Search Results (23,650)

Brief Admission by Self-referral (BA), a standardized crisis intervention for individuals with repeated self-harm or suicidal behavior, was adapted for adolescents from 13 years in Region Skåne, Sweden, in 2018. BA aims to offer access to support based on autonomy and has been associated with reduced need of emergency care. Interviews with adolescents and legal guardians have pointed to BA as valuable and challenging, and professional support as key. This study aims to describe healthcare professionals’ (HCPs) experiences of BA for adolescents with self-harm at risk of suicide. Interviews six years after implementation with fourteen HCPs from outpatient and inpatient psychiatric care were analyzed with qualitative content analysis. BA was perceived as valuable caretaking without taking over, promoting mental growth and agency by being brief and granting access. It was described as offering relief to families and HCPs, although perceived to lack a sufficient level of legal guardian participation. Key work processes included being grounded in leadership and outpatient treatment. Challenges included system inflexibility and fitting BA into the physical care context. The results of this study may support future implementation of BA for adolescents with self-harm at risk of suicide and add guidance around potential pitfalls. Full article

The swinging sticks pendulum is an intriguing physical system that exemplifies the intersection of Lagrangian mechanics and chaos theory. It consists of a series of slender, interconnected metal rods, each with a counterweighted end that introduces an asymmetrical mass distribution. The rods are arranged to pivot freely about their attachment points, enabling both rotational and translational motion. Unlike a simple pendulum, this system exhibits complex and chaotic behavior due to the interplay between its degrees of freedom. The Lagrangian formalism provides a robust framework for modeling the system’s dynamics, incorporating both rotational and translational components. The equations of motion are derived from the Euler–Lagrange equations and lack closed-form analytical solutions, necessitating the use of numerical methods. In this work, we employ the Bulirsch–Stoer method, a high-accuracy extrapolation technique based on the modified midpoint method, to solve the equations numerically. The system possesses four fixed points, each one associated with a different level of energy. The fixed point with the lowest energy level is a center, around which small perturbations are studied. The other three fixed points are unstable. The maximum energy used for the perturbations is $0.001\%$ larger than the lowest equilibrium energy. When the system’s total energy is low, nonlinear terms in the equations can be neglected, allowing for a linearized treatment based on small-angle approximations. Under these conditions, the pendulum oscillates with small amplitudes around a stable equilibrium point. The resulting motion is analyzed using tools from nonlinear dynamics and Fourier analysis. Several trajectories are generated and examined to reveal frequency interactions and the emergence of complex dynamical behavior. When a small initial perturbation is applied to one rod, its motion is characterized by a single frequency with significantly greater amplitude and angular velocity compared to the second rod. In contrast, the second rod displayed dynamics that involved two frequencies. The present study, to the best of our knowledge, is the first attempt to describe the dynamical behavior of this pendulum. Full article

A 4-month-old male child was admitted with failure to thrive, persistent osmotic diarrhea, and presence of multiple metabolic abnormalities, which included hypertriglyceridemia, hypercholesterolemia, hypercalcemia, and medullary nephrocalcinosis. He was diagnosed with congenital glucose–galactose malabsorption (CGGM). The exome analysis showed presence of pathogenic mutation in exon 8 of the SLC5A1 gene (c875G>A, p.Cys292Tyr). This gene codes for a sodium–glucose cotransporter called SGLT1. To date, no clinical case reports have reported hypertriglyceridemia and hypercholesterolemia with CGGM. Hypercalcemia and medullary nephrocalcinosis have also been reported only in a handful of CGGM cases worldwide. Through this case, the authors attempt to highlight the uncommon manifestation of this rare disease to facilitate timely management. Although the child died due to healthcare-associated infection (HCAI), pre-natal counseling of the family was carried out for the management of future pregnancies. Full article

