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Survivors of child sexual abuse often experience trauma-related sequelae, including increased risk for psychiatric disorders. The objectives of this study are to (1) epidemiologically describe youth evaluated at a child advocacy center for concerns of child sexual abuse and compare the characteristics of those who did and did not experience subsequent suicidality and (2) explore associations between the presentation of suicidality and the victim-alleged perpetrator relationship. Electronic health records of children aged 10 to 17 years who were evaluated for child sexual abuse at a medically based child advocacy center in the Midwestern United States between January 1, 2018, and December 31, 2022, were retrospectively reviewed to identify suicidality within 90 days following assessment. Demographic, medical, mental health, and alleged perpetrator relationship data were descriptively analyzed. Among 1391 youth medically assessed for child sexual abuse, 11.1% of youth reported suicidality within 90 days. Of those youth, 21.9% attempted suicide within that time period. When the relationship between the adolescent and alleged perpetrator was known, a significantly greater percentage of suicide attempts occurred among youth whose perpetrator was a nonrelative, rather than a relative (3.2% vs 1.4%, respectively; P = .03). This study supports the need for suicidality screening for youth both at the time of child sexual abuse evaluation and in the weeks and months following disclosure. Prompt, trauma-informed mental health care is critical for preventing further harm, especially for high-risk youth, including individuals with current depressive symptoms, those with prior suicidal ideation, and those who identify as sexual and gender diverse.

Evaluating message credibility is critical for understanding scientific information and informed decision making. People's ability to assess the credibility of science communication texts is influenced by several factors. In three experiments, we examined the impact of authors' gender as well as different types of expertise on readers' credibility perceptions. In Experiment 1 (n = 203), we varied authors' alleged gender and expertise. We found that a text allegedly written by a high-expertise author was rated as more credible than the same text by a low-expertise author. There was no effect of authors' gender. Experiment 2 (n = 182) was a replication of the first study with a different sample. We did not find any effects of gender or expertise on perceived message credibility. In Experiment 3 (n = 206), we differentiated between academic and personal expertise and manipulated these types of expertise independently. The data indicated that academic expertise was a significant positive predictor of perceived message credibility, while personal expertise was not. We discuss these findings in terms of their significance for the trustworthiness of science communication and examine the relevance of differentiating the concept of expertise in this context.

A predictive risk model (PRM) was trained to stratify risk among children investigated for alleged maltreatment based on the likelihood of future child protection involvement. In the current brief, we assess the model's ability to differentiate risk of adverse events not used to build the model (i.e., arrest, death) among adolescent populations investigated following reported maltreatment to guide prevention-oriented services. Child welfare and vital statistics records were obtained through a data use agreement. Among adolescents born in 2000 and 2001 and investigated for alleged maltreatment between ages 11 and 17 (n = 72,340), risk scores were calculated using a random forest algorithm based on information available at the time of maltreatment report. The records of these adolescents were then linked to arrest and death records. Among adolescents investigated for maltreatment, 5.8% experienced a juvenile arrest or death before age 21. Of those who experienced an arrest or death, 43.9% fell in the highest risk decile. A PRM trained to predict foster care placement had strong external validity in predicting both future arrests and deaths. The average time from investigation to adverse event indicates a meaningful window for interventions to be delivered focused on supporting and stabilizing adolescents and their families.

A routine paternity test using 23 autosomal short tandem repeats (A-STRs) revealed three Mendelian inconsistencies at D21S11, D13S317, and D7S820 between the alleged father and child, yielding a combined paternity index (CPI) below the confirmation threshold (CPI > 10⁴) stipulated in the Chinese technical specifications. Extended capillary electrophoresis typing of 48 A-STRs and 17 Y-STRs eliminated further mismatches and raised the CPI above the standard. Subsequent massively parallel sequencing (MPS) of 54 A-STRs, 27 X-STRs, 48 Y-STRs, 132 identity-informative single nucleotide polymorphisms (iiSNPs), and mitochondrial DNA (mtDNA) provided both length- and sequence-based genotypes. The CPI reached 2.78 × 10²¹ (A-STRs) and 6.28 × 10¹⁷ (iiSNPs), strongly supporting the paternity. All other marker systems were consistent with the alleged relationships. The three observed incompatibilities were attributed to single-step paternal mutations. This case highlights the risk of misinterpreting multi-locus STR mismatches and demonstrates the value of MPS-based genotyping in resolving complex paternity evaluations.

