bluuebunny/crossref_metadata_2025 huggingface dataset:
Hybrid nanocomposites—An efficient representative volume element formulation with interface properties
Authors: Vattathurvalappil Suhail Hyder , Haq Mahmoodul , Kundurthi Saratchandra
Published: March 2022

Reinforcement of polymers with multiple inclusions of varying length scales and morphologies enable enhancement and tailorability of thermo-mechanical properties in resulting polymers. Computational material models can eliminate the trial-and-error approach of developing these hybrid reinforced polymers, enable prediction of interphase properties, and allow virtual exploration of design space. In this work, computational models, specifically representative volume elements were developed for acrylonitrile butadiene styrene polymer reinforced with nanoscale iron oxide particles and micro-scale short carbon fibers. These representative volume elements were used to predict the tensile modulus of resulting polymer nanocomposite with varying particle concentrations, orientations, interphases, and clustering to realistically replicate the actual material as observed in optical and electron microscopy. The interphase elastic modulus was obtained through established analytical formulations and incorporated into the representative volume elements by defining an interphase region around the reinforcements. The tensile modulus estimated using representative volume elements agreed well with the experiments, evidently showing that the effective tensile modulus of the polymer nanocomposite increased with increase in interphase thickness, aspect ratio, and particle content. Clustering was only observed in Fe3O4 nanoparticles but its size did not have any effect on the effective tensile modulus. The developed computational modeling framework and the resultant prediction of tensile modulus offers a design path which can be extended to other polymer nanocomposites containing multiple inclusions.
Sectoral Compositions of Output and Employment in India: Are We Moving Towards Jobless, Job-loss or Job-enabled Growth?
Authors: Das Ramesh Chandra
Published: March 2022

Indian economy, after maintaining a very low growth rate in the pre-reform phase, experienced high growth rate of its income in the post-reform phase. But the sparking growth rates in India after the onset of the liberalisation policy has questioned its sustainability in terms of sufficient employment generations. The present study aims to find out whether the aggregate economy and the sectors within it are moving towards jobless, job-loss or job-enabled growth for the period 1973–2018. The study thus calculated the output elasticity of employment in total period and phase-wise periods, and obtained that the values of the output elasticity of employment show no sign of sparking employment growth like that of the income. The average values of the elasticity of employment lie mostly less than half which signify the emergence of jobless growth. In some years, there are job-loss growths as well, mainly in industrial sector. Hence, it can be inferred that the Indian economy is not going in the right directions so far as employment opportunity is concerned; putting a big question on attaining the sustainable developmental goal.

JEL Classification: J21, J64, O10
Austerity in the United Kingdom and its legacy: Lessons from the COVID-19 pandemic
Authors: Arrieta Tania
Published: March 2022

The COVID-19 pandemic revealed that public institutions and some households in the United Kingdom (UK) were in a vulnerable and weak financial position to mitigate its immediate outcomes. Public institutions did not have the necessary resources to support their communities and low-income groups were disproportionally affected by the economic contraction of 2020–2021. This paper explores how the disastrous consequences of the pandemic were exacerbated by the implementation of an austerity programme, that as an extension of a neoliberal ideology, supported the development of the market at the expense of reducing the welfare state. Through an assessment of four trends that were reinforced during austerity—the four ‘Ds’—this article shows that austerity influenced many of the struggles observed during the pandemic. These trends are disinvestment, decentralisation, decollectivisation and disintegration. Despite the lessons learnt in 2020–2021 and the evident need to move away from a neoliberal agenda that dismantled the capacities of the state, this article concludes that neoliberalism continues to threaten the welfare state and the formation of social collectivities. Some expenditure decisions taken by the British government in 2020–2021 could further deepen social class divisions and regional inequalities. More is needed from the government to tackle these social problems and to build a fairer and more equal society.
Evaluating a peer-led wellbeing programme for doctors-in-training during the COVID-19 pandemic in Victoria, Australia, using the Most Significant Change technique
Authors: Crinall Karen , Ward Madeleine , McDonald Rebecca , Crinall William , Aridas James , Rolnik Daniel L
Published: March 2022