This study first situates the discourse on Proudhon’s federalism and nationalism within the framework of his comprehensive economic, social, and philosophical system. Proudhon attempts to construct a federalism based on an associational and decentralized political structure that could accommodate plural groups and avoid the exclusive interpretation of sovereignty that prevailed in nationalism at the time. Such federalism is not only a design of political institutions but also a reflection of his economic mutualism and the idea of commutative justice. Then, this study proposes a relatively concise and intuitive dual critique framework to focus on how his federalism directly refutes nationalism. Proudhon’s federalism aims to protect the culture, language, and identity of minority groups from the oppression of the unitary nation-state internally, and advocates the establishment of an external confederation beyond national borders to eliminate national conflicts and achieve universal peace. Full article

Background/Objectives: Neural compensation, in which healthy brain regions take over functions lost due to lesions, is a potential biomarker for functional recovery after stroke. However, previous neuroimaging studies often speculated on neural compensation simply based on greater measures in patients (compared to healthy controls) without demonstrating a more direct link between these measures and the functional recovery. Because taking over the function of a lesion region means taking on a similar role as that lesion region in its functional network, the present study attempted to explore neural compensation based on the similarity of functional connectivity (FC) patterns between a healthy regions and lesion regions. Methods: Seventeen stroke patients (13M4F, 63.2 ± 9.1 y.o.) underwent three resting-state functional MRI (rs-fMRI) sessions during rehabilitation. FC patterns of their lesion regions were derived by lesion network analysis; and these patterns were correlated with healthy FC patterns derived from each brain voxel of 51 healthy subjects (32M19F, 61.0 ± 14.3 y.o.) for the assessment of pattern similarity. Results: We identified five healthy regions showing decreasing FC similarity (29–54%, all corrected p < 0.05, effect size η²: 0.10–0.20) to the lesion network over time. These decreasing similarities were associated with increasing behavioral scores on activities of daily living (ADL, p < 0.001, η² = 0.90), suggesting greater neural compensation at early-stage post-stroke and reduced compensation toward the end of effective rehabilitation. Conclusions: Besides direct FC measures, the present results propose an alternative biomarker of neural compensation in functional recovery from stroke. For sensorimotor recoveries like ADL, this biomarker could be more sensitive than direct measures of lesion connectivity in the motor network. Full article

Background/Objectives: IBDs are chronic relapsing inflammatory intestinal disorders whose precise etiology is still only poorly defined: critical for their pathogenesis is the CCL20/CCR6 axis, whose modulation by small molecules may represent an innovative therapeutic approach. The aim of the present work is to test the potential efficacy of two molecules, MR120, a small selective CCR6 antagonist, active in TNBS- and chronic DSS-induced murine models of intestinal inflammation, and its derivative MR452, a well-tolerated agent endowed with improved anti-chemotactic in vitro properties, in the adoptive transfer colitis model. To the best of our knowledge, this is the first attempt to use adoptive transfer colitis to test modulators of the CCL20/CCR6 axis. Methods and Results: The induction of colitis in immunocompromised mice receiving CD4⁺CD25⁻ T cells i.p. resulted in a moderate inflammation and was met with limited protective responses following daily subcutaneous administration of MR120 or MR452 for 8 weeks. Both compounds significantly reduced colonic myeloperoxidase activity, and MR452 also lowered CCL20 levels in the gut, but they failed to prevent the increase in the Disease Activity Index, colon wall thickening, and macroscopic inflammation score. Conclusions: Our findings suggest that, despite the beneficial effects played by MR120 against subacute TNBS- and chronic DSS-induced colitis, the pharmacological targeting of the CCL20/CCR6 axis in the adoptive transfer model has a negligible effect in ameliorating the IBD-like phenotype driven by the altered intestinal immune homeostasis and by the disrupted function of immune-suppressive Treg cells. Full article

