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Martuwarra the Fitzroy River, is a living entity encompassing law, values, ethics and virtues who has laid the foundation for learning and self-regulation. Martuwarra foster peace, harmony and balance within a water system covering 93,829 square kilometres of the Western Australian Kimberley region. However, climate uncertainty as part of the unfolding metacrisis demonstrates the limitations of decades of colonial invasive development in the Kimberley. In this paper the authors illustrate Traditional Owner water knowledge, science and lived experiences as managers of the catchment from the beginning of time. Traditional Owner knowledge and practices, fine-tuned over thousands of years, carry water governance and management through First Law, the law of the land and not man. The authors advocate for this ancient knowledge to be learned by fellow citizens in the region, governments, industries and other parts of Australia, as it is essential to modernity. They propose a bicultural and bioregional governance model to create a better future for the greater good of all.
Outbreaks of vancomycin-resistant Enterococcus faecium (VRE) are often difficult to contain. In this study, we developed and implemented a set of control measures, which resulted in a relatively limited outbreak in a secondary care hospital in Sweden.
Methods:
VRE screening was performed by rapid polymerase chain reaction (PCR) on fecal swabs, reported within 1–3 h. Vancomycin-resistant isolates PCR-positive for the vanA/vanB gene were further analyzed with whole-genome sequencing (WGS). Cleaning efficiency was evaluated directly after cleaning by using adenosine triphosphate (ATP) swabs, detecting organic live material. The hospital management appointed a task force consisting of experts in infectious diseases, microbiology, hospital hygiene, cleaning and representatives of the affected unit.
Results:
A total of 22 VRE-positive patients were identified, of which 12 isolates belonged to the same clone (ST 203) in a surgical ward. VRE screening by PCR shortened the turnaround time. The combination of rapid PCR and WGS could rule in or out cases from the outbreak within less than a week. The new cleaning routine indicated that 3 approved quality-controlled discharge cleanings were required to reduce VRE acquisition. The fast lane to decision-making on control measures resulted in rapid introduction of the above routines.
Conclusions:
With prompt infection control measures, the VRE outbreak was contained after 4 months. To prevent further outbreaks of VRE, active rapid screening, improved cleaning, and restriction of multiple-bed rooms are efficient measures to implement.
Having a child with a psychiatric diagnosis is associated with parents’ greater risk of subsequent mental disorders but no immediate change in their annual labour market metrics. This discrepancy could be explained by shorter absences from work. We examined first-time psychiatric sickness absences in parents whose children have psychiatric diagnoses.
Methods
Using several linked nationwide Finnish registers, in this cohort study we examined time to first psychiatric sickness absence in parents whose children were born in 2001–2012 (early-childhood-onset diagnoses) or 2005–2016 (late-childhood-onset diagnoses). Exposure was having a child with a psychiatric diagnosis. Follow-up started when the parent’s eldest turned 1 (early-childhood-onset diagnoses) or 5 (late-childhood-onset diagnoses) and ended at psychiatric sickness absence, emigration, 68th birthday, death, or 31 December 2020, whichever occurred first.
Results
The 2001–2012 and 2005–2016 cohorts included 357 135 and 397 874 parents followed for 3.31 and 3.70 million person-years. Having a diagnosed child was associated with greater risk of psychiatric sickness absence in all except men whose children had substance use or psychotic disorder diagnoses. Time-varying analyses showed the greatest associations for women (HR: 4.92; 95% CI: 3.97–6.10) and men (HR: 2.48; 95% CI: 1.61–3.80) within 6 months of a child’s eating disorder diagnosis.
Conclusions
Parents of children with psychiatric diagnoses may be at a greater risk of a psychiatric sickness absence. Associations differed by child’s diagnosis, parent’s gender and time since diagnosis.
