bluuebunny/crossref_metadata_2025 huggingface dataset:
Joint spatio-temporal modelling of adverse pregnancy outcomes sharing common risk factors at sub-county level in Kenya, 2016–2019
Authors: Odhiambo Julius Nyerere , Sartorius Benn
Published: December 2021

Background

Adverse pregnancy outcomes jointly account for a high proportion of mortality and morbidity among pregnant women and their infants. Furthermore, the burden attributed to adverse pregnancy outcomes remains high and inadequately characterised due to the intricate interplay of its etiology and shared set of important risk factors. This study sought to quantify and map the underlying risk of multiple adverse pregnancy outcomes in Kenya at sub-county level using a shared component space-time modelling framework.

Methods

Reported sub-county level adverse pregnancy outcomes count from January 2016 – December 2019 were obtained from the Kenyan District Health Information System. A Bayesian hierarchical spatio-temporal model was used to estimate the joint burden of adverse pregnancy outcomes in space (sub-county) and time (year). To improve the precision of our estimates over time and space, information across the outcomes were combined via the shared and the outcome-specific components using a shared component model with spatio-temporal interactions.

Results

Overall, the total number of adverse outcomes in pregnancy increased by 14.2% (95% UI: 14.0–14.5) from 88,816 cases in 2016 to 101,455 cases in 2019. Between 2016 and 2019, the estimated low birth weight rate and the pre-term birth rate were 4.5 (95% UI: 4.4–4.7) and 2.3 (95% UI: 2.2–2.5) per 100 live births. The stillbirth and neonatal death rates were estimated to be 18.7 (95% UI: 18.0–19.4) and 6.9 (95% UI: 6.4–7.4) per 1000 live births. The magnitude of the spatio-temporal variation attributed to shared risk was high for pre-term births, low birth weight, neonatal deaths, stillbirths and neonatal deaths, respectively. The shared risk patterns were dominant in sub-counties located along the Indian ocean coastline, central and western Kenya.

Conclusions

This study demonstrates the usefulness of a Bayesian joint spatio-temporal shared component model in exploiting specific and shared risk of adverse pregnancy outcomes sub-nationally. By identifying sub-counties with elevated risks and data gaps, our estimates not only assert the need for bolstering maternal health programs in the identified high-risk sub-counties but also provides a baseline against which to assess the progress towards the attainment of Sustainable Development Goals.
Women’s experiences of safety apps for sexualized violence: a narrative scoping review
Authors: Doria Nicole , Ausman Christine , Wilson Susan , Consalvo Annalisa , Sinno Jad , Boulos Leah , Numer Matthew
Published: December 2021

Background

Sexualized violence against women is a significant human rights problem worldwide. Safety apps have the capacity to provide women with resources to prevent or respond to experiences of sexualized violence.

Methods

The aim of the following study was to review the scope of the literature on women’s experiences of safety apps related to sexualized violence. The databases Embase, MEDLINE, PsycINFO, and Scopus were systematically searched, and seven studies were included in this review.

Results

Thematic analysis identified the following themes in the literature: (1) security; (2) accessibility; and (3) knowledge.

Conclusion

The gaps in the literature are identified and implications and recommendations for future research is discussed.
Social determinants and spatio-temporal variation of Ischemic Heart Disease in Manitoba
Authors: Dyck Justin , Tate Robert , Uhanova Julia , Torabi Mahmoud
Published: December 2021

Introduction

The aim was to study any spatial and/or temporal patterns of ischemic heart disease (IHD) prevalence and measure the effects of selected social determinants on these spatial and space-time patterns.

Methods

Data were obtained from the Population Research Data Repository housed at the Manitoba Centre for Health Policy to identify persons who were diagnosed with IHD between 1995 and 2018. These persons were geocoded to 96 geographic regions of Manitoba. An area-level socioeconomic factor index (SEFI-2) and the proportion of the population who was Indigenous were calculated for each geographic region using the 2016 Canadian Census data. Associations between these factors and IHD prevalence were measured using Bayesian spatial Poisson regression models. Temporal trends and spatio-temporal trends were measured using Bayesian spatio-temporal Poisson regression models.

Results

Univariable models showed a significant association with increased regional Indigenous population proportion associated with a higher prevalence of IHD (RR: 0.07, 95% CredInt: (0.05, 0.10)) and for SEFI-2 (RR: 0.17, 95% CredInt: (0.11, 0.23)). Using a multivariable model, after accounting for the proportion of the population that was Indigenous, there was no evidence of an association between IHD prevalence and area-level socioeconomic factor. Spatio-temporal models showed no significant overall temporal trend in IHD prevalence, but there were significant spatially varying temporal trends within the 96 regions.

Conclusions

Association between Indigenous population proportion and IHD is consistent with previous research. No significant overall temporal trend was measured. However, regions with significantly increasing trends and significantly decreasing trends in IHD prevalence were identified.
Associations of sickness absence and disability pension due to mental and somatic diagnoses when aged 60–64 with paid work after the standard retirement age; a prospective population-based cohort study in Sweden
Authors: Martikainen Aleksiina , Svensson Alavi Alice , Alexanderson Kristina , Farrants Kristin
Published: December 2021

Background

The proportion of people working beyond age 65 is increasing. We aimed to explore whether sickness absence (SA) and disability pension (DP) due to mental, somatic, or both diagnoses when aged 60–64 were associated with being in paid work when aged 66–71.

