bluuebunny/crossref_metadata_2025 huggingface dataset:
Political Culture and Cyclical Conflict in Ethiopia: Exploring the Generative Dynamics of Political Crisis in the 2020s
Authors: Abbink Jon
Published: October 2024

Ethiopia is frequently facing serious political–communal conflict. Prevailing narratives attempting to identify causes often focus on presumed ‘ethnic’ groups and inequalities – a perspective crystallized especially in the past ca. 30 years. While Ethiopia as a socio-political domain existed for ages before the Emperor Menilik period (1889–1913) of incorporation of adjacent territories, the question emerges whether the ‘roots’ of recent armed conflicts are as much contemporary-political as historical, and related to an established political culture, based on resilient authoritarian values among both elites and the wider population. Ethiopia’s current unresolved conflict dynamics need a renewed analysis of not only history and ‘political economy’ but also of recent constitutional features and group politics, which strongly impacted on its political culture. On the basis of document study and interviews, I examine crucial features of such recent processes so as to re-evaluate the specific articulations of ethno-regionally based governance in Ethiopia in recent years to find causal elements fuelling the repetitive cycles of conflict.
Folk Wisdom and Traditional Knowledge: A Study of Mother and Child Healthcare Practices of Maram Nagas in India
Authors: Huidina Judith , Yamsani Srikanth
Published: October 2024

Indigenous knowledge and healthcare practices are deeply embedded in the cultural fabric of tribal communities, influencing every aspect of life and ensuring the well-being of individuals. This paper delves into the Indigenous knowledge systems of the Maram Naga community in Manipur, India, mainly focusing on practices related to mother and child healthcare. The study is based on qualitative data gathered from 225 households across 12 Maram Naga villages through in-depth personal interviews and focus group discussions. It explains the beliefs, rituals, and other traditional cultural practices integral to the Maram Nagas in promoting the health and wellness of the mother and child in pre-natal and post-natal care.
Exploring delamination behavior in carbon nanofiber-reinforced sandwich structures with various corrugated cores: An experimental study on mixed-mode crack growth
Authors: Vahidi Bidhendi Mohammad , Rahimi Gholam Hosein , Zangoei Amir Reza , Azarniya Omid
Published: October 2024

In this paper, the delamination behavior between the face sheet and core of sandwich panels under a mixed mode of failure during TPSB (Three-Point Sandwich Beam) testing is investigated. The experiments were conducted on two sets of specimens: one reinforced with 0.25% carbon nanofiber weight and the other consisting of samples without carbon nanofibers. The core of the sandwich structures was made of PVC foam, and the corrugated cores and face sheets were made of glass-epoxy fibers. The investigated specimens had corrugated cores with different geometries, such as trapezoidal, square, and triangular. The Force-Displacement and R-CURVE diagrams of sandwich panels reinforced with and without carbon nanofibers were extracted. The strain energy release rate increased with increasing crack length, and this trend in the mixed mode of failure was generally upward. The strain energy release rate in the sandwich panel reinforced with carbon nanofibers with trapezoidal, square, and triangular corrugated cores increased by 20.7%, 39.8%, and 44.6%, respectively. These findings underscore the potential of carbon nanofiber-reinforced sandwich structures for diverse applications requiring enhanced fracture resistance under varying loading conditions. These structures have many applications in wind turbine blades and aerospace industry.
Why Onset Matters: Warfare, Intensity, and Duration in Civil War
Authors: Siberdt Benoit
Published: October 2024

Are civil wars shaped by how they start? While existing literature points to the path-dependent nature of conflict, the link between the type of onset and wartime dynamics have been largely overlooked. Building on a recent typology capturing the dynamics of civil war onset (1944–2020), I analyze conflict trajectories, focusing on three macro-level wartime dynamics: warfare, intensity, and duration. This article shows that how large-scale armed conflicts begin (e.g., whether they start as peripheral conflicts or are fought centrally) helps us predict how intensely they will be fought or how long they will last. These findings show that onset matters beyond signaling the start of large-scale conflict and tells us about the dynamics that will likely follow. Altogether, this article establishes a new process-oriented macro-level research program in the field of conflict analysis.
Macroeconomic Sovereignty in the European Economic and Monetary Union: A Republican Approach
Authors: Merlo Stefano
Published: October 2024

The Economic and Monetary Union has fundamentally changed how fiscal and monetary powers are exercised over democratic publics which raise the question of whether a normative vision of macroeconomic sovereignty is compatible with membership within the Eurozone. After conceptualising sovereignty in republican terms as the balance between four ‘power-countering strategies’, this article conducts a normative analysis of the evolution of Economic and Monetary Union governance. This exercise shows how – by neglecting one of the four republican strategies, namely to increase citizens’ democratic participation at the European Union level – successive institutional innovations as well as recent proposals fail to make the exercise of public powers compatible with citizens’ status equality. In contrast, the argument suggests that if citizens’ influence is channelled through a ‘system of dual partisanship’, in which national and European parliamentarians coordinate their activities, national and Economic and Monetary Union’ executives’ discretion can be democratically controlled.
What Is the Role of Imagined Futures in the Development of E-Cigarette Use among Young People?
Authors: Hughes Jason , Hughes Kahryn , Sykes Grace , O’Reilly Michelle , Sutton Charlie , Goodwin John , Karim Khalid
Published: October 2024