We examined the growth of English-L2 clausal density (CD) in narrative language samples from 129 school-age Syrian refugee children during their first 5 years of residency in Canada. First, we found that CD showed unique developmental trajectories from MLUw, and relatively rapid acquisition, consistent with studies with non-refugee participants. Second, faster growth in CD was associated with superior cognitive abilities and higher maternal education. An older-age advantage was found at Time 1, but a younger-age advantage emerged across Time 2–3. Factors more specific to the refugee experience (time in refugee camps and wellbeing difficulties) also predicted variance in CD and MLUw development but to a lesser extent. Finally, modeling performance on sentence repetition tasks revealed stronger contributions of lexical diversity and MLUw than CD. We conclude that complex syntax is relatively resilient in the L2 acquisition of refugee children and that CD in naturalistic production and SRT capture different abilities.
The first international expositions appeal to the imagination and have an almost mythical status, but for most participating countries, they were just a form of good marketing. The prevailing idea in literature is that the expositions were platforms for nation-building undertaken by national governments. What is still lacking, however, is research into the intersection of urban, regional and national identities at these events, and the role of the city in this process. This article, which is part of the special issue Urban Tourism Promotion in Belgium and the Netherlands, addresses this gap by examining the presence of Belgian city pavilions at the expositions in Belgium between 1885 and 1958 through the lens of urban tourism promotion. By analysing the different groups involved in tourism promotion at these events, the article reveals that cities were not merely venues for large events, but also served as platforms for identity promotion through urban tourism promotion.
Although extensive research has been conducted on the impact of the COVID-19 pandemic on global mental health, a systematic synthesis of the cross-time dynamics of suicidal ideation (SI) remains lacking. This study aims to systematically synthesise the global aggregated prevalence of SI before and after the pandemic, investigate the potential association between pandemic exposure and the SI risk through meta-regression analysis of longitudinal studies, and explore key moderating factors.
Methods
A systematic search was conducted in Web of Science, PubMed, PsycINFO and ProQuest databases up to August 2025. Observational studies were included if they employed cross-sectional or longitudinal designs and reported the prevalence of SI before and after the pandemic across global regions.
Results
The analysis included 354 cross-sectional studies (N = 8,247,875) and 27 longitudinal studies. In cross-sectional studies, the pooled prevalence of SI was 13.20% [95% CI 12.06%–14.42%]. Pre-pandemic prevalence was 12.52% [95% CI 8.46%–18.14%], and post-pandemic prevalence was 13.24% [95% CI 12.07%–14.50%], with no significant difference. Meta-regression analysis identified three moderators. Specifically, larger sample sizes (n) were associated with lower prevalence (β = −0.232, P < 0.0001); higher study quality predicted lower prevalence (β = −0.278, P < 0.001); and studies on adults reported significantly lower prevalence than adolescents (β = −0.366, P < 0.05). Conversely, time progression during the pandemic, development level, geographical area, gender and measurement method did not show significant independent effects. Interaction analyses also found no significant moderating effect of economic development level or geographical area on the temporal trend of SI prevalence. Longitudinal analysis found no significant increase in prevalence from the pre-pandemic to the post-pandemic period (P = 0.101). However, a small but significant increase occurred between early and late stages within the pandemic (β = 0.265, P = 0.021). Subgroup analyses showed no significant moderation of these temporal changes.
Conclusions
The COVID-19 pandemic’s impact on SI was dynamic. While no significant prevalence change was found between pre- and post-pandemic periods, a significant increase occurred as the crisis progressed. This deteriorating trend was more pronounced in adolescents, identifying them as a key vulnerable group. Methodologically, findings were moderated by the measurement instrument, study quality and sample size, with evidence suggesting potential small-study effects. These findings underscore the need for robust mental health surveillance and targeted interventions for at-risk populations during prolonged public health crises.
The protocol was registered on PROSPERO (CRD42024603151).
Medical Royal Colleges publish obituaries to record and celebrate the lives of colleagues after their deaths. Who is included in this roll of honour, the preferred literary style, and the organisation of the commissioning and publishing all vary between colleges. Since obituaries have fashions, shaped by culture and practical considerations, it is worthwhile, from time to time, for institutions to review the approaches they take. This paper draws on practices past and present, including those of national newspapers and Royal Colleges, to stimulate further discussion on the subject.