As the cathedral serving Zuoyun and parts of Inner Mongolia, the Batayizi Church in Datong, Shanxi is the largest surviving Italian Gothic-style Catholic church in the region. The church features a rigorous layout and refined details, making it a significant case study for the dissemination and development of Western architecture in China. Previous studies have focused on local chronicles, aesthetic analyses, and the indigenization of Catholic churches in Shanxi. Due to the scarcity of archival materials, research on the architecture itself has not yet been conducted. The article first summarizes the construction rules of local form and order of Italian Gothic churches based on related church remains and literature. Next, it establishes the architectural form of the church by combining construction rules and field surveys. Finally, the reconstruction design of the church is completed. As the first reconstruction study of the Batayizi Church, this paper attempts to explore a Reconstruction path based on the construction of local form and order of the church and systematically restores the main facade, floor plan, and structural form of the church. The results not only provide insights for the reconstruction of modern Catholic churches in Shanxi but also offer new ideas and methods for the study of the localization of Western architecture in China. Full article

Background: Endometriosis is a chronic disease defined by the presence of endometrial-like tissue outside the uterine cavity. While typically confined to the pelvis, extrapelvic manifestations—including thoracic endometriosis—can occur. Although rare, thoracic endometriosis is the most common extragenital form. In clinical practice, this presentation is often described as thoracic endometriosis syndrome (TES), a constellation of cyclic thoracic symptoms temporally associated with menstruation but not always histologically confirmed. Its atypical symptoms and limited clinical awareness frequently lead to delayed diagnosis, mismanagement and increased patient burden. Methods: In accordance with the CARE guidelines, we present a case report of a female patient with thoracic endometriosis syndrome, emphasizing the prolonged interval between symptom onset and final diagnosis. Case Report: We describe a 42-year-old woman with a longstanding history of dysmenorrhea and menorrhagia, who developed cyclical chest pain and dyspnea in 2019. Despite multiple thoracoscopic procedures, her symptoms persisted and were repeatedly misattributed to anxiety or infection. Thoracic endometriosis syndrome (TES) was suspected in 2022, and although histopathological confirmation was lacking, intraoperative visualization revealed diaphragmatic fenestrations. In 2025, a second laparoscopic intervention targeting the abdominal surface of the diaphragm resulted in significant symptom relief. The patient is currently continuing hormonal therapy with Dienogest and has reported a marked improvement in quality of life. Nevertheless, the protracted diagnostic and therapeutic process—marked by chronic pain and repeated hospitalizations—had a profound psychosocial impact, culminating in a suicide attempt. Conclusions: This case illustrates the substantial burden associated with the delayed recognition of thoracic endometriosis syndrome and the consequences of fragmented care. The patient’s experience underscores the urgent need for coordinated, multidisciplinary management and psychological support, particularly for patients with extrapelvic manifestations. Early multidisciplinary evaluation, with readiness to consider surgical intervention alongside individualized hormonal therapy, may support improved outcomes, provided they are reinforced by increased clinical awareness and systemic improvement in diagnostic pathways. Full article

Segmentary lineage theory fell out of favor in cultural anthropology during the 1980s. However, the core ideas of segmentary lineage have continued to shape political mobilization as well as political analysis in Africa long after the theory’s supposed death. This article analyzes how and why the framework of segmentary lineage has endured as a potent means of describing and experiencing politics in the Somali-inhabited Horn of Africa. It theorizes Somali clanship, a classic example of a “pure” segmentary lineage structure, as a framework for managing the near-term future rather than as an objective description of existing social structures. We show how segmentary lineage has been politicized during the colonial and postcolonial eras as a tool for pre-emptive action by governments. We link this broader dynamic of politicization to the functions of clanship in everyday life as a mode of anticipating other people’s likely behavior based on clan-framed narratives about the past. Based on archival research, ethnographic fieldwork, and analysis of media and social media, we argue that Somali clanship operates in politics less as a network of shared interests or mobilization based on anticipated collective gains, and more as a framework for anticipating and attempting to pre-empt other people’s likely behavior. Full article