This research aims to demonstrate the validity of using video analysis as a direct method of detecting the manipulation of sports competitions (i.e., match-fixing). Using the case of an allegedly manipulated professional handball competition, the direct detection method was developed and used as evidence during expert testimony for the courts. The analysis divided the video of the alleged fixed handball competition into key points. Biomechanical analysis was conducted on each key point to identify intentional performance deficiencies (i.e. match-fixing) in motor behavior actions with or without a ball, performed in a favorable environment, and contrary to the interest of the team or player. The video analysis method strongly limited the number of hypotheses for the explanation and thus demonstrated when aspects of the contest were fixed. This work demonstrates the high potential for a direct match-fixing detection method from video analysis not only for handball but more generally for team or individual sports. This research provides important support for the use of video analysis in real time to fight against match-fixing and to protect the integrity of sport more effectively.

The child welfare system (CWS) is often contacted when a child is born with prenatal substance exposure, but there is limited evidence on the beneficial and iatrogenic effects of CWS involvement. To examine whether involvement with the CWS at birth is associated with injuries and moderate- to high-complexity emergency department (ED) use in the first year of life among infants identified with prenatal substance exposure. Retrospective cohort study using probabilistically linked administrative data of Pennsylvania statewide child welfare administrative records linked to Medicaid claims. Births from January 1, 2015, to December 31, 2018, were followed up for 12 months. Data were analyzed from October 9, 2025, to March 21, 2026. A sibling fixed-effects design compared infants born to the same mother who differed in their CWS involvement status. The cohort included Medicaid-covered infants identified with prenatal substance exposure who were named in confirmed child welfare cases at birth involving alleged maltreatment or a sibling and met continuous Medicaid enrollment and successful linkage criteria. The discordant sibling sample included infants born to mothers with at least 2 infants who differed in involvement status. Involvement with the CWS in the birth month. Primary outcomes included any injury, serious injury (Abbreviated Injury Scale score ≥3 or CWS-documented fatalities/near fatalities), and moderate- to high-complexity ED visits (Current Procedural Terminology evaluation and management codes 99283-99285; critical care codes 99291-99292), including repeat visits. Secondary outcomes included well-child visits, low-resource-intensity ED visits, and maternal postpartum care. In this study in 5858 of infants (3001 male and 2839 female) identified with prenatal substance exposure, by age 1 year, 14.5% had an injury-related claim, 33.8% had a moderate- to high-complexity ED visit, and 14.3% had a repeat ED visit. In sibling fixed-effects models, involvement with the CWS at birth was associated with a 20% relative reduction in moderate- to high-complexity ED visits (-7.3 percentage points [pp]; 95% CI, -10.8 to -3.9 pp) and a 24% relative reduction in repeat ED visits (-3.7 pp; 95% CI, -6.3 to -1.2 pp). Conversely, on-time well-child visits were 15% lower (-7.8 pp; 95% CI, -11.7 to -4.0 pp) for CWS-involved siblings. Results of this study suggest that child welfare involvement is associated with reduced health care use among infants with prenatal substance exposure, especially moderate- to high-complexity ED use.

Congress mandates that each military service maintain a central registry to monitor the frequency of maltreatment incidents by service and installation across time. For over two decades, the Family Translational Research Group (FTRG; Co-directors: Amy Slep and Richard Heyman) at New York University has partnered with military Family Advocacy Programs (FAPs) to ensure that partner and child maltreatment determinations are fair and consistent. This collaboration resulted in the Field-Tested Assessment, Intervention-Planning, and Response (FAIR) system-an evidence-based practice mandated across all services for determining whether alleged incidents of partner and child abuse or neglect meet criteria as maltreatment. The US Army was the first service to require annual quality assurance (QA) to support FAIR sustainment. This paper will describe (a) FAIR and the evidence supporting its use, (b) the university-military partnership that supported FAIR dissemination in the US Army, and (c) the university-military partnership that established a QA and training system for FAIR sustainment in the US Army. In addition, the manuscript will provide empirical evidence demonstrating that FAIR implementation fidelity and the accuracy of determinations have improved across the first 2 years of QA. Challenges have included perceptions from local committees that FAIR QA is university-driven rather than FAP-owned, maintaining consistent standards, and adapting to policy changes. Collaborative decision-making, a focus on impact, and decades of immersion in military culture have supported this long-term university-government partnership.