Methods

This prospective population-based cohort study included all 98,551 individuals who in 2010 turned 65 years, lived in Sweden, and were in paid work at some point when aged 60–64. Data from three nationwide registers were used with 2010 as baseline, with SA or/and DP as the exposure variables (2005–2009) and paid work as the outcome variable (2011–2016). Logistic regression was conducted to calculate odds ratios (OR) with 95% confidence intervals (CI) for the association between exposures and outcome, controlling for sociodemographic factors. The analyses were also stratified by sex.

Results

Nearly half were in paid work during follow-up. Those with SA due to mental diagnoses had lower likelihood of being in paid work among both sexes (women OR: 0.76; 95% CI: 0.69–0.84; men 0.74; 0.65–0.84), while this association was smaller for SA due to somatic diagnoses (women 0.87; 0.84–0.91; men 0.92; 0.89–0.96). SA due to both mental and somatic diagnoses was associated with a lower likelihood of paid work for men (0.77; 0.65–0.91), but not women (0.98; 0.88–1.09). Regardless of diagnosis group and sex, DP had the strongest association with not being in paid work (women mental DP 0.39; 0.34–0.45; women somatic DP 0.38; 0.35–0.41; women mental and somatic DP 0.28; 0.15–0.56; men mental DP 0.36; 0.29–0.43; men somatic DP 0.35; 0.32–0.38; men mental and somatic DP 0.22; 0.10–0.51). Combined SA and/or DP demonstrated ORs in-between the diagnosis groups of SA and DP alone (e.g., mental SA and/or DP women and men combined 0.61; 0.57–0.65).

Conclusions

SA and DP were negatively associated with being in paid work after the standard retirement age of 65. The association was especially strong for DP, irrespective of diagnosis group. Moreover, compared to somatic diagnoses, SA due to mental diagnoses had a stronger association with not being in paid work. More knowledge is needed on how mental SA impedes extending working life.
Psychological distress, burnout, and coping strategies among Nigerian primary school teachers: a school-based cross-sectional study
Authors: Ozoemena Eyuche Lawretta , Agbaje Olaoluwa Samson , Ogundu Levi , Ononuju Amaka Harry , Umoke Prince Christian Iheanachor , Iweama Cylia Nkechi , Kato George Usman , Isabu Augustina Chikaodili , Obute Akor John
Published: December 2021

Background

The teaching profession is highly stressed job. A high level of stress is associated with poor health outcomes, such as burnout and psychological distress. Therefore, teachers’ use of coping styles becomes imperative. However, relatively little is known about primary school teachers’ psychological distress, burnout, coping strategies, and associated factors in Nigeria. The study investigated psychological distress, burnout, coping strategies among primary schools, and associated factors in Nigeria.

Methods

A total of 264 teachers aged 20–59 years participated in the study between May 2019 to October 2019. Questionnaires on psychological distress, burnout, coping strategies, and demographic profile form were used for data collection. Factors associated with psychological distress, burnout, and coping strategies were identified using t-test, univariate ANOVA, Pearson’s correlation, Chi-square test, and hierarchical linear regression analysis.

Results

Of 264 participants enrolled for the study, 253 responded, giving a response rate of 95.8%. The prevalence of psychological distress and burnout was 69.9% (176/253) and 36.0% (91/253), respectively. Sex (β = 0.158), a high level of emotional exhaustion (β = 0.193) and reduced personal accomplishment (β = 0.358), adoption of problem-focused strategies (β = 0.904), and dysfunctional strategies (β = 0.340) were positively associated with psychological distress. Age (β = − 0.338), academic qualification (β = − 0.210), and income level (β = − 0.146) were inversely associated with psychological distress, which together explained 51.5% of the total variance. Psychological distress (β = 0.275 vs. β = 0.404) was significantly associated with emotional exhaustion (EE) and reduced personal accomplishment (PA) and explained 11.4 and 24.2% of the variance in EE and reduced PA, respectively.

Conclusions

The high prevalence of psychological distress and burnout among teachers should receive urgent attention. Teachers’ training curricula should include developing interpersonal skills, stress management abilities, and resilience to equip them for the job. Also, teacher training curricula should integrate mental health promotion interventions.
Document-level medical relation extraction via edge-oriented graph neural network based on document structure and external knowledge
Authors: Li Tao , Xiong Ying , Wang Xiaolong , Chen Qingcai , Tang Buzhou
Published: December 2021

Objective

Relation extraction (RE) is a fundamental task of natural language processing, which always draws plenty of attention from researchers, especially RE at the document-level. We aim to explore an effective novel method for document-level medical relation extraction.

Methods

We propose a novel edge-oriented graph neural network based on document structure and external knowledge for document-level medical RE, called SKEoG. This network has the ability to take full advantage of document structure and external knowledge.

Results

We evaluate SKEoG on two public datasets, that is, Chemical-Disease Relation (CDR) dataset and Chemical Reactions dataset (CHR) dataset, by comparing it with other state-of-the-art methods. SKEoG achieves the highest F1-score of 70.7 on the CDR dataset and F1-score of 91.4 on the CHR dataset.