Public health ‘gateway’ narratives concerning young people’s e-cigarette use warn against a future generation beset by escalating addiction and a possible epidemic of tobacco- and vaping-related illnesses. We argue that such imaginaries of vaping futures are in fact based in smoking pasts, which, while likely not ‘real’ in the sense of predicting the development of youth vaping, have real consequences through influencing the conditions of young people’s e-cigarette use. Drawing on a study of 14–18-year-old vapers, we consider how the future imaginaries of gateway thinking – characterised by escalating dependence – both oppose and intersect with a cultural stock of neo-liberal future imaginaries – marked by progressive independence and self-determination. We show how both sets of imaginaries are negotiated and entangled within the logics and practices of young vapers’ ‘futures-in-process’ to advance debates in the sociology of futures and offer a radical rethinking of substance use by youth.
Improving Infant Mental Health: A Pilot Study on the Effectiveness, Acceptability and Feasibility of Eye Movement Desensitization and Reprocessing (EMDR) Storytelling in Infants With Post-traumatic Distress After Medical Procedures
Authors: Potharst Eva S. , Holtkamp Petra , Walliser Lily , Dommerholt Agnes H. , van den Heuvel Maartje E. N. , Spierts Indra , Maric Marija
Published: October 2024

Although the prevalence of symptoms of post-traumatic stress disorder (PTSD) in infants and young children is similar as in older age groups, and PTSD intervention is as important in this age group, research on PTSD-treatment in infants is very scarce. Eye Movement Desensitization and Reprocessing (EMDR) Storytelling is a trauma-focused treatment that is being used by clinicians for infants with PTSD-symptoms. The aim was to assess the feasibility, acceptability and initial indications of effectiveness of EMDR Storytelling for infants aged 3–24 months with PTSD-symptoms after medical procedures. We included 6 infants and administered personalized items to assess PTSD-symptoms during the baseline, intervention and follow-up phase on a day-to-day basis. Furthermore, we measured PTSD-classification and symptoms at three and four measurement points, respectively. The data was analysed visually and quantitatively. EMDR Storytelling was shown to be feasible and acceptable for all participating families. Parent- and therapist-report showed that four out of the six infants included in the current study showed a clear reduction over time in PTSD-classification, -symptoms, and daily measured PTSD-symptoms. The results concerning the other two infants were mixed. Attention should be paid to cognitive (language) as well as interactional (infant-parent) mechanisms potentially underlying the benefits of EMDR Storytelling.
Effect of hot deformation parameters on microstructure evolution mechanism and workability in a wear-resistance steel of machinery equipment
Authors: Jiang Jixun , Qin Fangcheng , Zhang Lianming , Zhao Hongli , Kang Yuehua
Published: October 2024

Hot compression experiments were conducted to study the flow behavior and hot workability of NM400 wear-resistance steel. A new Zener-Hollomon parameter ( Z) model is developed for coupling strain into the conventional Z model. The NM400 exhibits excellent resistance to instability owing to its low sensitivity to unsafe regions. Conversely, the peak efficiency of the power dissipation (EPD) region expands to the direction of low temperature with increasing of strain. The dynamic recrystallization (DRX) is facilitated at elevated temperatures and lower strain rates. DRX becomes the dominant softening mechanism with the increasing of temperature. Finally, 1050–1175 °C and 0.11–1.82 s−1 are recommended to be the optimal window. The optimal ln Z values for different strains are provided by the new Z model.
Effect of carbon on microstructure and mechanical properties of TiZrNb0.5V0.5 lightweight refractory high entropy alloy
Authors: Hu Zhongjie , Zhuang Changling , Qin Gang
Published: October 2024

The single-phase body-centered cubic TiZrNb0.5V0.5 lightweight refractory high entropy alloy exhibits good plasticity but poor strength. Therefore, C is added to this alloy to enhance its strength and improve its mechanical properties in this paper. The influence of varying C content on the microstructure, phase composition, and mechanical behavior of TiZrNb0.5V0.5C x RHEAs is investigated in detail. The results indicate that C addition leads to the dissolution of alloying dendrites and induces the formation of the FCC – MC carbides phase. The carbide volume fraction increases in proportion to the carbon content, thereby enhancing the alloy's yield strength and hardness. The yield strength increases by 36%, while the hardness increases by 39%. The physical parameters of the alloy are analyzed, which reveals that the introduction of C increases the alloy's electronegativity and atomic radius difference, thus promoting the formation of carbides.
Corrosion behaviour of nitroxy-QPQ additively manufactured 17-4 PH steel on marine and nuclear reactor components
Authors: Michla J R Jessy , Rajkumar C R
Published: October 2024