This article discusses the use of the Most Significant Change (MSC) technique in a mixed-methods evaluation of a pilot wellbeing programme for obstetrics and gynaecology doctors-in-training introduced at a large public hospital during Melbourne, Australia’s second coronavirus (COVID-19) lockdown, which occurred from 7 July to 26 October 2020. The evaluation was conducted remotely using videoconferencing technology, to conform with pandemic restrictions. MSC complemented the program’s participatory principles and was chosen because it seeks to learn about participants’ perceptions of programme impacts by evaluating their stories of significant change. Stakeholders select one story exemplifying the most significant change resulting from the evaluated program. Inductive thematic analysis of all stories is combined with reasons for making the selection, to inform learnings ( Dart & Davies, 2003 ; Tonkin et al., 2021 ). Nine stories of change were included in the selection. The most significant change was a more supportive workplace culture brought about by enabling basic needs to be met and breaking down hierarchical barriers. This was linked to five interconnected themes – connection, caring, communication, confidence and cooperation. The evaluation learnings are explored and reflections on remotely conducting MSC evaluation are shared.
How Wide is the Arc of Racial Solidarity? People of Color and Middle Easterners and North Africans
Authors: Eidgahy Kaumron , Pérez Efrén O.
Published: March 2022

Emerging work suggests that Blacks, Asians, and Latinos sometimes share a strong sense of solidarity as people of color (PoC), which unifies their political opinions on issues that strongly implicate some of these racial groups (e.g., Black Lives Matter). Yet much uncertainty remains about whether other non-White groups, beyond these traditional three, are compelled to engage in politics as PoC via this same mechanism. We investigate this with two studies focused on Middle Eastern and North African (MENA) individuals: a minoritized group with deep U.S. roots, but sparse theoretical and empirical attention in political science. Study 1 draws on in-depth interviews with MENA adults ( N=20), who suggest that, insofar as they sense solidarity with other people of color, it is because they feel racially marginalized as foreigners. Study 2 builds on this insight with a pre-registered experiment on MENA adults ( N=514), which randomly assigned them to read an article about Latinos, who are also marginalized as foreign (vs. control article). We find that exposure to treatment reliably heightens MENAs’ expression of solidarity with other PoC, which then significantly boosts support for flexible policies toward undocumented immigrants (which implicate Latinos, but not MENAs) and reduces belief in negative stereotypes of Latinos.
A Systematic Review and Meta-analysis of Randomized Controlled Trials of Stabilizing Exercises for Lumbopelvic Region Impact in Postpartum Women With Low Back and Pelvic Pain
Authors: Moheboleslam Zohreh , Mohammad Rahimi Nasser , Aminzadeh Reza
Published: March 2022

Background

Countless women experience lumbopelvic pain (LBPP) after pregnancy. Physical activity is revealed as a beneficial procedure to alleviate LBPP, yet it appears that individual investigations report mixed conclusions about its effectiveness. Objective: This systematic review and meta-analysis examined the impact of stabilizing exercises on pain intensity, disability, and quality of life (QoL) in postpartum women. Data sources: A systematic search was conducted in PubMed, MEDLINE, Google Scholar, Scopus, and reference lists of included studies up to September, 2021. Study selection: Eleven studies comprising 623 participants were included and analyzed using a random-effects model. Results: Data displayed that stabilizing exercises significantly reduced pain (standard mean difference; SMD: −0.76, 95% confidence interval (CI): −1.26 to −0.27, p = .002), and disability (SMD: −1.19, 95% CI: −1.7 to −0.68, p < .001). However, our study found no significant change in QoL following stabilizing exercises (MD: 4.42, 95% CI: −5.73, 14.57, p = .39). Conclusion: Our systematic review and meta-analysis demonstrated that stabilizing interventions had some benefits in postpartum women. While there is some evidence to display the efficacy of stabilizing exercises for relieving LBPP, additional longer-term and high-quality studies are required to confirm the current findings.
Challenges with tunneled dialysis catheter placement with subcutaneous emphysema
Authors: George Michael , Lane James , Vachharajani Tushar J.
Published: March 2022

Central vein catheter is a convenient and preferred vascular access for blood purification therapy in intensive care unit. Utilizing ultrasound to access the central vein is considered standard of care. However, critically ill patients can pose challenges while acquiring an optimal ultrasound image. The presence of subcutaneous air pockets, concerns for air embolism, and excessive bleeding from the exit site is one such clinical situation. We describe our experience with a unique situation while placing a tunneled dialysis catheter in a COVID-19 patient with acute respiratory failure and subcutaneous emphysema.
Intractable arteriovenous access-related pain relieved after a single, pain-free hemodialysis session under selective block of the sensory nerves in the upper limb: A psychosocial factorial case
Authors: Matsuda Hiroaki , Oka Yoshinari , Takeuchi Hidemi , Fujii Hiromi , Takatsu Shigeko , Miyazaki Masashi
Published: March 2022