Conclusion

The proposed SKEoG method achieves new state-of-the-art performance. Both document structure and external knowledge can bring performance improvement in the EoG framework. Selecting proper methods for knowledge node representation is also very important.
Persistent SARS-CoV-2 infection in patients with secondary antibody deficiency: successful clearance following combination casirivimab and imdevimab (REGN-COV2) monoclonal antibody therapy
Authors: Taha Yusri , Wardle Hayley , Evans Adam B. , Hunter Ewan R. , Marr Helen , Osborne Wendy , Bashton Matthew , Smith Darren , Burton-Fanning Shirelle , Schmid Matthias L. , Duncan Christopher J. A.
Published: December 2021

Background

There is growing evidence that antibody responses play a role in the resolution of SARS-CoV-2 infection. Patients with primary or secondary antibody deficiency are at increased risk of persistent infection. This challenging clinical scenario is associated with adverse patient outcome and potentially creates an ecological niche for the evolution of novel SARS-CoV-2 variants with immune evasion capacity. Case reports and/or series have implied a therapeutic role for convalescent plasma (CP) to secure virological clearance, although concerns have been raised about the effectiveness of CP and its potential to drive viral evolution, and it has largely been withdrawn from clinical use in the UK.

Case presentation

We report two cases in which persistent SARS-CoV-2 infection was cleared following administration of the monoclonal antibody combination casirivimab and imdevimab (REGN-COV2, Ronapreve). A 55-year-old male with follicular lymphoma, treated with B cell depleting therapy, developed SARS-CoV-2 infection in September 2020 which then persisted for over 200 days. He was hospitalised on four occasions with COVID-19 and suffered debilitating fatigue and malaise throughout. There was no clinical response to antiviral therapy with remdesivir or CP, and SARS-CoV-2 was consistently detected in nasopharyngeal swabs. Intrahost evolution of several spike variants of uncertain significance was identified by viral sequence analysis. Delivery of REGN-COV2, in combination with remdesivir, was associated with clinical improvement and viral clearance within 6 days, which was sustained for over 150 days despite immunotherapy for relapsed follicular lymphoma. The second case, a 68-year-old female with chronic lymphocytic leukaemia on ibrutinib, also developed persistent SARS-CoV-2 infection. Despite a lack of response to remdesivir, infection promptly cleared following REGN-COV2 in combination with remdesivir, accompanied by resolution of inflammation and full clinical recovery that has been maintained for over 290 days.

Conclusions

These cases highlight the potential benefit of REGN-COV2 as therapy for persistent SARS-CoV-2 infection in antibody deficient individuals, including after failure of CP treatment. Formal clinical studies are warranted to assess the effectiveness of REGN-COV2 in antibody-deficient patients, especially in light of the emergence of variants of concern, such as Omicron, that appear to evade REGN-COV2 neutralisation.
Assessing the usefulness of policy brief and policy dialogue as knowledge translation tools towards contextualizing the accountability framework for routine immunization at a subnational level in Nigeria
Authors: Ogbonnaya Lawrence Ulu , Okedo-Alex Ijeoma Nkem , Akamike Ifeyinwa Chizoba , Azuogu Benedict , Urochukwu Henry , Ogbu Ogbonnaya , Uneke Chigozie Jesse
Published: December 2021

Background

Evidence suggests that implementing an accountability mechanism such as the accountability framework for routine immunization in Nigeria (AFRIN) will improve routine immunization (RI) performance. The fact that the AFRIN, which was developed in 2012, still had not been operationalized at the subnational level (Ebonyi State) by 2018 may in part account for the poor RI coverage (33%) in 2017. Knowledge translation (KT) is defined as the methods for closing the gaps from knowledge to practice. Policy briefs (useful in communicating research findings to policy-makers) and policy dialogues (that enable stakeholders to understand research evidence and create context-resonant implementation plans) are two KT tools. This study evaluated their usefulness in enabling policy-makers to contextualize AFRIN in Ebonyi State, Nigeria.

Methods

The study design was cross-sectional descriptive with mixed-methods data collection. A policy brief developed from AFRIN guided deliberations in a 1-day multi-stakeholder policy dialogue by 30 policy actors. The usefulness of the KT tools in contextualizing policy recommendations in the AFRIN was assessed using validated questionnaires developed at McMaster University, Canada.

Results

At the end of the policy dialogue, the policy options in the policy brief were accepted but their implementation strategies were altered to suit the local context. The respondents’ mean ratings (MNR) of the overall usefulness of the policy brief and the policy dialogue in contextualizing the implementation strategies were 6.39 and 6.67, respectively, on a seven-point Likert scale (very useful). The MNR of the different dimensions of the policy brief and policy dialogue ranged from 6.17 to 6.60 and from 6.10 to 6.83, respectively (i.e. moderately helpful to very helpful).

Conclusion

The participants perceived the KT tools (policy brief and policy dialogue) as being very useful in contextualizing policy recommendations in a national policy document into state context-resonant implementable recommendations. We recommend the use of these KT tools in operationalizing AFRIN at the subnational level in Nigeria.
Risk factors for low back pain in active military personnel: a systematic review
Authors: To Daphne , Rezai Mana , Murnaghan Kent , Cancelliere Carol
Published: December 2021

Purpose

Low back pain (LBP) is prevalent in military personnel. We aimed to systematically review the literature regarding risk factors for first-time LBP during military service among active duty military personnel.