The study investigates the corrosion behavior of untreated and nitroxy QPQ treated 17-4 PH stainless steel under NaCl environments. Potentiodynamic polarization tests reveal that the nitroxy layer forms an oxide coating, leading to a passivation phase with gradually increasing current density. Oxidation at different temperatures shows variation in corrosion potential, with the lowest current density observed at 450 °C, indicating enhanced corrosion resistance. SEM images of untreated steel show severe crevice and pitting corrosion, whereas nitroxy QPQ treated surfaces exhibit reduced corrosion, with minimal disturbance at 450 °C. Elemental analysis confirms the formation of oxides and nitrides, with increased oxygen content in oxide layers and decreased nitrogen content due to the formation of chromium nitrides. The oxide layer, enriched with oxygen, nitrogen, and chromium, acts as a passive film, protecting against corrosion even in NaCl environments. Elemental mapping further illustrates the correlation between oxidation temperature and corrosion resistance, with higher temperatures resulting in reduced corrosion rates. The combined nitriding and oxidation process enhances corrosion resistance by forming a dense and adherent oxide layer, serving as a barrier against corrosive agents.
Cultural Engagement and Subjective Well-Being in the Cluj Metropolitan Area: An Exploration in Cultural Commoning and Collaborative Development
Authors: Petrovici Norbert , Pop Cristian , Zbranca Rarița
Published: October 2024

We explore cultural participation's impact on subjective well-being in Cluj Metropolitan Area. Using telephone surveys, we identify a positive correlation between cultural engagement and increased well-being, mediated by cultural appraisal. Three primary participation types—active, receptive, and entertainment-related—are identified. Active and entertainment-related activities indirectly enhance well-being through cultural appraisal, while receptive participation shows no significant direct or indirect effect. Controlling socio-economic factors, the mediation analysis underscores cultural practices’ significant impact on well-being. These findings support the “cultural commoning” hypothesis, indicating collective urban cultural engagement fosters shared values and improves subjective well-being.
The Critical Shoulder Angle as a Highly Specific Predictor of a Full-Thickness Rotator Cuff Tear: A Case-Control Study
Authors: Gerlach Erik , Nicolay Richard W. , Nayak Rusheel , Williams Carly L. , Johnson Daniel J. , Plantz Mark , Marra Guido
Published: October 2024

Background:

The critical shoulder angle (CSA) has become an important topic of study in patients with rotator cuff tears (RCTs). However, there are conflicting data on whether the CSA can differentiate between patients with normal shoulder pathology and full-thickness RCTs on shoulder radiographs.

Purpose/Hypothesis:

The purpose of this study was to define the relationship between full-thickness RCTs and the CSA. It was hypothesized that patients with full-thickness RCTs would have an increased CSA compared with matched controls.

Study Design:

Cross-sectional study; Level of evidence, 3.

Methods:

This retrospective case-control study identified patients with magnetic resonance imaging scans showing full-thickness RCTs between 2009 and 2019. A 1 to 1 propensity score match was performed to identify a control group with normal rotator cuffs while controlling for baseline participant characteristics—including age, sex, body mass index, and tobacco use. A total cohort of 532 was identified, with 266 cases and 266 controls. Two independent observers measured CSAs on true anteroposterior shoulder radiographs.

Results:

There was no difference in baseline participant characteristics between the RCT and the non-RCT groups ( P > .05). The mean CSA for the entire cohort was 33.6°± 4.2°. The CSA did not significantly vary by sex ( P = .088) or tobacco usage ( P = .16). The mean CSA for the RCT case group, 36.2°± 3.3°, was significantly different from the mean CSA for the control group, 30.9°± 3.3° ( P < .0001). The receiver operating characteristic curve analysis produced an area under the curve of 0.88 ( P < .0001). At CSAs ≥35°, there was a 67.7% sensitivity and 89.4% specificity for having a full-thickness RCT. Last, each degree of increase in the CSA increased the risk of having an associated RCT by 1.7 times (OR, 1.7 [95% CI, 1.551-1.852]; P < .0001).

Conclusion:

Patients with RCTs had significantly higher CSAs compared with matched controls. Increased CSA was an independent risk factor for RCTs, with an odds ratio of 1.7 per degree. The CSA is an accurate test (area under the curve, 0.88) with good sensitivity (67.7%) and specificity (89.4%) at values ≥35°. The CSA is a simple, reproducible measurement that can assist in clinical decision-making regarding full-thickness RCTs.
The hidden abode of artificial intelligence production: Stretching the limits of artificial intelligence ethics and critique
Authors: Paci Bernardo
Published: October 2024

The present article aims to discuss the possibility of including the sphere of artificial intelligence production within the domain of artificial intelligence ethics and investigate its moral implications. In the first section, the role of human labour in the artificial intelligence production processes is considered, with particular reference to the distinction between high-skilled and low-skilled jobs, their differential distribution in the production process itself, and the labour conditions of ghost workers, in order to analyse the main ethical issues emerging within the field. In the second section, some aspects of the existing critical literature concerning artificial intelligence and labour are discussed, focusing on Marxist and decolonial scholarship and more precisely on its lack of consideration of the global value chain through which artificial intelligence AI production processes are structured. Finally, the possibility and limits of an ethics of artificial intelligence production are reconsidered by assuming the centrality of workers’ struggles and agency along artificial intelligence's global value chain.
Integration as innovation in healthcare systems
Authors: Petrie David A.
Published: October 2024