Intractable arteriovenous access (AVA)-related pain can not only lead to abandonment of a well-functioning AVA, but can also cause hemodialysis (HD) patients to be unwilling to accept, interrupt, or withdraw from HD. Such pain primarily derives from nociceptive and neuropathic factors caused by mechanical stimulation of needle cannulation; however, this might be related to psychosocial factors making it difficult for patients to accept their dependency on HD. Furthermore, the pain can be complicated by the interaction of biological and psychosocial factors, which hampers appropriate pain management and treatment. However, there have been few investigations pertaining to this matter. Herein, we describe the case of an HD patient who experienced chronic refractory AVA-related pain during a 32-month period of HD sessions, which occasionally caused treatment interruption. After clinical inquiry, physical evaluation, and ultrasonographic assessment of the blood circulation and cutaneous nerves in the ipsilateral upper limb to the radiocephalic arteriovenous fistula in the anatomical snuffbox, we diagnosed the patient with primarily psychosocially driven pain in consultation with an experienced pain clinician. A single, pain-free HD session under ultrasound-guided sensory nerve blocks in the upper limb markedly relieved her pain, followed by HD sessions with subtle but acceptable pain. This report provides insights into the mechanism underlying the vicious cycle of AVA-related pain, including the psychosocial aspects that might trigger such pain, as well as into the importance of treating such pain to improve the patient’s quality of life, and underscores the need for cooperation of experts engaged in HD and pain management.
Travel and tourism competitiveness index and the tourism sector development
Authors: Uyar Ali , Kuzey Cemil , Koseoglu Mehmet Ali , Karaman Abdullah S
Published: March 2022

The objective of this study is to test whether Travel and Tourism Competitiveness Index (TTCI) enhances tourism sector development in terms of tourist arrivals, tourism receipts, and the change in both tourist arrivals and tourism receipts. The results found that TTCI main index (Level 1) is positively associated with tourist arrivals but not tourism receipts and the change in tourist arrivals and tourism receipts. Further analysis (Level 2) reveals that while the T&T policy and enabling conditions index is positively associated with tourist arrivals, the infrastructure index is positively associated with tourism receipts. None of the Level 2 indices drives the change in tourist arrivals and tourism receipts. Among results obtained from Level 3 sub-indices, while price competitiveness, air transportation infrastructure, and cultural resources indices have a positive association with tourist arrivals, only ground and port infrastructure have a positive association with tourism receipts. Moreover, while safety and security, human resources and labor market, and air transportation infrastructure sub-indices drive a positive change in tourist arrivals, ICT readiness and natural resources drive a negative change in tourist arrivals and none of the sub-indices drives a change in tourism receipts. The study suggests several practical implications for tourism firms and policymakers.
Learning with YouTube: Beyond formal and informal through new actors, strategies and affordances
Authors: Pires Fernanda , Masanet Maria-Jose , Tomasena José Miguel , Scolari Carlos A
Published: March 2022

This article focuses on the results from interviews and workshops on teens’ YouTube consumption and use as part of the Transmedia Literacy research project on teens and transmedia collaborative practices carried out in eight countries from Europe, South America and Australia. The project had two main objectives: to detect what teens are doing with media and to determine how they learn to do it. During the fieldwork, YouTube was identified as one of the platforms that teens use most for learning purposes. Therefore, this article maps teenagers’ main YouTube learning topics and motivations for using the platform. We studied the video formats that teens use and the way they use them to learn a wide variety of topics. Three main areas of interest were identified: formal school curriculum, video games and technology and wellness and culture. In all three areas, teens apply the apprenticeship model of learning as they follow YouTube instructors (teachers, experts and peers) to learn about these areas. Teens highlight different YouTube affordances that motivate them to use the platform, including using it as a search engine to find specific information, using the number of views or subscribers to validate the quality of the content, being able to control the video to learn at their own pace and using it as a repository and archive to find information. Teens use YouTube both to complement their formal school curriculum and to explore their own interests. Therefore, YouTube becomes an important learning space for adolescents to learn in a continuum. This means that it is a space that blurs the boundaries between classic oppositions like formal/informal learning due to how teens use it.
There is no cure: Paratexts as remediations of agency in Red Dead Redemption 2
Authors: Ruffino Paolo
Published: March 2022

