 24.7% using FACIT-Fatigue and 23.6-34.8% using PROMIS measures. Among lymphoma patients, FACIT-Fatigue and PROMIS Fatigue measures are responsive to meaningful change, with somewhat differing magnitude estimates across anchors and direction of change. These findings support planning for the use and interpretation of these fatigue measures in future clinical trials. Fatigue is one of the most common and troubling symptoms for people with lymphoma. It affects daily life, work, and recovery. To study and treat fatigue, researchers need good measures that can show when patients are feeling better or worse. We tested three fatigue questionnaires: FACIT-Fatigue, PROMIS Fatigue (with 4, 7, or 13 questions), and the Lymphoma Symptom Index (NFLymSI-18). Over 100 patients with lymphoma completed these at the start of the study and again three months later. All the questionnaires detected meaningful changes in fatigue, but the amount of change they showed depended on which tool was used and whether patients improved or worsened. Our findings can guide doctors and researchers in choosing the best fatigue measure for future studies.
Botswana's health system has been characterized in terms of its handling of HIV/AIDS and the comparability of public-sector delivery. These characterizations have pretty good bedrock. The 2025 declaration of an official public health emergency, after disruptions of the supply of almost all essential medicines, threw a spanner in the works. Public discourse changed in response. The conversation now became primarily about budgetary and supply chain procurement challenges. While these were concerns, there were several other issues, the most troubling being the absence of a systemic response to the multiple challenges and warnings that had been identified. We argue that the systemic response evidenced largely by the empty coffers and the absence of innovation-crisis stewardship indicates a concentration of executive authority in an overwhelmingly clinical, militarized, and potentially damaging supply zone. The analysis is grounded in the reviewed literature on health system governance and the system's lens that has been used to decenter public knowledge on the surface of recurring, persistent, and self-reinforcing institutional logics. The analysis is further informed by governance and decision theory, particularly the principal-agent theory, to identify likely facilitative mechanisms. Looking at the medicines shortage with this lens, there was a steady, predictable, and alarming succession of steps: signals were allowed to build, no corrective measures were taken, and emergency procedures were instituted and outside assistance was used, in particular, to stabilize the situation. Some of the more immediate and focused assistance from the United Nations was additional evidence of the absence of medicines caused by the routine care of the government. Central Medical Stores and hospital-level accountability were being discussed, and the absence of integration and accountability among the many professional areas likely caused delays in critical situations. The HIV governance arrangements of Botswana at that time illustrate an improvement in the ability to both detect and respond to the situation in a more consolidated fashion. The governing stress test of the 2025 episode is more significant than a one-off operational failure. Aimed at preventing the same situation from happening, further measures are needed that integrate clinical approval with management and financial administration, reinforce emergency measures, and create an environment of learning to influence the medicines system. Although some of the planned initiatives may have an impact, the authority and accountability gaps will continue to be the main issues that concern the leadership.
The integration of artificial intelligence (AI), particularly large language models (LLMs), into education, marks a profound shift in how knowledge is accessed, processed, and applied. These tools offer clear advantages-including improved efficiency, immediate support, and high productivity-but it may simultaneously weaken foundational skills. This Perspective examines the dual impact of AI on education, arguing that over-reliance on AI may displace essential cognitive processes that reinforce professional competence. Emerging evidence points to troubling associations between frequent AI use and diminished critical reasoning. We propose a model of critical alliance, in which AI augments but does not replace core intellectual processes. Unlike existing AI competency or digital literacy, this model centers on preserving human cognitive agency, judgment, reflection, and intellectual ownership, as primary educational outcomes. This framework not only emphasizes cognitive independence, but also equitable access, ethical vigilance, and faculty development as cornerstones of AI literacy. Addressing these questions is essential to safeguard both intellectual growth and educational equity in an AI-augmented era. Unlike existing digital literacy or AI competency frameworks, the critical alliance explicitly centers on preserving human cognitive agency and intellectual ownership as educational priorities, particularly in environments increasingly shaped by high-performing generative systems.