Healthcare systems in Canada are under pressure and require change—the status quo is no longer fit for purpose, if it ever was. Innovation is often held up as a cure for what ails us, but shiny new things or novel technologies alone have not been enough. This article will explore the concepts of differentiation and integration as being important drivers in the evolution of living organisms, ecosystems, and complex human organizations. The implications of this deep pattern of systems change are essential to understanding the roles of specialization in medicine, and optionality in primary care. Specifically, overspecialization without attention to the principles of healthcare integration can lead to fragmentation of care and worse patient outcomes. Finally, this article will describe some practical examples of system integration as innovation in the form of better public health and care delivery connections, health homes, and community care coordination centres.
Microstructure and properties of TiC ceramic powder on a cobalt-based alloy obtained via electromagnetic-assisted laser metal deposition
Authors: Qi Kang , Li Kun , Jiang Yiyang , Jiang Long
Published: October 2024

The crack sensitivity of laser metal ceramic deposition is an important factor restricting its development. In this paper, a TiC-reinforced cobalt-based alloy was deposited on 300M steel using electromagnetic-assisted laser metal deposition technology. The electromagnetic composite effect on the microstructure, mechanical properties, magnetic properties, wear resistance and crack sensitivity of the laser metal deposition layer was discussed. Under the action of an electromagnetic field, the size of the TiC decreased by 54.6% compared with that of the deposited layer without an electromagnetic field. The effect of the electromagnetic composite field can reach the bottom of the molten pool, thus refining the grain size at the bottom of the coating. This resulted in a 22% increase in the hardness of the deposition layer. The electromagnetic field effect reduces the elastic modulus of the deposition layer, thus improving the mechanical properties of the coatings. In addition, compared with that of the deposition layer without an external field, the wear of the deposition layer with an electromagnetic force is obviously reduced. With increasing electromagnetic parameters, the wear resistance of the deposit increased gradually, and the thermal expansion coefficient decreased significantly, which played an important role in improving the crack resistance and comprehensive properties of the deposition layer under extreme working conditions.
Optimal shift control for new dual-clutch full-powershift transmission of heavy-duty tractor based on genetic algorithm–particle swarm optimization
Authors: Wang Jian , Ma Wenhu
Published: October 2024

The calculation of a linear quadratic regulator (LQR) control weighting matrix determines whether it can achieve optimal control. In order to solve the problem of complex calculation and low efficiency of this matrix, this paper proposed genetic algorithm–particle swarm optimizatio algorithm (GAPSO) combining genetic algorithm and particle swarm algorithm to solve the weighting matrix of LQR clutch oil pressure control strategy, so as to control the design efficiency and precision of the strategy. Subsequently, the shifting quality of a tractor was improved. A dynamic model of the shifting process was established using a comprehensive indicator that combined jerk and sliding friction work as a quadratic function. An LQR-weighted matrix calculated using GAPSO enabled optimal control strategy designing for clutch hydraulic pressure. Furthermore, the shift process from the 11th to 12th gear was analyzed via simulations during plowing operations. The simulation results show that the genetic operation of crossover and variation is introduced into PSO, and the optimization ability of PSO is improved effectively. Compared with the clutch oil pressure control strategy calculated by GAPSO with LQR weighted matrix and LQR clutch oil pressure control strategy calculated by PSO with LQR weighted matrix, the clutch heat load is slightly increased, the smoothness of shifting is greatly improved, and the shifting quality of tractors is improved. Overall, this study provides valuable insights for designing and computationally analyzing optimal clutch LQR control.
Human poisoning with glyphosate-surfactant herbicides: Retrospective analysis of mortality outcomes of patients treated in a poison center
Authors: Liu Kuan-Hung , Chang Shu-Sen , Tu Chao-Ying , Chen Hsien-Yi , Lee Wen-Chin , Tsai Kai-Fan , Kuo Po-Yen , Yen Ju-Ching , Wang I-Kuan , Yen Tzung-Hai
Published: October 2024

Introduction

The toxicity and carcinogenicity of glyphosate have long been debated. Nevertheless, the mortality rate in patients with acute glyphosate-surfactant poisoning varies across different groups.

Methods

Between 2002 and 2020, 109 patients with glyphosate-surfactant poisoning received treatment at Chang Gung Memorial Hospital. Patients were stratified into two subgroups according to their prognosis: good ( n = 74) or poor ( n = 35). Baseline demographics, psychiatric comorbidities, medical complications, and laboratory data were collected, and mortality data were analyzed.

Results

The patients were 54.1 ± 17.5 years of age and were mostly male (68.8%). Most patients (91.7%) ingested pesticides intentionally, and patients arrived at the hospital within 7.1 ± 12.7 h. Psychiatric comorbidities were prevalent, and the top three comorbidities were mental (71.6%), depressive (48.6%), and adjustment (14.7%) disorder. Patients with poor prognoses were older than those with good prognoses ( p = .007). Moreover, patients with poor prognoses had lower Glasgow Coma Scale scores ( p < .001) and diastolic blood pressure ( p = .008), but higher incidences of upper gastrointestinal bleeding ( p < .001), aspiration pneumonia ( p < .001), hypotension ( p < .001), hyperglycemia ( p = .002), acute kidney injury ( p < .001), and metabolic acidosis ( p < .001) than patients with good prognoses. The mortality rate was 5.5%. A multivariate-logistic-regression model revealed that the Glasgow Coma Scale score was a significant risk factor for poor prognosis (odds ratio 0.653, confidence interval 0.427–0.998; p = .049). However, no risk factors for mortality were identified.