Towards the end of Rockstar Games’ Red Dead Redemption 2 (2018), the main character Arthur Morgan contracts tuberculosis. The videogame is set in the United States in 1899, a time when many died from the respiratory infection. The videogame does not provide a cure for the disease, nor does it show when the contagion happens. It is presented as the consequence of an invisible action. Combining auto-ethnographic analysis with (para-)textual readings, in this article, I articulate my engagement with the game and with YouTube videos in which players claim to have identified a strategy to save Arthur. I argue that these paratextual practices address, without fully resolving, an affective response that originates from an unresolved reading of the videogame ( Consalvo, 2016 ; Genette, 1987 ). The videos on Arthur’s sickness remediate (in the double sense of restoring upon and healing) players’ agency ( Bolter and Grusin, 1999 ). I argue that this imagination of a restoration of the player’s agency insists on two levels: a narrative level, interpreted as a navigable database of events, and on the environment, seen as a ‘gamespace’ of resources and non-player characters to exploit or keep at distance ( Jennings, 2019 ; Stang, 2019 ; Anikina, 2020 ; Wark 2007 ). The duration of the auto-ethnography overlaps with the spread of the COVID-19 pandemic. The article concludes by exploring some recent mediations of the virus, observing how they restore a view of human agency that runs parallel to that which players of Red Dead Redemption 2 have articulated in a much more marginal context. The case studies, although diverse in nature, gravity and scale, shed light on the variety of contexts in which agency is negotiated, on the affective potential of these negotiations, and on the pervasiveness of white and able-bodied normativity in contemporary digital culture.
The affective economy and fast fashion: Materiality, embodied learning and developing a sensibility for sustainable clothing
Authors: Willett Joanie , Saunders Clare , Hackney Fiona , Hill Katie
Published: March 2022

Many commentators recognise the need to make clothing more sustainable due to its deleterious environmental and social ramifications. However, it is challenging to change the consumer behaviour that drives fast fashion markets because people have complex relationships with clothing. In this study, we illustrate how the relationships that people have with clothing can be shaped by workshops that immerse them in making, mending, and modifying garments. Such experiential learning can encourage adoption of more sustainable clothing choices, such as reducing consumption of new garments and prolonging the life of already owned items of clothing. We present findings on a strand of work from the Arts and Humanities Research Council funded S4S: Designing a Sensibility for Sustainable Clothing project, which explored the affective economy around clothing, and considered how emotive affects around garments operate as a conduit to self-sustain particular practices. Our significant contribution brings political analysis firmly into the debate about sustainable clothing by merging literatures on behaviour change and affect, through exploration of a novel longitudinal (9-months) qualitative data set. At the start of the project, participants generally thought of clothes as being low-cost (and therefore disposable) items. The workshops, in contrast, presented garments and the materials from which they are made as precious, complex and fluid – in a process of continual possibility. For pro-environmental behavioural change, we find that immersion in the materiality of clothing mobilised affective processes, enabling potentially transformative affective encounters. Further, we found that group learning environments need to do more than simply teach approved normative values and behaviours. Pro-environmental behaviour change initiatives need to provide people with the space to create and situate their own knowledges, enabling affect to be mobilised, activated and supported by appropriate cultural milieu.
Truths, fakes and the deserving queer migrant
Authors: Abbey Matthew
Published: March 2022

This article explores the role of truth within queer migration. By analysing a host of cultural production – including the verbatim theatre performance Rights of Passage by Claire Summerskill, the short film Crypsis by Christopher McGill, the ethnofictional film Samira by Nicola Mai, and the film The Amazing Truth About Queen Raquela by Olaf de Fleur Johannesson – I will challenge the necessity of attempting to discover the truth of queer migrants as sexual and gendered subjects, particularly as related to asylum claims. Yet if questions are raised about the importance of truth, this also demands analysing the role of faking sexuality and gender, and ‘fake’ queer migrants more broadly, referring to those who allegedly fabricate their sexuality and gender to claim asylum. Instead of suggesting faking implies the possibility of undeservingness, I use faking as a theoretical tool to understand the demands of truth, and how faking may become means to subvert the grounds of who is considered a deserving queer migrant seeking asylum. By disrupting the binary between truths and fakes, the very notion of there being truths of queer migrants (and the subject more broadly) will be questioned.
Collective empiricism and the material witness
Authors: Barry Andrew
Published: March 2022

This article develops two arguments. One follows from the idea that materials can be made into witnesses to environmental violence by drawing together the evidence generated from multiple sensors. In this way, the practice of Forensic Architecture entails a commitment to a distinctive form of collective empiricism that leads to the generation of ‘informed materials’. The second theme of the article follows from Forensic Architecture’s claim that the microphysical investigation of specific incidents can be a starting point in reconstructing larger political and environmental processes. In light of this claim, the author interrogates the relation between the evidence generated by material witnesses and the political situations to which this evidence contributes. His contention is that qualitative forms of social and historical research are required that both complement and go beyond the limits of Forensic Architecture’s commitment to collective empiricism.
Assessing Bone Marrow Activity with [18F]FLT PET in Patients with Essential Thrombocythemia and Prefibrotic Myelofibrosis: A Proof of Concept
Authors: Yassin Mohamed A. , Nehmeh Sadek A. , Nashwan Abdulqadir J. , Kohla Samah A. , Mohamed Shehab F. , Ismail Omar M. , Al Sabbagh Ahmad , Soliman Dina S. , Szabados Lajos , Fayad Hadi
Published: March 2022