Neuropsychiatric symptoms in dementia (NPS) are common and among the most troubling aspects of living with dementia, yet their underlying mechanisms remain unclear. Here, we aimed to identify cerebrospinal fluid (CSF) proteins associated with NPS. Proteomes were profiled from CSF collected at baseline from participants of the Alzheimer's Disease Neuroimaging Initiative (ADNI) using mass spectrometry. Here, we included participants having positive AD CSF biomarkers (i.e., pTtau181 / Aβ42 ratio >0.025) and mild cognitive impairment or AD dementia (n=419). Eight NPS domains were assessed longitudinally with the Neuropsychiatric Symptom Inventory Questionnaire. Severity of cognitive impairment was evaluated using the CDR-SB. Proteome-wide differential expression analysis for each NPS domain at baseline was performed. Significant protein-NPS associations underwent mediation analysis to test whether they were mediated by cognitive impairment severity. Cox proportional hazard was modeled for baseline CSF proteins and incident NPS. Additionally, we tested whether candidate NPS causal proteins previously identified in brain are associated with NPS in CSF. We identified 8 CSF proteins associated with apathy at baseline (FDR q<0.05) after adjusting for sex, age, and education - NTNG2, S100A1, FZD1, FSTL5, CDH7, CHODL, FBXO2, and CACNA2D2. Mediation analysis revealed these associations were independent of cognitive impairment severity in four proteins and only partially mediated by cognitive impairment severity in the remaining four proteins. Among the 10 NPS candidate causal proteins previously identified in brain and detected in CSF, the abundance of two proteins (CPD, GRN) in CSF was associated with baseline disinhibition and of two other proteins (PIK3IP1, PCMT1) with both baseline apathy and incident apathy after adjusting for sex, age, and education. These findings suggest that proteomic alterations in apathy in MCI/AD encompass synaptic connectivity, calcium regulation, Wnt-signaling, and neuronal proteostasis, highlighting potential CSF biological processes and biomarker candidates for apathy.
Adults with attention-deficit/hyperactivity disorder (ADHD) often experience executive dysfunction that disrupts daily routines, occupational performance, and quality of life. Occupation-based interventions such as Cognitive-Functional Intervention for Adults (Cog-Fun-A) aim to address these challenges, yet little is known about variability in engagement and outcomes. This brief report describes three contrasting cases drawn from a Cog-Fun-A pilot study. Participants completed pre-post assessments including the Behavior Rating Inventory of Executive Function-Adult Version, Canadian Occupational Performance Measure, Adult ADHD Quality of Life Scale, Self-Regulation Skills Interview, and Model of Human Occupation Screening Tool. Therapist session logs were analyzed using descriptive content analysis to construct within-case and cross-case profiles. Two participants demonstrated clinically meaningful improvements in occupational performance, satisfaction, quality of life, and self-regulation, whereas one showed minimal change. Patterns across cases suggested that motivation, attribution style, routine stability, and environmental supports may influence engagement and strategy use in metacognitive, occupation-based intervention. Why some adults with ADHD benefit more than others from an occupational therapy programAdults with attention-deficit/hyperactivity disorder (ADHD) often have difficulties with everyday tasks. They may struggle with planning, organizing, starting tasks, managing time, or controlling emotions. These challenges can affect work, home life, and relationships. Occupational therapy can help adults with ADHD develop practical strategies to manage daily activities. One program designed for this purpose is called the Cognitive–Functional Intervention for Adults (Cog-Fun-A). In this program, people learn to better understand how ADHD affects their daily life and practice new strategies to manage routines and tasks. This article describes three adults with ADHD who took part in the Cog-Fun-A program. Each person attended weekly therapy sessions and completed questionnaires before and after the program. These questionnaires looked at their daily functioning, quality of life, and how well they felt they were performing important activities. The therapist also kept notes about how the participants took part in the sessions. Two of the participants showed clear improvements. After the program, they reported doing daily activities better, feeling more satisfied with their routines, and having a better quality of life. They also became more aware of their difficulties and were able to use strategies they learned in therapy. The third participant showed little improvement. He had difficulty attending sessions regularly and had trouble using the strategies in daily life. Looking at these three cases suggests that several factors may influence how much people benefit from therapy. These may include motivation, stable daily routines, personal beliefs about ADHD, and support from family or others in the environment. More research with larger groups of adults with ADHD is needed to better understand how therapy programs like Cog-Fun-A can be adapted to meet different needs.