Conclusions

A total of 32.1% of patients with glyphosate-surfactant poisoning had poor prognoses, and 5.5% of patients died despite treatment. The mortality outcome is comparable to that of published reports from other international poison centers.
Applying survey weights to ordinal regression models for improved inference in outcome-dependent samples with ordinal outcomes
Authors: Mitani Aya A , Espin-Garcia Osvaldo , Fernández Daniel , Landsman Victoria
Published: October 2024

Researchers often use outcome-dependent sampling to study the exposure-outcome association. The case-control study is a widely used example of outcome-dependent sampling when the outcome is binary. When the outcome is ordinal, standard ordinal regression models generally produce biased coefficients when the sampling fractions depend on the values of the outcome variable. To address this problem, we studied the performance of survey-weighted ordinal regression models with weights inversely proportional to the sampling fractions. Through an extensive simulation study, we compared the performance of four ordinal regression models (SM: stereotype model; AC: adjacent-category logit model; CR: continuation-ratio logit model; and CM: cumulative logit model), with and without sampling weights under outcome-dependent sampling. We observed that when using weights, all four models produced estimates with negligible bias of all regression coefficients. Without weights, only stereotype model and adjacent-category logit model produced estimates with negligible to low bias for all coefficients except for the intercepts in all scenarios. In one scenario, the unweighted continuation-ratio logit model also produced estimates with low bias. The weighted stereotype model and adjacent-category logit model also produced estimates with lower relative root mean square errors compared to the unweighted models in most scenarios. In some of the scenarios with unevenly distributed categories, the weighted continuation-ratio logit model and cumulative logit model produced estimates with lower relative root mean square errors compared to the respective unweighted models. We used a study of knee osteoarthritis as an example.
Becoming Yoga Bodies of Instagram: Women’s Agency, Platform Negotiations and Everyday Activism
Authors: Dixit Shamika
Published: October 2024

Women’s yoga bodies have been overutilised in mainstream media through their stereotypical representation aligned with the market forces. Previous studies have shown the domination of similar visuals in yoga spaces on Instagram, following the algorithmic platform structures. Avoiding the dichotomy of subject–object bodies, this article brings out women participants’ living experiences of becoming yoga bodies on Instagram and their practices countering the dominant visual culture related to yoga bodies. The article argues that women use ‘everyday activism’ on Instagram to formulate their yoga body experiences. These findings are based on in-depth interviews with 17 women yoga practitioners active on Instagram. The analysis reveals the emergence of three main themes contributing to the ‘becoming of yoga bodies on Instagram’, namely (a) reclaiming the space through increased visibility, (b) training gazes towards women’s yoga bodies and (c) breaking the yoga body stereotype.
Agriculture, Livelihood and Vulnerability: A Case Study of the Char Dwellers in Bankura District, West Bengal
Authors: Ghatak Raima , Kipgen Ngamjahao
Published: October 2024

This paper examines the livelihood vulnerabilities and coping strategies of char dwellers through a field study conducted in Mana Char. The analysis of their responses underscores the complexities of perceived agrarian threats and vulnerabilities of the Char inhabitants. It also suggests the need for re-examining the narrative of environmental risk and vulnerability within which chars are usually viewed. This study emphasises the component of subjectivity in perceiving agrarian threats. In doing so, it puts across the subtle differences in conceptualising agrarian threats in a char ecology and argues for ruling out the possibility of any generalisation regarding the environment of char and the operability of social life in it.
Second Wave Positive Psychology in the Prevention and Reduction of Parental Burnout: The CARE Intervention
Authors: Urbanowicz Agata M. , Shankland Rebecca , Rance Jaynie , Bennett Paul , Gauchet Aurélie
Published: October 2024

Positive psychology interventions aim to enhance individuals’ resilience, mental health, and well-being. This study ( N = 34) aimed to assess whether the CARE (Coherence, Attention, Relationship, Engagement) intervention tailored to enhance parental strengths and resources may contribute to the prevention and reduction of parental burnout. We tested the hypothesis that, compared to a waiting-list control group, parents attending the intervention would present lower scores of parental burnout postintervention (T2). The results of the study showed that compared to the control group the CARE program contributed to the significant reduction of parental burnout within the intervention group, with a large effect size ( F(1, 32) = 7.74 , p = .01, η2p = 0.20). Within the CARE group, the severity of parental burnout significantly decreased ( t(32)  = 3.87, Mdiff = 16.71, SEdiff = 4.32, p = .01), whereas there was no statistically significant difference in parental burnout symptoms between T1 and T2 among the participants from the control group ( t(32)  = −0.07, Mdiff = −0.29, SEdiff = 4.32, p = 1.00). In conclusion, the findings of the present study suggest that the CARE intervention may significantly contribute to the reduction of parental burnout.
‘We’ve Done Our Bit’: Post-COVID Experiences of Precarious Privilege Among Western International School Teachers in Shanghai
Authors: Poole Adam , Nehring Daniel
Published: October 2024