This study assessed the impact and cost-effectiveness of pre-exposure prophylaxis (PrEP) in reducing HIV infections and HIV-related deaths among four key populations in China: men who have sex with men (MSM). Female sex workers (FSW), people who inject drugs (PWID), and HIV-negative partners of serodiscordant couples (SDC). Decision-analytic Markov models simulated HIV transmission and progression in cohorts of 100,000 adults over 40 years under three strategies: no PrEP, daily oral PrEP, and on-demand oral PrEP evaluated nationaly and high-incidence provinces. Cost-effectiveness was measured using a willingness-to-pay threshold of US$37,653 per QALY. Across all populations, on-demand PrEP was the most cost-effective strategy. Among MSM, it was cost-effective both nationwide (ICER: $4,554/QALY) and in high-incidence provinces (ICER: $1,045-2,129/QALY), reducing new infections by 24.7%. Daily PrEP was also const-effective for MSM nationally and prevented 19.9% of infections. For FSW, on-demand PrEP was cost-effective in high-incidence provinces (ICER: $25,399-37,045/QALY), reducing infections by 21.8%-22.5%. For PWID, it was cost-effective in high-incidence provinces (ICER: $10,361-29,560/QALY), reducing infections by 15.5%-17.9%. For HIV-negative partners of SDC, on-demand PrEP was cost-effective both nationally and in high-incidence provinces, reducing infections by 24.0%. Overall, on-demand PrEP offers substantial health and economic benefits, particularly for HIV-negative partners of SDC and high-incidence regions.
To assess levels of restrictive practice in approved centres in Ireland following the introduction of revised rules and codes of practice and the implementation by the Mental Health Commission (MHC)) as regulator of a near real-time reporting mechanism.
Methods:
We examined data reported to the MHC via its computerised system from 65 approved centres during a two-year period from 2024 to 2025.
Results:
The data indicate an accelerated decline in restrictive practice in approved centres in Ireland.
Discussion:
Restrictive practice (Restraint and Seclusion) has been declining in approved centres in Ireland. This progress accelerated following the implementation of revised, human rights-based Rules governing the use seclusion and a Code of Practice on the use of physical restraint which were developed by the MHC after consultation with stakeholders and came into effect on 1 January 2023. Many factors contributed to this progress including steps taken by the regulator and by approved centres to enhance this welcome trend.
With the rapid growth of scholarly literature, efficient artificial intelligence (AI)–aided abstract screening tools are becoming increasingly important. This study evaluated 10 different machine learning (ML) algorithms used in AI-aided screening tools for ordering abstracts according to their estimated relevance. We focused on assessing their performance in terms of the number of abstracts required to screen to achieve a sufficient detection rate of relevant articles. Our evaluation included articles screened with diverse inclusion and exclusion criteria. Crucially, we examined how characteristics of the screening data—such as the proportion of relevant articles, the overall frequency of abstracts, and the amount of training data—impacted algorithm effectiveness. Our findings provide valuable insights for researchers across disciplines, highlighting key factors to consider when selecting an ML algorithm and determining a stopping point for AI-aided screening. Specifically, we observed that the algorithm combining the logistic regression (LR) classifier with the sentence-bidirectional encoder representations from transformers (SBERT) feature extractor outperformed other algorithms, demonstrating both the highest efficiency and the lowest variability in performance. Nonetheless, the algorithm’s performance varied across experimental conditions. Building on these findings, we discuss the results and provide practical recommendations to assist users in the AI-aided screening process.
The global ex situ conservation system reflects the collective efforts of individual genebanks, each influenced by its unique history, opportunities for acquisition and user demands. As a result, acquisition activities in most genebanks have been opportunistic rather than strategic to support representation of national crop diversity or driven by clearly identified conservation priorities.