Objectives: This study aims to assess the value of FLT-PET as a non-invasive tool to differentiate between patients with ET and Pre-PMF. This study is a pilot study to have a proof of concept only. Methods: This is a prospective, interventional study where a total of 12 patients were included. Each patient underwent FLT PET imaging as well as bone marrow examination (gold standard). In addition, semi-quantitative (SUVmax and SUVmean) measurements of FLT uptake in the liver, spleen, and Lspine, SUVmean, as well as the Total Lesion Glycolysis (TLG) of the Lspine were performed. Results from the two patient cohorts were compared using = Kruskal-Wallis statistical test. A P-value of <.05 is considered to be statistically significant. Results: The differences in FLT SUVmax and SUVmean measurements in the three organs (liver, spleen, and LSpine) between the ET and Pre-PMF patients were not statistically significant ( P > .05). In contrast, TLG measurements in the LSpine were statistically different ( P = .013), and therefore, compared to gold standard bone marrow results, TLG can separate ET and Pre-PMF patients. Conclusion: This study is a proof of concept about the potential to discriminate between ET and pre-PMF patients in a non-invasive way. TLG of the LSpine in FLT PET images is a potential quantitative parameter to distinguish between ET and pre-PMF patients.
Treatment Strategies and Prognostic Factors of 2018 FIGO Stage IIIC Cervical Cancer: A Review
Authors: Qin Fengying , Pang Huiting , Yu Tao , Luo Yahong , Dong Yue
Published: March 2022

Cervical cancer is the fourth most common malignant tumor globally in terms of morbidity and mortality. The presence of lymph node metastasis (LNM) is an independent prognostic factor for progression-free survival (PFS) and overall survival (OS) in cervical cancer patients. The International Federation of Gynecology and Obstetrics (FIGO) staging system was revised in 2018. An important revision designates patients with regional LNM as stage IIIC, pelvic LNM only as stage IIIC1, and para-aortic LNM as stage IIIC2. However, the current staging system is only based on the anatomical location of metastatic lymph nodes (LNs). It does not consider other LN status parameters, which may limit its prognostic significance to a certain extent and needs further exploration and confirmation in the future. The purpose of this review is to summarize the choice of treatment for stage IIIC cervical cancer and the effect of different LN status parameters on prognosis.
Breast Cancer Classification on Multiparametric MRI – Increased Performance of Boosting Ensemble Methods
Authors: Vamvakas Alexandros , Tsivaka Dimitra , Logothetis Andreas , Vassiou Katerina , Tsougos Ioannis
Published: March 2022

Introduction: This study aims to assess the utility of Boosting ensemble classification methods for increasing the diagnostic performance of multiparametric Magnetic Resonance Imaging (mpMRI) radiomic models, in differentiating benign and malignant breast lesions. Methods: The dataset includes mpMR images of 140 female patients with mass-like breast lesions (70 benign and 70 malignant), consisting of Dynamic Contrast Enhanced (DCE) and T2-weighted sequences, and the Apparent Diffusion Coefficient (ADC) calculated from the Diffusion Weighted Imaging (DWI) sequence. Tumor masks were manually defined in all consecutive slices of the respective MRI volumes and 3D radiomic features were extracted with the Pyradiomics package. Feature dimensionality reduction was based on statistical tests and the Boruta wrapper. Hierarchical Clustering on Spearman's rank correlation coefficients between features and Random Forest classification for obtaining feature importance, were implemented for selecting the final feature subset. Adaptive Boosting (AdaBoost), Gradient Boosting (GB), Extreme Gradient Boosting (XGBoost) and Light Gradient Boosting Machine (LightGBM) classifiers, were trained and tested with bootstrap validation in differentiating breast lesions. A Support Vector Machine (SVM) classifier was also exploited for comparison. The Receiver Operator Characteristic (ROC) curves and DeLong's test were utilized to evaluate the classification performances. Results: The final feature subset consisted of 5 features derived from the lesion shape and the first order histogram of DCE and ADC images volumes. XGboost and LGBM achieved statistically significantly higher average classification performances [AUC = 0.95 and 0.94 respectively], followed by Adaboost [AUC = 0.90], GB [AUC = 0.89] and SVM [AUC = 0.88]. Conclusion: Overall, the integration of Ensemble Learning methods within mpMRI radiomic analysis can improve the performance of computer-assisted diagnosis of breast cancer lesions.
Navigating Through the Narrative Montages: Including Voices of Older Adults With Dementia Through Collaborative Narrative Inquiry
Authors: Li Bingyu
Published: March 2022