This study investigates the practices and perceptions of educators regarding evidence-based mathematics interventions for children with autism spectrum disorder (ASD). A quantitative survey design was employed, collecting data from 250 teachers in special and inclusive education settings. Findings revealed strong educator awareness and positive perceptions of the effectiveness of strategies such as explicit instruction, the concrete-representational-abstract sequence, task analysis, and technology-assisted learning like video modeling. Despite high implementation rates and recognition of these practices' benefits for conceptual understanding and skill generalization, significant barriers impeded consistent application. Primary challenges included insufficient training, time constraints, limited resources, and a lack of institutional support. The study concludes that a critical research-to-practice gap persists, underscoring the necessity for enhanced professional development, systemic resource allocation, and stronger administrative support to translate evidence-based knowledge into sustained, high-fidelity classroom practice for improved mathematics outcomes in students with ASD. Résumé Objectifs:Cette étude examine les pratiques et les perceptions des enseignants concernant les interventions en mathématiques fondées sur des données probantes destinées aux enfants présentant un trouble du spectre de l’autisme (TSA).Méthodes:Un plan d’enquête quantitative a été utilisé, avec la collecte de données auprès de 250 enseignants exerçant dans des contextes d’éducation spécialisée et d’éducation inclusive.Résultats:Les résultats ont révélé une forte sensibilisation des enseignants ainsi que des perceptions positives quant à l’efficacité de stratégies telles que l’enseignement explicite, la séquence concret-représentationnel-abstrait, l’analyse des tâches et l’apprentissage assisté par la technologie, notamment le modelage vidéo. Malgré des taux élevés de mise en œuvre et la reconnaissance des bénéfices de ces pratiques pour la compréhension conceptuelle et la généralisation des compétences, d’importants obstacles ont entravé leur application systématique. Les principaux défis comprenaient une formation insuffisante, des contraintes de temps, des ressources limitées et un manque de soutien institutionnel.Conclusions:Cette étude conclut qu’un écart important entre la recherche et la pratique persiste, soulignant la nécessité de renforcer le développement professionnel, l’allocation systémique des ressources et le soutien administratif afin de traduire les connaissances fondées sur des données probantes en pratiques pédagogiques durables et mises en œuvre avec un haut degré de fidélité, dans le but d’améliorer les résultats en mathématiques des élèves présentant un TSA.
What is this review about?During the menopausal transition, women may experience disruptive symptoms like hot flashes during the day or night (night sweats) and have trouble sleeping. Many current treatments for hot flashes do not work for everyone because of potential side effects, health concerns, or individual needs and preferences.Elinzanetant is a hormone-free treatment for hot flashes linked to menopause. It works by targeting the source of hot flashes in the brain. This summary covers the results from four randomized clinical trials that tested elinzanetant in women: OASIS-1, OASIS-2, OASIS-3, and OASIS-4.The OASIS trials looked at how well elinzanetant works for women with menopause symptoms. OASIS-1, OASIS-2, and OASIS-3 included women with hot flashes from natural or surgical menopause. OASIS-4 focused on women who had hot flashes because they were taking endocrine therapy after initial treatment for breast cancer.What were the results?The OASIS trials showed that elinzanetant rapidly reduces the number and severity of hot flashes experienced by women from natural or surgical menopause or due to endocrine therapy for breast cancer. Elinzanetant also improved their sleep and overall well-being. The side effects seen with elinzanetant were mainly mild and tolerable, the most common being headache, fatigue, and sleepiness.We use the term 'women' throughout for simplicity, but we recognize that menopause and its treatments may also be relevant to people who do not identify as women.