Methods

We searched six electronic databases (inception-April 2020) for randomised controlled trials, cohort studies, and case–control studies published in English in peer-reviewed journals. Eligible studies were independently critically appraised by paired reviewers and a descriptive synthesis was conducted.

Results

We screened 1981 records, reviewed 118 full-text articles, and synthesised data from eight acceptable quality cohort studies. Studies assessed physical (n = 4), sociodemographic (n = 2), and/or occupational factors (n = 5) associated with LBP. Two studies reported prior LBP was associated with a greater than twofold increased risk of LBP compared to those without prior LBP. Other factors consistently associated with LBP included previous musculoskeletal injury (n = 2), less time spent on physical training (n = 2), female sex (n = 2), and lower rank (n = 2). Factors associated with LBP from single studies included marital status, lower education level, blast injury, job duties, and service type. We found inconsistent associations for performance on physical fitness tests, age, and occupation type. Psychological risk factors were not assessed in any included studies.

Conclusion

In active duty personnel, prior history of LBP, previous musculoskeletal injury, less time in physical training, female sex, and lower rank were consistent risk factors for LBP. This information is relevant for researchers, active duty military personnel, and other decision makers. Future studies should explore causal relationships for LBP in this population.

PROSPERO registration number: CRD42018084549.
An infant with 49XXXXY syndrome: a case report
Authors: Naotunna N. P. G. C. R. , Liyanage C. , Atapattu N.
Published: December 2021

Background

49XXXXY syndrome is the rarest X chromosome aneuploidy, with approximate incidence of 1:85,000–100,000 male births. Worldwide, around 100 cases have been reported. In this report, we describe one such case seen in Sri Lanka.

Case presentation

A 10-day-old Sri Lankan neonate born in a tertiary care center was referred to the pediatric endocrinology unit of Lady Ridgeway Hospital due to detection of ambiguous genitalia at birth. He was the first child born to nonconsanguineous healthy parents following an uncomplicated antenatal period. He was born at term via normal vaginal delivery, with a birth weight of 2.385 kg. The baby was active, and there was no documented hypoglycemia or alteration in basic biochemical investigations. On examination, the child had hypertelorism, upslanting palpebral fissures, flat occiput, and mild webbing of the neck. System examination was normal. Genitalia examination revealed bifid scrotum, perineal urethra, 2 cm phallus, and bilateral testis in situ. Hormonal analysis, including dehydroepiandrosterone sulfate, testosterone, and 17-OH progesterone levels, was normal except for an elevated level of follicle-stimulating hormone, indicating gonadal dysgenesis. Ultrasound of the abdomen detected testis located at bilateral inguinal canal, and no Müllerian structures were visible. Echocardiography showed a small patent foramen ovale with otherwise normal heart. Chromosome analysis revealed 49XXXXY syndrome.

Conclusion

49XXXXY syndrome should be entertained as a rare possibility for ambiguous genitalia, and karyotyping is an essential investigation for evaluation of such patients.
Non-intrusive nonlinear model reduction via machine learning approximations to low-dimensional operators
Authors: Bai Zhe , Peng Liqian
Published: December 2021

Although projection-based reduced-order models (ROMs) for parameterized nonlinear dynamical systems have demonstrated exciting results across a range of applications, their broad adoption has been limited by their intrusivity: implementing such a reduced-order model typically requires significant modifications to the underlying simulation code. To address this, we propose a method that enables traditionally intrusive reduced-order models to be accurately approximated in a non-intrusive manner. Specifically, the approach approximates the low-dimensional operators associated with projection-based reduced-order models (ROMs) using modern machine-learning regression techniques. The only requirement of the simulation code is the ability to export the velocity given the state and parameters; this functionality is used to train the approximated low-dimensional operators. In addition to enabling nonintrusivity, we demonstrate that the approach also leads to very low computational complexity, achieving up to$$10^3{\times }$$103×in run time. We demonstrate the effectiveness of the proposed technique on two types of PDEs. The domain of applications include both parabolic and hyperbolic PDEs, regardless of the dimension of full-order models (FOMs).
The involvement of local communities in the conservation process of earthen architecture in the Sahel-Sahara region – the case of Djenné, Mali
Authors: Sacko Oussouby
Published: December 2021

Recently, many cultural aspects of some African countries have been in danger of being lost due to cultural disruptions, nonadaptive construction techniques and a lack of adequate conservation systems and strategies. These include the well-known manuscripts of Timbuktu (Tombouctou) as well as architecture, languages, beads, textiles, costumes and other cultural objects. Immaterial heritage, such as oral history, traditional music, instruments and dance, is also affected.

In the northwestern part of Africa, the so-called Sahel-Sahara region, earthen architecture has played an important role in cultural identity and has been a key means of community establishment. This architectural heritage includes a wide variety of creations ranging from simple houses, granaries, and palaces to religious buildings, urban centres, cultural landscapes and archaeological sites. By studying northwestern African cultural heritage and cultural exchanges during trans-Saharan trade, we can benefit from traditional knowledge and use these teachings to build a sustainable knowledge system for earthen architecture conservation. This work is urgent since these structures are in danger of being lost, destroyed, badly conserved, or not documented.