Having the opportunity to express oneself is an important right to every human being. However, narratives of older adults with moderate to severe dementia are constantly ignored for their incoherence and inaccuracy. In most studies, their narratives were solely collected to measure their cognitive function, rendering their lived stories untold, unheard and undocumented. To include voices of older adults with moderate to severe dementia in research and liberate them from the patient identity, this article proposes collaborative narrative inquiry as a method to explore the meaning-making mechanisms and selfhood construction processes embedded in their incoherent narratives. Integrating narrative inquiry and collaborative analysis, collaborative narrative inquiry aims to collect, construct and deconstruct narratives of participants through an iterative and reflective way, in collaboration with caregivers. This method requires a paradigm shift from generating one essential truth of people’s lived experience to co-creating plural lived truths situated in different temporal, social and cultural backgrounds. Facilitating the proliferation of identities beyond the patient identity among older adults with moderate to severe dementia, collaborative narrative inquiry generates counter narratives against a single disease narrative. It de-marginalizes this group by inviting their voices back into the society, and destigmatises them by creating a new way to engage with them.
Re-thinking lactation-related nipple pain and damage
Authors: Douglas Pamela
Published: March 2022

Nipple pain is a common reason for premature cessation of breastfeeding. Despite the benefits of breastfeeding for both infant and mother, clinical support for problems such as maternal nipple pain remains a research frontier. Maternal pharmaceutical treatments, and infant surgery and bodywork interventions are commonly recommended for lactation-related nipple pain without evidence of benefit. The pain is frequently attributed to mammary dysbiosis, candidiasis, or infant anatomic anomaly (including to diagnoses of posterior or upper lip-tie, high palate, retrognathia, or subtle cranial nerve abnormalities). Although clinical protocols universally state that improved fit and hold is the mainstay of treatment of nipple pain and wounds, the biomechanical parameters of pain-free fit and hold remain an omitted variable bias in almost all clinical breastfeeding research. This article reviews the research literature concerning aetiology, classification, prevention, and management of lactation-related nipple–areolar complex (NAC) pain and damage. Evolutionary and complex systems perspectives are applied to develop a narrative synthesis of the heterogeneous and interdisciplinary evidence elucidating nipple pain in breastfeeding women. Lactation-related nipple pain is most commonly a symptom of inflammation due to repetitive application of excessive mechanical stretching and deformational forces to nipple epidermis, dermis and stroma during milk removal. Keratinocytes lock together when mechanical forces exceed desmosome yield points, but if mechanical loads continue to increase, desmosomes may rupture, resulting in inflammation and epithelial fracture. Mechanical stretching and deformation forces may cause stromal micro-haemorrhage and inflammation. Although the environment of the skin of the nipple–areolar complex is uniquely conducive to wound healing, it is also uniquely exposed to environmental risks. The two key factors that both prevent and treat nipple pain and inflammation are, first, elimination of conflicting vectors of force during suckling or mechanical milk removal, and second, elimination of overhydration of the epithelium which risks moisture-associated skin damage. There is urgent need for evaluation of evidence-based interventions for the elimination of conflicting intra-oral vectors of force during suckling.
Understanding the sleep of ultra-marathon swimmers: Guidance for coaches and swimmers
Authors: Dunican Ian C , Perry Emma L , Gemma Maisey , Nesci Elena , Roberts Spencer
Published: March 2022

Open water swimming ultra-marathon events ≥10 km have become increasingly popular amongst master athletes. However, very little is known about the timing of training sessions and the impact on sleep. This study aimed to examine sleep behaviours, sleep problems and disorders and the relationship with training timings.

This study used a longitudinal observational design for 42 nights with 24 masters' swimmers (n = 13 females), aged 39 ± 11 years, body mass index of 26 ± 3 kg/m2 during a training squad for an ocean ultra-swim (19.7 km) in Western Australia. Objective measures of sleep were obtained from a wrist-activity monitor, the Readiband™ (Fatigue Science Inc., Canada). Swimmers completed a survey instrument related to sleep problems, disorders, chronotype, anthropometric and demographic information. Generalised linear mixed models were fitted to examine relationships between predictor variables and sleep responses.

Body mass index was associated with a decline in Total Sleep Time (TST), each one-unit increase in BMI was associated with 5 min less TST (p = 0.04). Swimmers with a “high risk” of sleep apnea had 21 min more wake time (p = 0.04) and 5% lower Sleep Efficiency (p = 0.04). Sleep Offset on the morning of a morning training session was earlier by 48 min (p < 0.001) resulting in less TST by 39 min (p < 0.001).