Ethylene glycol (EG) is a common cause of fatal poisoning in companion animals and may be involved in intentional or negligent animal cruelty. We describe a forensic veterinary investigation of a free-roaming cat submitted by the Seoul Gangbuk Police in relation to an alleged violation of the Korean Animal Protection Act. Complete necropsy revealed focal gastric erosion and bilaterally congested kidneys, while histopathology of the kidneys showed acute tubular epithelial necrosis with abundant intraluminal calcium oxalate crystal deposition. Toxicological analysis of gastric tissue using a validated GC-MS method demonstrated the presence of ethylene glycol and its primary metabolite glycolic acid, confirming ethylene glycol exposure and, together with the gross and microscopic renal lesions, supporting antifreeze poisoning as the cause of death. PCR testing of pooled tissue samples was positive for feline parvovirus and feces were positive for feline coronavirus, but these infections were not considered the proximate cause of death. This case highlights the value of forensic veterinary pathology and toxicology in objectively determining cause of death in suspected animal cruelty investigations and demonstrates that targeted analysis of gastric tissue can provide definitive evidence of ethylene glycol exposure.

To examine how federal appellate courts evaluate constitutional claims concerning custodial dental care and to characterize the clinical and procedural features of these cases. Decisions of the U.S. courts of appeals issued between 1980 and 2025 were identified through structured database searches. Cases substantively evaluating dental care were coded for severe pain, infection, abscess (coded separately), functional impairment, delay, custody type, representation status, defendant level, and appellate outcome. Descriptive statistics summarized case characteristics, and logistic regression evaluated associations between selected variables and appellate outcomes. A total of 182 appellate decisions met inclusion criteria, of which 174 evaluated adequacy of care. Severe pain was described in 86% of coded cases and functional impairment in 62%. Infection was documented in 41% of cases, with an abscess specifically identified in 16%. Delay was alleged in 73% of cases. Overall, 35% of decisions resulted in reversal or remand. Among cases with documented delay duration, the median delay was substantially longer in plaintiff-favorable cases, and delays exceeding 90 days were associated with higher odds of reversal or remand. Appellate review emphasizes documented awareness and response rather than equivalence to community standards. This legal threshold does not ensure timely clinical resolution. Public health evaluation of custodial dental systems should consider disease progression and access to definitive treatment in addition to legal compliance. Improvements are likely to depend on system-level monitoring of access and timeliness of care rather than litigation alone, reflecting the distinction between legal sufficiency and clinical adequacy.

This article explores the philosophical and linguistic inquiries of Bhartṛhari, a renowned grammarian and philosopher who lived between 460 and 510 CE. Focusing on his seminal work, the Vākyapadīya, the article examines Bhartṛhari's investigation into the problem of universals. It begins by providing an overview of the debates surrounding universals in both Euro-American and Indian philosophies. The article then delves into Bhartṛhari's unique distinction between linguistic and ontic universals, analyzing his arguments and discussing how his concepts address a common criticism faced by universal realists-the alleged vicious regress of universals.

Since 2019, sex equity in traffic crashes has been a highly debated topic in vehicle safety, especially following the 2019 study by Forman et al. (1) claiming that female occupants face a 73 percent greater risk of serious injury in frontal crashes compared to male occupants. This was soon followed by a Consumer Reports Article by Keith Barry (2), which attempted to identify underlying factors contributing to the higher risk. These have been embraced by several parties since 2019. Firstly, it was alleged that vehicle design practice over the last four decades considered safety for the male population only and ignored that of the female as evidenced by the exclusive use of the mid-sized male Anthropomorphic Test Devices (ATDs) in Regulatory and Safety Ratings tests and not with an average sized female ATD. The absence of such an ATD for testing of vehicles "set the course for four decades' worth of car safety design, with deadly consequences" (2). Secondly, although there is a recognition of the fact that Regulatory testing with a Small Female ATD, the Hybrid III-05F, was introduced in the FMVSS208 in 2003, this ATD was only a scaled version of the average male ATD of the 1970's implying that this ATD is incapable of driving the design of restraint systems for females due to "They're put together differently. Their material properties-their structure-is different" (2). Thirdly, according to a quote "These same trends have been observed in many, many studies in the past." We assume that the trends refer to the apparent disparity in safety of females when compared to those of males. This document aims to outline historical activities, associated research and the development of countermeasures addressing crashworthiness concerns related to vehicle safety for females, as well as factors affecting both males and females, such as age-related impacts. This paper deals mainly with the frontal crash modes, mentions side impacts briefly as it affected designs of inflatable restraints for side impact to protect the smaller portion of the population from inflation induced injuries but the history behind the use of female ATDs by IIHS and NHTSA in full scale testing is not covered. Where ever possible, the time periods of reported activities related to female safety have been divided to pre-1997 corresponding to a change in US frontal crash regulation to address serious-to-fatal injuries to females and children, between 1997 to 2003 corresponding to the proposal by Canada for its frontal impact standard, and between 2003 and 2006 when the Advanced Restraint Regulation in the US FMVSS 208 was promulgated. This was followed by activities between 2007 and 2019, and post 2019 period.