The aim of this research is to point out, through an anthropological approach, the importance of local community involvement in the conservation process. This research is based on a comparative study of different earthen architecture conservation spaces within the abovementioned region that have been important and were influenced by cultural exchanges during trans-Saharan trade. In these historical towns, some architectural heritage sites have been abandoned and are in ruins, while others have been preserved solely as tourist attractions. In this paper, I introduce the case of Djenné to share our research approach. This paper provides insight into earthen architecture conservation issues and how local communities have used tangible and intangible methods to preserve cultural heritage.
State-of-the-art and annual progress of bridge engineering in 2020
Authors: Zhao Renda , Zheng Kaifeng , Wei Xing , Jia Hongyu , Liao Haili , Li Xiaozhen , Wei Kai , Zhan Yulin , Zhang Qinghua , Xiao Lin , Zhou Lingyuan , Shen Ruili , Gou Hongye , Pu Qianhui , Zhang Fang , Xu Ziyi , Yu Chuanjin
Published: December 2021

Bridge construction is one of the cores of traffic infrastructure construction. To better develop relevant bridge science, this paper introduces the main research progress in China and abroad in 2020 from 16 aspects. The content consists of four major categories in 16 aspects. The first part is about the bridge structure, including concrete bridge and high-performance materials, steel bridges, composite girders. The second part is about the bridge disaster prevention and mitigation, including bridge seismic resistance, wind resistance of bridge, train-bridge coupling vibration research, bridge hydrodynamics, the durability of the concrete bridges, fatigue of steel bridge, temperature field and temperature effect of bridge; The third part is about the bridge analyses, including numerical simulation of bridge structure, box girder and cable-stayed bridge analysis theories. The last part is concerning the bridge emerging technologies, including bridge informatization and intelligent bridge, the technology in bridge structure test, bridge assessment and reinforcement, prefabricated concrete bridge structure.
Beige Adipocyte as the Flame of White Adipose Tissue: Regulation of Browning and Impact of Obesity
Authors: Altınova Alev Eroğlu
Published: December 2021

Beige adipocyte, the third and relatively new type of adipocyte, can emerge in white adipose tissue (WAT) under thermogenic stimulations that is termed as browning of WAT. Recent studies suggest that browning of WAT deserves more attention and therapies targeting browning of WAT can be helpful for reducing obesity. Beyond the major inducers of browning, namely cold and β 3-adrenergic stimulation, beige adipocytes are affected by several factors, and excess adiposity per se may also influence the browning process. The objective of the present review is to provide an overview of recent clinical and preclinical studies on the hormonal and nonhormonal factors that affect the browning of WAT. This review further focuses on the role of obesity per se on browning process.
Challenges of Pediatric Anesthesia Services and Training Infrastructure in Tertiary Care Teaching Institutions in Pakistan: A Perspective From the Province of Sindh
Authors: Khan Fauzia A. , Haider Saeeda , Abbas Nighat , Akhtar Navaid , Haq Nur Ul , Khaskheli M. Saleh , Khatri Younis , Munir Nadeem , Raza Hamid , Siddiqui Maqsood Ahmed , Soomro Ahmed Uddin , Siddiqui Safia Zafar
Published: December 2021

BACKGROUND:

Pakistan is a lower middle–income country located in South Asia with a population of nearly 208 million. Sindh is its second largest province. The aim of this survey was to identify the current setup of pediatric services, staffing, equipment, and training infrastructure in the teaching hospitals of Sindh.

METHODS:

The survey was conducted between June 2018 and September 2018. A questionnaire was designed with input from experts and pretested. One faculty coordinator from each of 12 of the 13 teaching hospitals (7 government and 5 private) completed the form. Information was exported into Statistical Package for the Social Sciences (SPSS) version 22. Frequency and percentages were computed for all variables. Confidentiality was ensured by anonymizing the data.

RESULTS:

Anesthesia services are provided by consultants with either membership or fellowship in anesthesia of the College of Physicians and Surgeons of Pakistan (CPSP). All drugs on the World Health Organization (WHO) essential medication list were available, although narcotic supply was often inconsistent. Weak areas identified were absence of standardization of practice regarding premedication, preoperative laboratory testing, pain assessment, and management. No national practice guidelines exist. Pulse oximeters and capnometers were available in all private hospitals but in only 86% and 44% of the government hospitals, respectively. Some training centers were not providing the training as outlined by the CPSP criteria.

CONCLUSIONS:

Several gaps have been identified in the practice and training infrastructure of pediatric anesthesia. There is a need for national guidelines, standardization of protocols, provision of basic equipment, and improved supervision of trainees. One suggestion is to have combined residency programs between private and government hospitals to take advantage of the strengths of both. Recommendations by this group have been shared with all teaching hospitals and training bodies.
An Intensity-dependent Slow Component of HR Interferes with Accurate Exercise Implementation in Postmenopausal Women
Authors: TESO MASSIMO , COLOSIO ALESSANDRO L. , POGLIAGHI SILVIA
Published: December 2021

Heart rate (HR) targets are commonly used to administer exercise intensity in sport and clinical practice. However, as exercise protracts, a time-dependent dissociation between HR and metabolism can lead to a misprescription of the intensity ingredient of the exercise dose.

Purpose

We tested the hypothesis that a slow component of HR (i.e., scHR) occurs in all intensity domains, greater than the slow component of oxygen uptake (scV˙O2), and we developed an equation to predict it across exercise intensities.