In this article, we consider how the COVID-19 pandemic has affected migration experiences and decisions among transnationally mobile Western international school teachers in China. International school teachers are among the most numerous groups of Western ‘expats’ in the country, arriving from the beginning of China’s ‘Reform period’. Drawing on exploratory interviews with international school teachers, we examine experiences of precarious privilege against the backdrop of COVID-19 lockdowns. We analyse our participants’ decisions about onward migration or permanence in China. In spite of evidence showing erosion of privilege during the pandemic, international school teachers remain largely insulated from its impact due to the privileged nature of their employment. Of greater significance was the impact of the Shanghai lockdown on the participants’ mobility and emotions, which proved the catalyst for two of the three participants to return to the UK.
I trust (you) therefore I am! From trust to post-trust: Transforming social paradigms
Authors: Seyfert Robert
Published: October 2024

This paper challenges the conventional belief that trust is an essential component of social cohesion, for example, in the context of climate change denial and post-truth politics. It argues that simply increasing trust or distrust does not address the underlying issues of contemporary societal challenges. This is because these efforts presuppose a ‘trusting subject’ at the heart of the problem. The paper examines the process of subjectification, exploring forms of modern subjectification and how they relate to trust, and how individuals become trusting subjects in relation to and within certain social frameworks. Introducing a new typology, it categorises trust into subjectifying, counter-subjectifying and post-subjectifying forms, revealing how trust both influences and is influenced by social dynamics and power structures. The conclusion advocates a ‘post-trust’ approach, urging a reimagining of relationships with nature and others. This approach emphasises the interconnectedness of human and non-human actors and calls for new forms of relationality and sensitivity to address global challenges effectively.
The democratic public and the practices of the oppressed
Authors: Herzog Lisa , Serrano-Zamora Just
Published: October 2024

Democratic theory, especially deliberative democracy, centrally focuses on verbal communication. In contrast, social movements, especially those fighting against oppression, often use practices such as dance, theatre, or other practical activities. In recent years, theorists have also turned to practices beyond words, for example, artistic expressions and the contributions they can make to democratic life. We expand this line of argument by exploring experimental and transformative practices and their connection to the democratic imperative to overcome oppression. Drawing on practical examples and on the literature on the epistemology and pedagogy of the oppressed, we explore the mechanisms through which experimental and transformative practices can help citizens to improve their epistemic position and to develop their political agency. We argue that even though such practices can also be used by non-democratic forces, democratic societies need to create space for, and take seriously, the contributions that such practices make to democratic life.
Abemaciclib combined with endocrine therapy as adjuvant treatment for hormone-receptor-positive, HER2−, high-risk early breast cancer: 5-year Chinese population analysis of the phase III randomized monarchE study
Authors: Zhang Qingyuan , Shen Kunwei , Song Chuan-gui , Ouyang Quchang , Liu Zhenzhen , Liu Qiang , Feng Jifeng , Chiu Joanne W. Y. , Tang Jinhai , Jiang Zefei , Tseng Ling-Ming , Wang Xiaojia , Yang Liu , Qian Chenxi , Shao Zhimin
Published: October 2024

Background:

Abemaciclib was the first cyclin-dependent kinase 4/6 (CDK4/6) inhibitor approved globally in the adjuvant setting for high-risk hormone-receptor positive (HR+)/human epidermal growth factor 2 negative (HER2−) early breast cancer (EBC), based on the phase III monarchE trial.

Objective:

To report an exploratory Chinese population analysis based on the preplanned overall survival (OS) interim analysis with 5-year efficacy results of monarchE.

Design and methods:

Patients with HR+/HER2−, high-risk (⩾4 positive lymph nodes, or 1–3 nodes and either tumor size ⩾5 cm, histologic grade 3, or Ki-67 ⩾20%) EBC were randomized (1:1) to abemaciclib (150 mg twice daily for 2 years) plus endocrine therapy (ET), or ET alone. This analysis included Chinese patients enrolled in mainland China, Hong Kong, and Taiwan. The primary endpoint was invasive disease-free survival (IDFS); key secondary endpoints included distant relapse-free survival (DRFS), safety, and patient-reported outcomes (PROs).

Results:

Overall, 501 Chinese patients were included (abemaciclib + ET, n = 259; ET, n = 242). With a median follow-up of 53 months, the addition of abemaciclib to ET resulted in improvements in IDFS (estimated 5-year IDFS rate: 85.9% vs 79.1%; hazard ratio (HR), 0.65 (95% confidence interval (CI) 0.41–1.03)) and DRFS (estimated 5-year DRFS rate: 88.4% vs 82.3%; HR, 0.65 (95% CI, 0.39–1.07)). The most common grade ⩾3 treatment-emergent adverse events in the abemaciclib + ET versus ET groups were neutropenia (24.7% vs 0.8%) and leukopenia (22.4% vs 0.4%). Generally, no clinically meaningful difference in PROs (endocrine symptoms and fatigue) was observed between groups, except for diarrhea.

Conclusion:

At this prespecified OS interim analysis, which provides 5-year data, the addition of abemaciclib to ET in Chinese patients with high-risk HR+, HER2− EBC was associated with sustained and clinically meaningful improvements in IDFS and DRFS, with acceptable safety and tolerability profiles and minimal impact on PROs. These results represent the first full report of a CDK4/6 inhibitor in Chinese patients with EBC and support the positive benefit–risk profile of adjuvant abemaciclib + ET in Chinese patients.