Identifying child abuse in young children, especially through hand fractures, presents a significant challenge for healthcare providers. This study aimed to explore the socio-demographic and medical characteristics associated with child abuse in children under five who presented with hand fractures at a pediatric emergency department in north-central Israel from 2018 to 2023. This retrospective study analyzed data from 828 children who presented with hand fractures. Key factors, such as nationality, history of previous fractures, and recent hospitalizations, were examined for their association with child abuse. Statistical analyses, including logistic regression, were performed to determine associations and significance. The study identified 30 (3.6%) victims of abuse among the cohort. Significant factors associated with a higher likelihood of abuse included Arab nationality (OR 2.4; 95% CI 1.01-5.93), prior fracture history (OR 1.9; 95% CI 1.20-2.99), and hospitalization within the past year (OR 3.1; 95% CI 1.31-7.46), all with p-values&#x2009;<&#x2009;0.01. Victims of abuse had more previous fractures (M&#x2009;=&#x2009;0.93) and more hospitalizations in the previous year (M&#x2009;=&#x2009;1.13) compared to non-victims. In the reviewed cases classified as abuse, documentation indicated the father as the alleged perpetrator in each instance. These findings highlight the critical role of healthcare providers in recognizing and reporting potential child abuse, particularly in cases of recurrent injuries and frequent hospital visits. Understanding these risk factors can help in early identification and protection of at-risk children. Further research is needed to enhance protective measures and gain deeper insights into the factors influencing the identification of child abuse.

A label of "penicillin allergy" among hospitalized patients often leads to the use of second-line antibiotics. It has been demonstrated that alleged penicillin allergy is associated with prolonged hospitalization, increased risk of antimicrobial resistance, and higher mortality rates. Approximately 90% of reported penicillin allergies are inaccurate and may reflect adverse drug reactions or misinterpretation of medical history. To evaluate penicillin allergy among hospitalized patients through an educational intervention program. A prospective study implementing an intervention program aimed at removing inaccurate penicillin allergy labels in hospitalized patients in internal medicine and surgical departments. The intervention was carried out by the physicians of the department and supported by specialists in allergy and clinical immunology, infectious diseases, and clinical pharmacy. The program included educational lectures about drug allergies and clinical training in conducting penicillin drug provocation tests (DPT). A negative DPT result led to the removal of the allergy label from the patient's medical record. Between January and October 2024, a total of 26,985 patients were admitted to the internal medicine departments and the surgical division at Meir Medical Center. Of these, 2,001 patients (7.4%) had a documented penicillin allergy label. Among the labeled patients, 114 (5.7%) underwent inpatient evaluation for penicillin allergy. In the internal medicine departments, 16,791 patients were hospitalized during the study period. Of these, 1,320 (7.8%) carried a penicillin allergy label, and 54 (4.0%) underwent evaluation as part of the de-labeling intervention. In departments where the structured program was implemented, 27 of 530 patients had their allergy label removed, compared with 27 of 790 patients in departments without the intervention (5% vs. 3.4%, p = 0.1). During the same period, 10,194 patients were admitted to the surgical division. Of these, 681 patients (6.6%) had a documented penicillin allergy label, and 60 (8.8%) underwent evaluation as part of the intervention program. In departments participating in the program (gynecology, otolaryngology, and orthopedics), 38 of 200 patients underwent inpatient assessment for penicillin allergy, compared with 22 of 481 patients in departments not participating in the intervention (19% vs. 4.5%, p < 0.01). The intervention program led to a modest improvement in the rate of penicillin allergy label removal among hospitalized patients, with relatively greater success observed in surgical departments. We believe that the learning curve inherent to this process requires a prolonged implementation period. On-going application and refinement of the intervention, across both medical and surgical departments, may further reduce the prevalence of inaccurate allergy labeling.