Method

Eighteen healthy, postmenopausal women (54 ± 4 yr) performed on a cycle ergometer: i) a ramp incremental test for thresholds and V˙O2max detection; ii) 30-min constant work exercise at 40%, 50%, 60%, 70%, and 80% V˙O2max for the measurement of scHR, scV˙O2, stroke volume, and body temperature (T°). scHR and scV˙O2 were compared by two-way repeated-measures ANOVA (intensity and variable). Pearson correlation was calculated between the slow component of all variables, relative intensity, and domain. scHR (in beats per minute) was predicted with a linear model based on exercise intensity relative to the respiratory compensation point (RCP).

Results

A positive scHR was present in all domains, twice the size of scV̇O2 (P < 0.001), and significantly correlated with the slow components of V̇O2 (r
2 = 0.46), T° (r
2 = 0.52), and relative intensity (r
2 = 0.66). A linear equation accurately predicts scHR based on %RCP (r
2 = 0.66, SEE = 0.15).

Conclusions

A mismatch exists between the slow components of HR and metabolic intensity. Whenever exercise is prescribed based on HR, target values should be adjusted over time to grant that the desired metabolic stimulus is maintained throughout the exercise session.
Physiological Adaptations to High-Intensity Interval Training Combined with Blood Flow Restriction in Masters Road Cyclists
Authors: TANGCHAISURIYA PATCHARIN , CHUENSIRI NAPASAKORN , TANAKA HIROFUMI , SUKSOM DAROONWAN
Published: December 2021

Purpose

High-intensity interval training (HIIT) and blood flow restriction (BFR) training have been used to enhance athletic performance and cardiovascular health. Combining these training modalities might be an effective training modality for masters athletes who seek to enhance athletic performance and to reduce cardiovascular risks.

Methods

Fifty masters road cyclists age 35–49 yr were randomly assigned to the continuous exercise training (n = 16), continuous plus HIIT (n = 17), and continuous plus BFR training combined with HIIT (BFRIT; n = 17) for 12 wk. Both HIIT and BFRIT were performed on a cycle ergometer twice a week.

Results

Maximal oxygen consumption (V̇O2max) increased in the HIIT and BFRIT groups (P < 0.05). This was accompanied by significant improvements in maximal cardiac output and stroke volume (P < 0.05). Forty-kilometer time trial performance improved in all three groups (P < 0.05). Peak power output increased in both HIIT and BFRIT groups (P < 0.05). Flow-mediated dilation in both brachial and popliteal arteries increased in all three groups (all P < 0.05). There were no significant changes in carotid intima-media thickness and arterial stiffness in any of the groups. Total lean mass, muscle cross-sectional area and thickness in rectus femoris and vastus lateralis, and peak torque of isokinetic knee extension increased only in the BFRIT group (all P < 0.05). Tissue saturation index decreased only in the BFRIT group (P < 0.05). Changes in 40-km time trial performance were associated with corresponding changes in V̇O2max (r = −0.312, P = 0.029) and peak isokinetic extensor torque (r = −0.432, P = 0.002).

Conclusions

Including HIIT particularly with BFR in the routine continuous training may be more effective in enhancing performance and physiological functions in masters road cyclists.
On the Macroeconomic Consequences of Over-Optimism
Authors: Beaudry Paul , Willems Tim
Published: December 2021

Analyzing International Monetary Fund (IMF) data, we find that overly optimistic growth expectations for a country induce economic contractions a few years later. To isolate the causal effect, we take an instrumental variable approach—exploiting randomness in the country allocation of IMF mission chiefs. We first document that IMF mission chiefs differ in their individual degrees of forecast optimism, yielding quasi-experimental variation in the degree of forecast optimism at the country level. The mechanism appears to run through excessive accumulation of debt (public and private). Our findings illustrate the potency of unjustified optimism and underline the importance of basing economic forecasts upon realistic medium-term prospects. (JEL C53, E23, E27, E32, F33, H63)
Knowledge Diffusion, Trade, and Innovation across Countries and Sectors
Authors: Cai Jie , Li Nan , Santacreu Ana Maria
Published: December 2021

This paper provides a unified framework for quantifying the cross-country and cross-sector interactions among trade, innovation, and knowledge diffusion. This framework is used to study the effect of trade liberalization in an endogenous growth model in which comparative advantage and the stock of knowledge are determined by innovation and diffusion. The model is calibrated to match observed cross-country and cross-sector heterogeneity in production, innovation efficiency, and knowledge spillovers. The counterfactual analysis shows that a reduction in trade costs induces a reallocation of R&D and comparative advantage across sectors. Heterogeneous knowledge diffusion amplifies the specialization effects of trade-induced R&D reallocation, becoming an important source of welfare. (JEL F12, F14, O33, O34, O41)
Aristotle and Aristoxenus on Effort
Authors: Bagby John Robert
Published: December 2021