This study provides evidence that coaches need to consider sleep behaviours and problems before designing training schedules. Swimmers need to plan and allocate an adequate sleep opportunity and those who have a suspected sleep disorder or problem should seek the support of a sleep physician.
Reliability assessment of PEEK/17-4PH stainless steel tribopair under seawater lubrication
Authors: Nie Songlin , Song Yixuan , Ma Zhonghai , Yin Fanglong , Ji Hui
Published: March 2022

The high reliability and extended life of seawater hydraulic components depends on the tribological properties of the key tribopairs. The main reason that restricts their life is the wear of the tribopairs in relative motion. Therefore, the performance degradation of the tribopair should be investigated. Due to the limitation of the test sample size and test time, a large number of tests cannot be performed in a short period of time. Therefore, with the development of the sensor and monitoring technologies, the Accelerated Degradation Testing (ADT) has become an accelerated test method that can efficiently select and analyze the reliability of tribopairs. In this paper, the friction and wear characteristics of polyether ether ketone (PEEK)/17-4PH stainless steel are investigated, and the acceleration stress related to its performance is analyzed. Taking into account the random characteristics of the degradation process, an ADT model based on the Wiener stochastic process is constructed, while using the MLE solver. Finally, the model is estimated and verified using PEEK/17-4PH stainless steel experimental data. The results show that the proposed model helps the reliable assessment and further research of tribopair material.
Psoriatic arthritis: prospects for the future
Authors: Hackett Simon , Ogdie Alexis , Coates Laura C.
Published: March 2022

Psoriatic arthritis (PsA) is a form of chronic inflammatory arthritis associated with psoriasis and a multitude of other symptoms, most commonly arthritis, dactylitis, enthesitis and axial involvement. PsA is significantly heterogeneous, with a highly variable clinical course of PsA. Patients may experience significant or mild skin and joint symptoms, with some patients developing rapidly progressing joint destruction and skin symptoms. Despite the range of symptom severity, PsA is frequently associated with significantly impaired quality of life from joint destruction, as well as chronic pain and a range of comorbidities such as depression and cardiovascular disease. Currently, there are no definitive diagnostic tests for PsA, with diagnosis remaining challenging owing to the heterogeneous presentation and course of the disease. Presently, the CASPAR criteria are often used to aid rheumatologists in distinguishing PsA from other inflammatory arthritides. Treatment options for patients have been expanded over the last two decades with the emerging clinical utility of biological therapies. However, early identification and diagnosis of patients and effective disease control remain unmet medical needs within the PsA community. In addition, predicting response to treatment also remains a challenge to rheumatologists. This review highlights the current hurdles faced by healthcare professionals in the diagnosis and management of PsA patients and provides future action points for consideration by the members of the multidisciplinary team who treat PsA patients.
A novel ensemble approach for heterogeneous data with active learning
Authors: Salama Mohamed , Abdelkader Hatem , Abdelwahab Amira
Published: March 2022

At present, millions of internet users are contributing a huge amount of data. This data is extremely heterogeneous, and so, it is hard to analyze and derive information from this data that is considered an indispensable source for decision-makers. Due to this massive growth, the classification of data and analysis has become an important research subject. Extracting information from this data has become a necessity. As a result, it was necessary to process these enormous volumes of data to uncover hidden information and therefore improve data analysis and, in turn, classification accuracy. In this paper, firstly, we focus on developing an ensemble machine-learning model based on active learning which identifies the most effective feature extraction strategy for heterogeneous data analysis, and compare it with traditional machine-learning algorithms. Secondly, we evaluate the proposed model during the experiments; five heterogeneous datasets from various domains were used, such as a Health Care Reform dataset, Sander Frandsen dataset, Financial Phrase Bank dataset, SMS Spam Collection dataset, and Textbook sales dataset. According to the results, the novel approach for data analysis performed better than conventional methods. Finally, the study’s findings confirmed the validity of the suggested technique, meeting the study’s goal of using ensemble methods with active learning to raise the model’s overall accuracy for effectively classifying and analyzing heterogeneous data, reducing the time and money spent training the model, and delivering superior analysis performance as well as insights into other elements of extracting information from heterogeneous data.
Effects of Gradient and Speed on Uphill Running Gait Variability
Authors: Padulo Johnny , Ayalon Moshe , Barbieri Fabio A. , Di Capua Roberto , Doria Christian , Ardigò Luca P. , Dello Iacono Antonio
Published: March 2022

Background:

The aim of this study was to investigate the effects of gradient and speed on running variability (RV) and local dynamic stability (LDS) during uphill running.

Hypotheses:

(1) Both gradient and speed increase metabolic effort, in terms of heart rate (HR) and perceived exertion (CR10), in line with the contemporary literature, and (2) gradient increases RV and impairs LDS.

Study design:

“Crossover” observational design.