The objective of this study was to characterize the composition of national collections in 20 countries within the global ex situ conservation system. It assessed the representation of crop genetic diversity that originated nationally within the global system and evaluated the composition balance, as it relates to duplication and gaps in conservation. Across these 20 countries, numerous genebanks are conserving large number of accessions for only a few genera, while a much smaller number of genebanks are conserving fewer than 10 accessions from a broader range of genera. The findings indicate that ex situ conservation, both nationally and globally, has significant potential duplications and gaps in the genetic resource coverage.
Individual institutes in the global system must carefully reconsider the composition of their collections, especially given the significant costs and limited financial and human resources available for long-term ex situ conservation. As national genebanks and the global system become increasingly important resources for the future, it will be essential for genebanks to ensure that the composition of their collections meets future demands.
Hybrid stochastic differential equations (SDEs) are a useful tool for modeling continuously varying stochastic systems modulated by a random environment, which may depend on the system state itself. In this paper we establish the pathwise convergence of solutions to hybrid SDEs using space-grid discretizations. Though time-grid discretizations are a classical approach for simulation purposes, our space-grid discretization provides a link with multi-regime Markov-modulated Brownian motions. This connection allows us to explore aspects that have been largely unexplored in the hybrid SDE literature. Specifically, we exploit our convergence result to obtain efficient and computationally tractable approximations for first-passage probabilities and expected occupation times of the solutions to hybrid SDEs. Lastly, we illustrate the effectiveness of the resulting approximations through numerical examples.
Motivated by the astonishing capabilities of large language models (LLMs) in text-generation, reasoning, and simulation of complex human behaviors, in this paper, we propose a novel multi-component LLM-based framework, namely LLM4ACOE, that fully automates the collaborative ontology engineering (COE) process using role-playing simulation of LLM agents and retrieval augmented generation (RAG) technology. The proposed solution enhances the LLM-powered role-playing simulation with RAG ‘feeding’ the LLM with three different types of external knowledge. This knowledge corresponds to the knowledge required by each of the COE roles (agents), using a component-based framework, as follows: (a) domain-specific data-centric documents, (b) OWL documentation, and (c) ReAct guidelines. The aforementioned components are evaluated in combination, with the aim of investigating their impact on the quality of generated ontologies. The aim of this work is twofold, (a) to identify the capacity of LLM-based agents to generate acceptable (by human-experts) ontologies through agentic collaborative ontology engineering (ACOE) role-playing simulation, at specific levels of acceptance (accuracy, validity, and expressiveness of ontologies) without human intervention and (b) to investigate whether and/or to what extent the selected RAG components affect the quality of the generated ontologies. The evaluation of this novel approach is performed using ChatGPT-o in the domain of search and rescue (SAR) missions. To assess the generated ontologies, quantitative and qualitative measures are employed, focusing on coverage, expressiveness, structure, and human involvement.
Hong Kong’s history remains contested during its decolonisation. The colonial government of Hong Kong, the People’s Republic of China (PRC), and historians at the University of Hong Kong (HKU) all attempted to interpret the past in their own right. This article argues that the contest for epistemological territory between the Chinese and British colonial governments led to the fragmented accounts of Hong Kong history in official curricula. Unlike other cases, Hong Kong’s decolonisation did not result in independence. Instead, the United Kingdom transferred the colony’s sovereignty to the PRC in 1997. Both sides attempted to showcase their right and ability to shape the colony’s past. Instead of having an ultimate “winner,” both occupied a share of the epistemological territory regarding historical knowledge, producing fragmented accounts of the past. The article also recovers and examines the agency of locally trained historians. These people of Hong Kong did not have any chance to produce their own “autonomous history” precisely because of the impossibility of independence. This process resulted in the partially decolonised yet censored historical narratives that persist in Hong Kong under Chinese rule. Through this case, this article calls for further discussion of what ‘decolonisation’ meant for actors beyond the state.