Trial registration:

ClinicalTrials.gov identifier: NCT03155997 (first posted: May 16, 2017).
Probation counseling for substance use disorders in Romania: An analysis of challenges and opportunities
Authors: Ilie Cristina , Șerban Ionuț-Virgil , Dan Adrian-Nicolae
Published: October 2024

The article aims to analyze the intervention techniques used in probation services when working with convicted persons with substance use disorders, and it is structured in two directions. The first direction includes the theoretical analysis of the concept of “substance use disorders” and the specific interventions used in the probation system. The second part of the paper highlights the results of a sociological survey based on a questionnaire administered to probation counselors in Romania. This survey highlights the strengths and weaknesses of intervention with people suffering from substance use disorders and provides a set of recommendations for counselors to apply in their work with this category of beneficiaries.
Immersive Technologies in Healthcare: An In-Depth Exploration of Virtual Reality and Augmented Reality in Enhancing Patient Care, Medical Education, and Training Paradigms
Authors: Iqbal Arham I. , Aamir Ali , Hammad Abdullah , Hafsa Hafiza , Basit Abdul , Oduoye Malik Olatunde , Anis Muhammad Wajeeh , Ahmed Shaheer , Younus Mohammad Ijlal , Jabeen Sarwat
Published: October 2024

Background:

Virtual reality (VR) and augmented reality (AR) are rapidly gaining traction in healthcare, offering transformative opportunities for patient care, medical education, and therapeutic interventions. Despite their potential, challenges remain regarding the implementation and integration of these technologies into existing healthcare practices.

Objective:

This review aims to explore the current applications of VR and AR in healthcare, particularly focusing on their roles in enhancing patient care and medical training, as well as identifying research gaps that hinder their widespread adoption.

Methods:

A comprehensive literature search was conducted across 2 primary databases, PubMed, and Google Scholar. The search was restricted to peer-reviewed articles, systematic reviews, meta-analyses, and randomized controlled trials (RCTs) published from 2000 to 2024. Reference lists of included articles were also examined for additional relevant studies. Inclusion criteria focused on empirical studies addressing the use of VR and/or AR in patient care or medical training, while editorial pieces, non-peer-reviewed sources, and unrelated studies were excluded. A total of 17 900 search results were identified on Google Scholar and 300 on PubMed, leading to the inclusion of 89 articles in this review.

Results:

The findings indicate that VR and AR technologies significantly enhance patient experiences and medical training, providing immersive and interactive environments for learning and practice. However, notable challenges include integration issues with existing electronic health record systems, the need for appropriate implementation models, and a lack of substantial evidence supporting the clinical efficacy of AR-assisted procedures.

Conclusion:

While VR and AR hold considerable promise in revolutionizing healthcare practices, further research is essential to address existing gaps, particularly regarding implementation strategies, user acceptance, and empirical evaluation of patient outcomes and training effectiveness. Understanding the needs of healthcare professionals and patients will be critical to maximizing the impact of these technologies in clinical settings.
“An Algorithm for Public Service Media?” Embedding Public Service Values in the News Recommender System on RTBF's Platform
Authors: Carillon Kevin
Published: October 2024

In a rapidly evolving digital landscape, public service media (PSM) face a significant challenge: how to leverage recommendation algorithms to enhance their visibility and attractiveness without sacrificing their core values. This study examines the extent to which the Belgian Radio-Television of the French Community (RTBF) has integrated PSM values into the development of a recommender system for news articles on its platform (rtbf.be). The research highlights a conscientious effort to define and translate PSM values before the algorithm design phase, both inside and outside the organization. However, the study also reveals limitations that hinder the full realization of PSM values within the recommender system. Consequently, these values currently function more as abstract guiding principles and communication tools than tangible technical features. The study emphasizes the challenge of reconciling public service ethos with algorithmic realities and concludes by highlighting the need for further empirical research to bridge this gap in the digital age.
Procoagulant platelet activation promotes venous thrombosis
Authors: Kaiser Rainer , Dewender Robin , Mulkers Maité , Stermann Julia , Rossaro Dario , Di Fina Lea , Li Lukas , Gold Christoph , Schmid Michael , Kääb Lily , Eivers Luke , Akgöl Sezer , Yue Keyang , Kammerer Lisa , Loew Quentin , Anjum Afra , Escaig Raphael , Akhalkatsi Anastassia , Laun Lisa , Kranich Jan , Brocker Thomas , Mueller Tonina T. , Krächan Angelina , Gmeiner Jonas , Pekayvaz Kami , Thienel Manuela , Massberg Steffen , Stark Konstantin , Kilani Badr , Nicolai Leo
Published: October 2024