Intermuscular adipose tissue (IMAT) is increasingly recognized as a contributor to insulin resistance and metabolic dysfunction in type 2 diabetes (T2D). Accumulation of IMAT was found to correlate with impaired skeletal muscle insulin sensitivity, as well as a generally reduced muscle strength and physical performance in humans. Beyond serving as an energy depot at physiological levels, increased IMAT is thought to actively impair muscle metabolism through secretion of adipokines, cytokines and lipid intermediates that create an inflammatory environment and modulate insulin signaling pathways. This review discusses current evidence on the pathophysiological role of IMAT based on clinical studies, including interventions, and current mechanistic insight from biopsied human IMAT. We further explore traditional and emerging methods to investigate IMAT that could expand mechanistic understanding of IMAT-muscle-crosstalk, highlighting their strengths and limitations. Human in vitro co-culture-models are valuable future tools for dissecting cellular and molecular responses. Despite growing interest in IMAT as a potential key player in metabolic disease, uncertainty remains about its origin, regulation and functionality. We suggest further research to integrate and intertwine traditional imaging techniques, multi-omics characterization of IMAT biopsies and advanced, physiologically relevant human in vitro systems to close these knowledge gaps to develop therapeutic strategies targeting metabolic disease.
Nightclubs and bars are more than leisure spaces allowing participants to forget daily troubles and have fun; they are also political sites that illuminate social and cultural tensions and conflicts. This ethnographic study examines the first Israeli Mizrahi gay party-Arisa-which was dedicated to presenting Mizrahi culture (i.e., the cultural products of Jewish communities who immigrated to Israel from North Africa and Islamic countries). Arisa was a queer initiative that worked to strengthen the socio-cultural status of Mizrahi culture in the local Israeli LGBTQ+ community, which is often perceived and led by Ashkenazi (European) and American characteristics and representatives. We argue that this innovative party, as an ethnic-heterotopic space, reflects liminal moments which intersect between sexuality, gender and ethnicity. On the one hand, Mizrahi gay partygoers felt a sense of belonging to their ethnic group and celebrated their identity. Additionally, Arisa advanced other marginalized groups, opening the door for Israeli-Arab, Ethiopian, and Orthodox gay people to feel comfortable. On the other, Arisa served to reinforce certain Mizrahi stereotypes and stigmas. Thus, we suggest that this particular case highlights how social exclusion mechanisms in queer spaces are reproduced and undergo transformations.
Wilson disease is an autosomal recessive disorder that affects copper metabolism due to mutations in the ATP7B gene. It causes problems with the liver and the nervous system. On magnetic resonance imaging (MRI), the typical sign is the "face of the giant panda" in the midbrain. A rarer sign, called the "panda with bright eyes," suggests more extensive brainstem involvement and is not often seen. A 21-year-old man developed worsening behavior changes, mood swings, and trouble with his studies. He later had tremors in both arms and mild speech difficulties. His liver tests were abnormal, and his ceruloplasmin level was low at 8 mg/dL. An eye exam showed Kayser-Fleischer rings in both eyes. Brain MRI showed symmetrical T2/FLAIR hyperintensities in the caudate nuclei, putamina, globus pallidi, thalami, posterior limbs of the internal capsules, and both the superior and middle cerebellar peduncles, as well as the pons. Increased T2 signal in the red nuclei and substantia nigra produced the "panda with bright eyes" sign. There was also diffusion restriction in both globus pallidi and thalami. The Leipzig score confirmed Wilson disease. The patient started D-penicillamine treatment and showed clinical improvement. Radiologists need to recognize both common and rare MRI features of Wilson disease, especially when neuropsychiatric symptoms are present. Spotting the "panda with bright eyes" sign can help with early diagnosis, guide metabolic testing, and allow prompt chelation therapy, which can improve neurological outcomes.