The discussions of conatus – force, tendency, effort, and striving – in early modern metaphysics have roots in Aristotle’s understanding of life as an internal experience of living force. This paper examines the ways that Spinoza’s conatus is consonant with Aristotle on effort. By tracking effort from his psychology and ethics to aesthetics, I show there is a conatus at the heart of the activity of the ψυχή that involves an intensification of power in a way which anticipates many of the central insights of early modern and 20th century European philosophy. The first section outlines how Aristotle’s developmental conception of the soul as geometrically ordered lays the foundation for his understanding of effort. The developmental series of powers of the soul are analogous to the series of shapes in mathematics. The second section links the striving of the soul to the gradual acquisition of virtues as a directed activity unifying multiplicity. The third examines the paradigm of self-awareness that Aristotelian effort involves. In the final section I show how ancient Greek theories of music were founded on the experience of striving. The “nature” of music is defined by Aristoxenus, and Theophrastus, in relation to the passion and intentionality of the soul. The geometrical order, as a synthesis of elements in geometry, music, or ethics, is a generative process in which past elements are retained and reintegrated in later stages of development. It requires effort to think geometrically, and the progress of knowledge itself is an integral aspect of all effort. Effort is the lived and self-aware cause which, moving step by step in an orderly and deliberate way, grows and advances upon itself. For both Spinoza and Aristotle, effort is the immanent intelligence which accomplishes what is in the purview of its understanding. Thus, will, in this conception of effort, is not something we already possess innately, but emerges gradually by an effort aimed at improvement.
A New Conatus for the New World: Dewey’s Response to Perfectionist Conceptions of Democratic Education
Authors: Özel Jasmin , Beisecker David , Ervin Joe
Published: December 2021

We argue for a reconsideration of the claim that Spinoza’s perfectionist conception of education was ushering in a form of radical humanism distinctly favorable to democratic ideals. With the rise of democratic societies and the corresponding need to constitute educational institutions within those societies, a more thoroughgoing commitment to democratic social ideals arose, first and foremost in American educational thought. This commitment can be seen especially in Dewey’s philosophy of education. Specifically, Dewey and Spinoza had strikingly distinct conceptions of the overall aims of schooling. While Spinoza takes the aim of education to be the perfection of a student’s original nature, Dewey takes education to involve the collective acquisition of an additional nature, reflecting the norms and expectations of one’s specific community. In this paper, we juxtapose these two distinct conceptions of education alongside one another, with an eye towards illuminating the limitations of a perfectionist theory of education for the individual, as we find it in Spinoza, within a democratic society.
Aristotelian Concept of Happiness (Eudaimonia) and its Conative Role in Human Existence: A Critical Evaluation
Authors: Egbekpalu Purissima Emelda
Published: December 2021

Despite the challenges of human existence, identifying the major features that sustain man’s striving to persist in life (conatus) is very essential in understanding who man is. This paper critically evaluates Aristotelian concept of happiness (eudaimonia) and its conative role in human existence as it ignites newness of interest in Aristotelian theory of happiness as the ultimate end of all human activities. Aristotle’s notion of happiness connotes conative experiences; actions that signify movements of some sorts for preservation of life. With regard to self-preservation in existence, Aristotle held the opinion that man has the natural inclination to actualize his potentialities through strong efforts of the will towards the right, and at the same time to create new potentialities to sustain his life. Through the activities of the soul (virtuous acts), man propels himself in a distinctive way towards objects of his desire for survival and flourishing. His concept of emotions as having the affective, cognitive as well as behavioural dimensions revealed that emotions have psychological values and vital functions which serve as survival instinct in man. However, they differ in their aims in that they have both attractive and aversive characteristics such that they move him either to seek or to avoid necessary objects that enhance or harm his existence, respectively. Considering the subjective experiences of pains and pleasures of emotions, they dispose man to virtuous actions towards excellence. However, to sustain man’s inner drive to persist in life, this paper objects to the theses that happiness can be restricted to only cognitive activities. Despite the weaknesses of his treatise concerning happiness in relation to man’s striving to persist, it was observed that Aristotle’s notion of happiness aids man’s striving in life. For further studies, it recommended clarification of ambiguous concepts and reconciliation of contradictions inherent in the theory.
Conatus, the Will to Persist: An Introduction
Authors: Özel Jasmin , Psarros Nikos
Published: December 2021

The papers collected in this issue address a variety of aspects of the concept of conatus ranging from the explorations of its roots in early ancient Greek thought to its application on modern theories of democratic education. The conatus is a special relation between the parts of a monad and their subparts and the subparts of the subparts to infinity, which ensures that each part and subpart is a part of this monad and not of any other. As a fundamental trait of monadic existence, the conatus is manifested in a multiplicity of facets that sustain the persistence of any real existence. It is thus obvious that there is still a vast field of such manifestations of conatus that awaits philosophical exploration, especially in the realms of Social Ontology and of the Philosophy of Nature.
Competencias profesionales adquiridas en opinión de una muestra de estudiantes universitarios mediante el método de Aprendizaje Orientado a Proyectos (AOP).
Authors: Gómez Torres María José
Published: December 2021