Platelets are key players in cardiovascular disease, and platelet aggregation represents a central pharmacologic target, particularly in secondary prevention. However, inhibition of adenosine diphosphate and thromboxane signaling has low efficacy in preventing venous thromboembolism, necessitating the inhibition of the plasmatic coagulation cascade in this disease entity. Anticoagulation carries a significantly higher risk of bleeding complications, highlighting the need of alternative therapeutic approaches. We hypothesized that procoagulant activation (PA) of platelets promotes venous thrombus formation and that targeting PA could alleviate venous thrombosis. Here, we found elevated levels of procoagulant platelets in the circulation and in thrombi of patients with deep vein thrombosis (DVT) and pulmonary embolism, and in mice developing DVT following inferior vena cava stenosis. Furthermore, we detected PA of recruited platelets within murine venous thrombi and human pulmonary emboli. Mice with platelet-specific deficiency in central pathways of PA—cyclophilin D and transmembrane protein 16F—were more resistant toward low flow–induced venous thrombosis. Finally, we found that a clinically approved carbonic anhydrase inhibitor, methazolamide, reduced platelet procoagulant activity and alleviated murine thrombus formation without affecting trauma-associated hemostasis. These findings identify an essential role of platelet procoagulant function in venous thrombosis and delineate novel pharmacologic strategies targeting platelets in the prevention of venous thromboembolism.
Wunderlich syndrome in pregnancy: life threatening bleeding renal angiomyolipoma in first and third trimesters—two case reports and literature review
Authors: Khor Vincent , Mohd Naim Mohd Yakob , Fahmy Omar , Lee Christopher Kheng Siang , Azli Saiful , Rahim Ezamin Abdul , Kamis Mohd Fandi Al Khafiz , Khairul-Asri Mohd Ghani
Published: October 2024

Background

Renal angiomyolipoma (AML) is a prevalent benign tumour of the kidney. However, Wunderlich syndrome, marked by retroperitoneal haemorrhage, remains a rare and critical complication of large AMLs. During pregnancy, AMLs demonstrate an accelerated growth pattern and pose an elevated risk of rupture, leading to massive retroperitoneal haemorrhage. This report presents two compelling cases of life-threatening bleeding AML during the first and third trimesters, shedding light on the urgent need for heightened awareness and management strategies in pregnant women with AML. These cases underscore the novel and crucial aspect of the increased vulnerability of AMLs in pregnancy, emphasizing the importance of timely diagnosis and intervention.

Cases presentation

The first patient is a 37-year-old lady who presented at 27 weeks of gestation with foetal distress, abdominal pain and hypovolemic shock. Emergency Caesarean section was performed for possible abruptio placenta, and a large non-expanding retroperitoneal hematoma was found intra-operatively. Post-delivery computed tomography (CT) angiography assessment showed left perinephric hematoma from bleeding AML at the lower pole. She was hemodynamically unstable after CT and underwent an emergency nephrectomy. Post-operative recovery was uneventful. The second patient is a 30-year-old lady who presented with right abdominal pain at 11 weeks of gestation with hypotension and an actively bleeding ruptured AML found on the abdominal MRI. She underwent angioembolization at 12 weeks of pregnancy with a radiation shield to protect the foetus. She recovered well after the procedure and continued her pregnancy. Her baby was born healthy at term with no evidence of any congenital malformation.

Conclusions

When dealing with renal angiomyolipoma during pregnancy, multidisciplinary team management is crucial for the best management care. Stable cases can be treated conservatively, while unstable cases may require angioembolization or nephrectomy. The management plan should prioritize the best outcomes for both the mother and foetus. During the first trimester, angioembolization is safe and effective in controlling bleeding. However, minimizing radiation exposure is crucial, especially during organogenesis. Tailored interventions are essential to optimize outcomes in this unique patient population.
Molecular characterisation of virulence genes in bacterial pathogens from daycare centres in Ile-Ife, Nigeria: implications for infection control
Authors: Wilkie Eunice Damilola , Alao Jude Oluwapelumi , Sotala Toyosi Teniola , Oluduro Anthonia Olufunke
Published: October 2024

Background

Daycare centres play a critical role in early childhood development but are high-risk environments for infectious disease transmission due to close physical contact, shared toys, inadequate hygiene, and poor ventilation. These risks are especially concerning in low- and middle-income countries (LMICs) like Nigeria, where resources for infection control may be limited. This study aimed to identify and characterise virulence genes in bacterial isolates from daycare centres in Ile-Ife, Nigeria, to assess infection risks.

Methods

Between November 2017 and July 2019, 233 samples were collected from 76 children, 33 daycare workers, and 124 fomites in 17 daycare centres. The bacterial isolates were analysed using conventional PCR and RAPD analysis to detect the presence of virulence genes. The frequency of crucial virulence genes and the prevalence of each bacterial species were recorded.

Results

Key virulence genes were detected, including fimH in Klebsiella species (22.73% of Gram-negative isolates), algD in Pseudomonas aeruginosa (50%), and icaA and cna in Staphylococcus aureus (16.67%). Staphylococcus aureus was the most prevalent species (35%), followed by Klebsiella (28%) and Pseudomonas aeruginosa (20%).

Conclusion

This study highlights the presence of virulent bacterial pathogens in daycare environments, posing a severe infection risk to children. To mitigate these risks, it is essential to implement enhanced infection control measures, such as regular microbial screening, improved hand hygiene practices, and disinfection protocols for fomites. Training programs for daycare workers on hygiene practices and routine monitoring could also significantly reduce infection transmission. These interventions are vital for safeguarding the health of daycare children in Nigeria and similar settings globally.