Precise crop prediction is now of utmost significance in the era of escalating climate dynamics. In this paper, a new structured Bayesian optimized hybrid deep learning model is proposed by using existing methodologies to make accurate predictions for prominent crops wheat and rice based on long-term climate variables average maximum temperature, Co2 and precipitation from 1961 to 2021 in Pakistan. The primary objective of this research is to enhance previous models that have trouble understanding intricate climate impacts and provide reliable predictions about future agricultural production. Using a deep learning model and a classical statistical approach, we employed Bayesian Optimization to automatically identify the optimal parameters. This improved learning and prediction accuracy for our model. It incorporates both temporal patterns and climatic patterns influencing agricultural production. Forecasting is performed for the 2022-2031 decade and tested against strong metrics such as RMSE, MAE, and R². Compared to known models CNN, RNN, LSTM, GRU, BiLSTM and VAR, the proposed BO-VAR-BiLSTM hybrid model showed to have a better accuracy and stability compared to the baselines. The proposed had a R2 of 0.9611 and MAPE of 8.01% show that the model had high forecasting power in predicting climate-driven production of crops. Apart from the scholarly interest, the model provides prescriptive insights to policymakers, agricultural planners, and stakeholders in climate-sensitive areas. By allowing data-driven decision-making. It facilitates adaptive crop management strategies under changing environmental conditions. This study not only pushes the frontier of AI for agriculture but also provides a scalable solution for resilient agriculture in the age of climate uncertainty.
The evidence-based practice (EBP) paradigm has become a dominant approach to clinical care, organizing healthcare around the production, synthesis, and implementation of evidence. Yet despite sustained efforts to standardize practice in terms of evidence, variability in care delivery, outcomes, and decision-making persists. Nursing scholarship has critically examined EBP as a dominant epistemological orientation to practice, often identifying variability as that which troubles the evidentiary aspiration to standardize, generalize, and govern practice. Building on this work, I take variability as a starting point for examining how healthcare is configured as an evidentiary domain in the first place. Drawing on Michel Callon's concepts of framing and overflowing, EBP is approached as an ongoing effort to make clinical practice sufficiently calculable, comparable, and actionable. The analysis shows how variability appears not simply as what exceeds or opposes evidence, but as that which is directly operative in the processes through which evidentiary arrangements are developed, enacted, and transformed. In this way, evidence and practice emerge not as pre-existing domains requiring reconciliation, but as ongoing accomplishments produced through processes of framing and overflowing. What then becomes visible is the continual formation of healthcare, where evidentiary arrangements, clinical practices, problems, and possibilities are continually encountered, enacted, and made consequential, inviting inquiry into the ways nursing participates in these processes.
Participants with psychotic-like experiences (PLEs) have higher suicide behavior (e.g., suicide attempts, suicide deaths), but it remains unclear which features influence suicide behavior in this population. This study aims to identify different PLEs subgroups based on multiple clinical symptoms and psychological characteristics relevant to suicidality, and examine their associations with suicide behavior. Among 6390 college students at baseline, 2913 screened positive for lifetime PLEs. Latent profile analysis was conducted to identify different PLEs profiles based on baseline clinical symptoms and psychological characteristics. Model fit indices guided model selection. A generalized linear model examined PLEs profile- suicide behavior associations at one-year follow-up, controlling for covariates, and the population attributable fraction (PAF) was calculated. A three-profile solution was optimal (entropy = 0.915): troubled (10.3%), vulnerable (3.0%), and symptomatic but content (32.3%). Compared to the non PLEs group (54.4%), all three PLEs groups exhibited significantly higher odd of suicide behavior one year later (OR = 1.69-6.49, PAF = 42.8%). However, only the troubled PLEs group showed significant higher subsequent suicide behavior (OR=2.12, 95%CI: 1.37-3.28, PAF = 14.7%) after controlling for covariates. PLEs exhibit heterogeneity across symptoms and psychological characteristics associated with suicide behavior. A comprehensive PLEs assessment may enhance suicide prevention efforts.