A 32-year-old male presented with a history of decreased urine output following an alleged history of deliberate self-harm by consuming glufosinate ammonium 13.5% w/w SL herbicide (Synkill&#xae;) two days earlier. General physical examination revealed pulse 86 beats/minute, blood pressure 140/90 mmHg, and respiratory rate 20/minute. Laboratory investigations revealed elevated serum creatinine (5.96 mg/dl), creatinine phosphokinase (340 i.u./L), and elevated serum hepatic transaminases. On day 6 of hospitalization, he developed right-sided lower motor neuron facial palsy and was started on oral prednisolone. The following day, the weakness progressed, and bilateral lower motor neuron facial palsy developed. During the next few days, a descending type of flaccid paralysis developed, including involvement of respiratory muscles, requiring assisted mechanical ventilatory support. Magnetic resonance imaging (MRI) of the brain showed a normal study. The electroneuromyography test showed prolonged latency with reduced amplitude and conduction velocity. The sensorium of the patient also worsened with a Glasgow Coma Scale (GCS) of E1VTM1 by day 11 of hospital stay. A computed tomography scan of the brain done after a fall in GCS showed no abnormality of the brain parenchyma. The blood and urine samples sent for toxicological analysis revealed the presence of glufosinate in urine alone. The patient was discharged against medical advice from the hospital. Our patients highlights a very rare manifestation of glufosinate ammonium herbicide poisoning.

Pregnancies resulting from sexual assault present complex ethical and investigative challenges, especially in cases that involve minors or individuals with intellectual disabilities. When suspect samples are unavailable, identifying whether the biological father is a close relative can substantially narrow the scope of the investigation. This study presents interpretable machine learning models to evaluate the likelihood of a consanguineous relationship between an alleged perpetrator and a victim in cases of pregnancies resulting from suspected sexual assault, using short tandem repeat (STR) profiles of the fetus or newborn and the mother. We simulated 100,000 STR profiles across four incestuous relationship scenarios: parent (father-daughter), sibling (brother-sister), grandparent (grandfather-granddaughter), and uncle (uncle-niece) scenarios. Logistic regression and decision tree models were trained using two STR-derived features: the number of homozygous loci and the number of loci matching the maternal genotype. Both models demonstrated excellent predictive performance, particularly in the parent and sibling scenarios (area under the curve >0.9). The models' interpretability ensures the transparency essential for forensic casework. This approach enables informed investigative decisions and may prevent unnecessary DNA testing, thereby improving forensic efficiency while protecting human rights.

As social beings, humans make decisions partly based on social interaction. Observing the behavior of others can lead to learning from and about them, potentially increasing trust and prompting trust-based behavioral changes. Observation-based decision making involves different neural structures. The orbitofrontal cortex (OFC) and lateral prefrontal cortex (LPFC) are known as neural structures mainly involved in processing emotional and cognitive decision values, respectively, while the anterior cingulate cortex (ACC) plays a pivotal role as a social hub, integrating the afferent expectancy signals from the OFC and LPFC. This paper presents a neurocomputational model of the interplay between observational learning and trust, as well as their role in individual decision making. Hence, our model provides a framework for investigating how emotional and rational responses may change when individuals observe the action-outcome associations of an alleged expert. We have modeled the neurodynamics of three cortical structures (OFC, LPFC, and ACC) and their interactions, where the neural oscillatory properties, modeled with Dynamic Bayesian Probability, represent the observer's attitude towards the expert and the decision options. As an example of an everyday behavioral situation related to climate change, we use the choice of transportation between home and work. The model generates EEG-like signals that show how patterns of neural activity change during observation-based decision making. The simulations suggest that higher levels of trust influence both emotional and rational evaluations when individuals observe the actions and outcomes of an expert. Overall, the proposed framework provides insight into how observational learning and trust work together to shape decision making. It highlights the dynamic interplay between emotional and cognitive processes and offers a mechanistic understanding of how social information can influence behavior.