This article argues that the asylum policy and legislative changes introduced by the UK government in the years 2022–2024 altered the original meaning of the concept ‘safe country’ as understood in international and EU law. The UK modified this concept, which from a solidarity concept became a means of exclusion, and which negatively affects the lives and rights of people seeking asylum in the UK. Using a doctrinal approach, the first part of this article sets the legal and historical context of the concept ‘safe country’. Departing from the analysis of the Refugee Convention, the article discusses how this mechanism was used by the EU legislation. From an idea of solidarity among EU Member States, it shifted from responsibility-sharing to burden-sharing while still allowing some guarantees to people seeking asylum. Using content analysis, the second part of this article evaluates the legal requirements set by the UK legislation together with implications of applying the ‘safe country’ concept to the asylum claims. It argues that, in recent years, the UK Government used the term ‘safe country’ as synonym of two (possibly three) different concepts, such as ‘first safe country’ and ‘safe third country’. It also shifted and pushed its meaning beyond the current commonly agreed interpretation of the term because it eroded the requirement of a link between the person seeking asylum and the ‘safe country’. Thus, the UK legislation deviated even further from the rationale underlying the Refugee Convention, international human rights standards and EU legislation because it passed the obligation to assess asylum claims to states with no link to people seeking asylum and without adequate risk assessment. The final part of this article discusses the limit to this policy and analyses the legal battle between the UK Parliament, the Government’s executive power, the UK Supreme Court and the Belfast High Court, which barred the UK Government from deporting people seeking asylum to a third country. This article concludes that there is some irony in the fact the term ‘safe country’ has been weaponised as a bordering tool by the UK Government, but ‘a border’ between the Republic of Ireland and Northern Ireland is limiting the negative effect of the concept ‘safe country’ on the very same people that is attempting to exclude from protection. Full article

Recently, visual odometry and SLAM (Simultaneous Localization and Mapping) have shown tremendous performance improvements compared to LiDAR and 3D sensor techniques. Unfortunately, attempts to achieve these improvements always face numerous challenges due to their complexity and insufficient compatibility for real-time environments. This paper presents an enhanced deep-learning-based SLAM system, primarily for Monocular Visual SLAM, by utilizing a Mini-GRU (gated recurrent unit). The proposed system, MINI-DROID-SLAM, demonstrates significant improvements and robustness through persistent iteration of the camera position. Similar to the original DROID SLAM, the system calculates pixel-wise depth mapping and enhances it using the BA (Bundle Adjustment) technique. The architecture introduced in this research reduces the time used and computation complexity compared to the original DROID-SLAM network. The introduced model is trained locally on a single GPU using monocular camera images from the TartanAir datasets. The training time and reconstruction metric, assessed using ATE (Absolute Trajectory Error), show robustness and high performance compared to the original DROID-SLAM. Full article

Herein we report the very first experiments which were conducted in an attempt to demonstrate the ability of low-field (LF), compact benchtop NMR spectrometers to provide spectral profiles of whole human biofluids, which took place in September–November 2014, and this paper represents a 10-year (decennial) anniversary of this work. LF ¹H NMR analysis was performed on ²H₂O-reconstituted lyophilizates of urine samples (pH 7.00) collected from untreated Niemann-Pick type C1 (NPC1) disease patients and their heterozygous carrier controls (n = 3 in each case). ¹H NMR spectra were acquired on a 60 MHz Oxford Instruments Pulsar compact benchtop spectrometer with spectral filter widths of 5000 Hz, using 1000–1600 scans, and relaxation delays of 15 or 30 s. Further, 400 MHz spectra were also obtained on these samples. Following parameter optimisation, the benchtop system generated reasonable quality urinary ¹H NMR profiles containing ca. 30 signals. Benchtop ¹H NMR analysis confirmed the abnormal urinary metabolic signature of NPC1 disease, and also revealed a gastric permeability disorder in one patient (detection of upregulated urinary sucrose, verified by 400 MHz NMR analysis). Early LF NMR experiments also demonstrated that glucose was trackable in control urine samples pre-spiked with this metabolite. This paper continues with further developments made on LF NMR-based metabolomics technologies, which are systematically discussed for related investigations conducted since 2014. In conclusion, such ‘first-time’ bioanalytical information regarding spectral quality served to pave the way forward for benchtop NMR-based metabolomics investigations of biofluids, which could provide invaluable disease-engendered ‘snapshots’ of disturbances to metabolic pathways and activities, along with those of any co-linked or unlinked comorbidities. Full article