The heterogeneity in both the neurobiological mechanisms and the phenotypic presentations of autism spectrum disorder (ASD) poses a major challenge to clinical and translational research. Alterations in functional connectivity (FC) have been associated with ASD, yet it remains unclear whether and how divergent brain network properties may account for individual differences across ASD-related symptomatology and behaviors. We applied source-level reconstruction to rest-like non-task-related high-density EEG data in a cohort of 104 young children (38 with ASD) to identify global and local alterations of cortical network connectivity. We subsequently used regularized canonical correlation analysis (rCCA) to characterize specific FC patterns linked to variation in cognitive, social and sensory dimensions derived from standard clinical instruments. We found increased low-frequency FC in frontotemporal cross-hemispheric networks and lateral-occipital regions of young ASD children versus healthy peers. RCCA revealed three distinct FC patterns in recurrent ASD-related networks, each contributing to predict individual differences in cognitive, social and sensory features. These linked FC-behavior dimensions may shed light on atypical brain network topology associated with specific phenotypic manifestations of ASD, which might implicate unique underlying neurobiological mechanisms.
Raising concerns (speaking up or whistleblowing) is essential to detect and prevent unsafe practice and to uphold professional standards. While medical and dental students are frontline observers during clinical rotations, they face barriers to escalation. However, to guide policy and training, it is essential to gather local data on students' confidence and the readiness of institutions to support them in raising concerns. This study aimed to assess Syrian medical and dental students' institutional awareness and exposure to safety concerns, confidence in speaking up, perceived barriers to raising concerns, and institutional readiness to support reporting during clinical training. A cross-sectional survey was administered to a total of 812 medical and dental students in clinical training from all 13 universities offering undergraduate medical education in Syria between 15 October and 22 December 2025. A scenario-based Arabic questionnaire, translated and back-translated, was delivered via online and paper modes to maximize inclusion, with a pilot study of 40 students demonstrating excellent internal consistency (Cronbach's α = 0.95). Data were analyzed using descriptive statistics, t-tests, one-way ANOVA with Tukey's post-hoc tests, and multivariate linear regression to identify predictors of confidence (SPSS v27). Sample size calculations indicated a minimum requirement of 385 participants, and statistical significance was set at p < 0.05. Among participants, 40.9% reported encountering unsafe or unprofessional behavior, while 17.6% reported the presence of an institutional whistleblowing policy and 4.8% had received formal training, despite 82.3% expressing interest in such training. Overall confidence in raising concerns was moderate, with the highest confidence reported for patient safety issues and reporting to clinical supervisors. Confidence declined significantly with each advancing academic year (p < .001) and was independently associated with formal training in multivariable analysis (p = .001). The most frequently reported barriers were reluctance to "cause trouble" (42.6%), uncertainty about whom to contact (41.9%) and perceived lack of institutional support (39.0%); top enablers were assurances of reporter safety (74.1%) and ensuring changes will be implemented following reporting (59.9%). A substantial proportion of students reported exposure to unsafe or unprofessional behavior, while reporting policies, training, and institutional support were limited. These findings suggest gaps in reporting preparedness and perceived safety that may influence students' willingness to raise concerns. Further research is needed to evaluate strategies to improve reporting confidence and institutional support. In this context, educational institutions should incorporate practical, scenario-based training into their curricula. Future research should also assess the long-term effects of these measures on students, and extend the evaluation to include residents and practitioners.