: El presente estudio tiene como objetivo validar un cuestionario diseñado para conocer las competencias que, según una muestra de estudiantes universitarios en su último año de carrera, han alcanzado mediante el método Aprendizaje Orientado a Proyectos (AOP). Los resultados obtenidos posibilitan, además, establecer el impacto que, en opinión de la muestra, ha tenido el método AOP en el desarrollo de tres modalidades de competencias genéricas: instrumentales, interpersonales y sistémicas. El enfoque metodológico utilizado de carácter empírico-analítico responde a las metas del paradigma cuantitativo: producción de conocimiento, instrumentación y aplicación práctica. Los datos obtenidos han sido analizados mediante un programa informático cuyos resultados permiten comprobar la fiabilidad y validez del instrumento diseñado, así como, conocer las principales competencias genéricas adquiridas y determinar el efecto que el método AOP ha tenido en la obtención de estas entre el estudiantado que cursa su último año de grado universitario. Las competencias que, en opinión de las personas encuestadas, se fomentan especialmente mediante la utilización de la metodología AOP se encuentran: el pensamiento colegiado, el pensamiento creativo, del trabajo en equipo, la gestión por objetivos y la comunicación interpersonal. En menor medida se valoran, por el contrario, las competencias instrumentales referidas al uso de TIC como medio de expresión y comunicación y al manejo de lenguas extranjeras, así como la adquisición de sentido ético.
Forma en que se puede disponer el viaje del Perú, toca también a algo de gobierno y hase de ver algunas veces
Authors: Riopedre Ferreira Lucía
Published: December 2021

Relación de bienes que deben llevarse para realizar el viaje al Perú y motivos por los que se mencionan. Se incluyen consejos sobre el gobierno.
Empirische Studien und didaktische Implikationen der modernen Fremdsprachenforschung: am Beispiel des Deutschen
Authors: Kołsut Sławomira , Gębal Przemysław
Published: December 2021

Mehrsprachigkeit und Multikulturalität in Europa sind Tatsachen, denen die moderne Sprachforschung Rechnung tragen muss. Auch der Fremdsprachenunterricht sollte die soziokulturellen Veränderungen wahrnehmen und ihnen begegnen. Zu den Trends, die die zeitgenössische Sprachforschung kennzeichnen, gehören: der Fokus auf die Kompetenzorientierung, die zunehmend über das Wissen dominiert, der Fokus auf die Pragmatik der Sprache, die Interdisziplinarität der Forschung und der Einsatz von mobilen Geräten sowohl in der Kommunikation als auch im Prozess des Sprachlehrens und -lernens. Alle diese Richtungen sind in den in diesem Band vorgestellten Reflexionen und Studien präsent.
Angewandte Interdisziplinarität: Stärkung der Berufsorientierung im Informatikstudium mittels handlungsorientierter Lehrmethoden der Fremdsprachendidaktik
Authors: Ilse Viktoria
Published: December 2021

APPLIED INTERDISCIPLINARITY: STRENGTHENING CAREER ORIENTATION IN COMPUTER SCIENCE STUDIES BY APPLYING THE ACTION-ORIENTED TEACHING METHODS OF FOREIGN LANGUAGE DIDACTICS Can teaching methods be simply adapted in an interdisciplinary context? Does a teaching method from foreign language didactics work also in teaching during the first semester of computer science? If so, how can this process look and work in practice? These questions are addressed in this article.
Über 40 Jahre Deutscholympiade in Polen: ein interdisziplinärer Wettbewerb
Authors: Moskała Paweł
Published: December 2021

OVER 40 YEARS OF THE POLISH CONTEST DEDICATED TO THE GERMAN LANGUAGE AND CULTURE: THE INTERDISCIPLINARY COMPETITION The aim of the presented article is to analyse the structure of the contest dedicated to the German language and culture, taking into special account language competences and knowledge of the subject, which are required from students on each stage of the competition. The characteristics of individual tasks concerning the language competences studied within them can contribute to more effective work of teachers with students, and simultaneously increase their chances in the contest.
Recognising, assessing and managing chest pain
Authors: Maria Sonja J , Micalos Peter S , Ahern Lauren
Published: December 2021

Chest pain is a common medical symptom that paramedics attend to in the out-of-hospital environment. The causes of chest pain and the signs and symptoms are explained in this article, alongside tools that could be useful in diagnosis, such as clinical risk scores and troponin testing. Finally, pain management strategies that use a balanced approach for optimal patient care are referred to, with some specificity for cardiac chest pain explained.
Intravenous ketamine as an analgesia in prehospital adult trauma patients
Authors: Critchley Anya
Published: December 2021

Background:

Prehospital traumatic pain is common, but the quality of pain management in these patients is poor. Current practice recommends morphine as the first-line analgesia in major trauma but this carries high risks and is often contraindicated. Alternative paramedic-administered analgesia does not provide adequate pain relief or may be contraindicated. As a result, many patients remain in pain. Analgesic ketamine is used safely and effectively in international civilian and military settings and by paramedics with additional training, education and qualifications.

Aim:

The study had two aims. Namely, these were to find out whether intravenous ketamine: provides effective relief of prehospital traumatic pain in adults; and is safe for prehospital administration by non-specialist paramedics.

Method:

Three databases, CINAHL, MEDLINE and AMED, were searched to identify articles published between 2009 and 2021. Exclusion criteria were applied and results subjected to critical appraisal and evaluation.

Findings:

Four studies were included in the review. Two themes were identified for thematic analysis: therapeutic effectiveness; and the safety of IV ketamine administration by paramedics. The evidence drew predominantly homogenous conclusions, but was substandard regarding external validity, which limited the quality of these conclusions.

Conclusion:

Ketamine provides effective pain relief in line with morphine and is safe for paramedics to administer. However, clear gaps in the evidence mean the research questions are not fully answered, so changes to current paramedic practice cannot be recommended.
Taking meaningful steps
Authors: Costello Barry
Published: December 2021

‘Five hundred twenty five thousand six hundred minutes, how do you measure a year in the life?’ - Seasons of Love, Jonathan Larson