Virtual environment simulations have gained great importance in the field of robotics by enabling the validation and optimization of control algorithms before their implementation on real platforms. However, the construction of accurate digital models is limited not only by the lack of detailed characterization of the components but also by the uncertainty introduced by the physics engine and the plugins used in the simulation. Unlike other works, which attempted to model each element of the robot in detail and rely on the physics engine to reproduce its behavior, this paper proposes a methodology based on model following. The proposed architecture forces the simulated robot to replicate the dynamics of the real robot without requiring exactly the same physical parameters. The experimental validation was carried out on two unmanned surface vehicle (USV) platforms with different dynamic parameters and, therefore, different responses to excitation signals, demonstrating that the proposed approach enables a drastic reduction in error. In particular, RMSE and MAE were reduced by more than 98%, with $R^2$ values close to 1.0, demonstrating an almost perfect correspondence between the real and simulated dynamics. Full article

Background: Biliary strictures are diagnosed using endoscopic retrograde cholangiopancreatography (ERCP) with brush cytology and biopsy. However, brush cytology shows a sensitivity of 9–56.1% and a diagnostic accuracy of 43–65.4%, while biopsy demonstrates a sensitivity of 48%. Both methods exhibit high specificity but limited sensitivity. While rapid on-site evaluation (ROSE) is effective in endoscopic ultrasound-guided fine needle aspiration (EUS-FNA), its application in ERCP-obtained samples remains underexplored. Methods: This prospective pilot study was conducted at Okayama University Hospital from April 2019 to July 2024. Patients requiring ERCP-guided sampling for bile duct strictures were included. ROSE was applied to brush cytology with up to three additional attempts and to imprint cytology from biopsy samples with up to two attempts. Diagnostic accuracy was assessed based on pathology and clinical course. Results: Among 37 patients (median age: 73 years, add range, and male–female ratio: 27:10), 18 had hilar and 19 had distal bile duct strictures. Brush cytology required one, two, or three attempts in twenty-six, six, and five cases, respectively, whereas biopsy required one or two attempts in thirty-five and two cases, respectively. Among the thirty-seven cases, thirty-five were malignant and two were benign. The B-ROSE group showed a sensitivity, specificity, and accuracy of 71.4%, 100.0%, and 73.0%, respectively, compared to lower accuracy in the conventional group, where single brush cytology attempts yielded a sensitivity of 48.6% and an accuracy of 48.6%, and single biopsy attempts showed a sensitivity of 68.6% and an accuracy of 70.3%. Conclusions: B-ROSE improves diagnostic accuracy, reduces repeat sampling, and minimizes patient burden in ERCP-based diagnosis of bile duct strictures, making it a valuable addition to current diagnostic protocols. Full article

The rise of generative AI in higher education has disrupted our traditional understandings of academic integrity, moving our focus from clear-cut infractions to evolving ethical judgment. In this study, a survey of 401 students from major U.S. universities provides insight into how beliefs, behaviors, and policy awareness intersect in shaping how students interact with AI-assisted writing. The findings indicate that students’ ethical beliefs—not institutional policies—are the strongest predictors of perceived misconduct and actual AI use in writing. Policy awareness was found to have no significant effect on ethical judgments or behavior. Instead, students who believe AI writing is cheating were found to be substantially less likely to view it as ethical or engage with it. These findings suggest that many students do not treat AI use in learning activities as an extension of conventional cheating (e.g., plagiarism), but rather as a distinct category of academic conduct/misconduct. Rather than using punitive models to attempt to punish students for using AI, this study suggests that education about AI ethics and the risk of AI overreliance may prove more successful for curbing unethical AI use in higher education. Full article