Level of Evidence:

Level 3.

Methods:

A total of 25 runners completed 10-minute running trials in 3 different conditions and in a randomized order: gradient at 0% (0CON), 2% (2CON), and 2% at isoefficiency speed (2IES). 0CON and 2CON speeds were calculated as the “best 10-km race performance” minus 1 km·h−1, whereas 2IES speed was adjusted to induce the same metabolic expenditure as 0CON. HR and perceived exertion as well as running kinematic variables were collected across all trials and conditions. Running variability was calculated as the standard deviation of the mean stride-to-stride intervals over 100 strides, while LDS was expressed by the Lyapunov exponent (LyE) determined on running cycle time over different running conditions.

Results:

Increases in HR and CR10 were observed between 0CON and 2CON ( P < 0.001) and between 2IES and 2CON ( P < 0.01). Higher RV was found in 2CON compared with 0CON and 2IES (both P < 0.001). Finally, the largest LyE was observed in 2IES compared with 0CON and 2CON ( P = 0.02 and P = 0.01, respectively).

Conclusion:

Whereas RV seems to be dependent more on metabolic effort, LDS is affected by gradient to a greater extent.

Clinical Relevance:

Running variability could be used to monitor external training load in marathon runners.
Urban hen legislation: Exposing an unexpected public health problem
Authors: Martin Wanda , Wagner Lindsey , Marshall Kerry
Published: March 2022

Urban hen keeping is one means for local food production, allowing for control over the supply. Many Canadian cities allow urban hens, while others are opposed to this form of urban agriculture. The purpose of this research was to understand the controversy of urban hens to support communities facing challenging futures. We report on the qualitative portion of a stepwise mixed methods study of 15 urban residents. Data consisted of semi-structured interviews and thematic analysis derived from open coding and selective coding based on a system change conceptual framework. Three main discourse areas on the struggle with urban hen bylaws included education on urban agriculture, differing values and visions for city life, and tensions between individual rights and the collective good.
Changing paradigms of hemophilia care across larger specialized treatment centers in the European region
Authors: Windyga Jerzy , Boban Ana , Zupan Irena , O’Connell Niamh , Hermans Cedric
Published: March 2022

Introduction:

In early 2021, the European Collaborative Haemophilia Network (ECHN) conducted a survey to determine whether the paradigms of care across the European region have changed with the introduction of novel therapies for people with hemophilia.

Methods:

We conducted a survey in 19 ECHN centers from 17 countries in the European region. The aim was to track recent changes in the hemophilia treatment landscape, determine the impact of these changes on hemophilia treatment centers and comprehensive care centers in the region, and to look into the future of care as applied to people with hemophilia. The survey was structured to include three key areas: demographics and organization; current challenges and opportunities; and future directions.

Discussion:

Our survey provides a snapshot of the current approach to hemophilia treatment that highlights a move toward preventive, rather than reactive care, but that also raises a number of key concerns related to costs and accessibility (particularly as related to novel therapies), time limitations for clinical research, and ongoing issues regarding human resources (particularly in terms of new doctors entering the field) and availability of laboratory resources as the use of novel therapies (some with unique modes of action and unusual adverse events, some with specialized monitoring requirements) becomes commonplace.

Conclusion:

While our survey suggests that specialized care will continue to play a central role in the management of hemophilia, the standards and protocols, as well as the centers themselves, will have to continue to evolve if they are to continue to provide the highest level of care. To meet this requirement, there is a clear need for engaging, ongoing education programs for healthcare professionals working in the field of hemophilia that can be adjusted to the changing landscape of hemophilia therapy and monitoring.
From impact of RC flat slabs in a building to its progressive collapse
Authors: Yankelevsky David Z. , Karinski Yuri S , Tsemakh Dina , Feldgun Vladimir R.
Published: March 2022

This paper presents a realistic model for the simulation of a progressive collapse scenario in a typical low-rise building that is constructed from RC flat slabs and supported by columns. The progressive collapse scenario starts after failure of the top slab connections, where the slab is falling downward and impacts with the slab below. This impact event is analyzed, and the dynamic failure of the impacted slab’s connections starts the progressive collapse event. Two different scenarios are identified, depending on the first slab damage condition prior to impact. The first scenario refers to an undamaged impacting slab where an elastic collision occurs with the slab below; in the second scenario, the first slab is damaged, and its collision with the slab below is plastic. In the first scenario, the impacting slab velocity drops to zero while its velocity is fully imparted to the impacted slab. In the second scenario, both slabs continue their motion jointly at a common velocity. In the subsequent impacts, the impacting slabs are a-priori damaged, hence plastic collisions occur. These impact occurrences are analyzed separately, depending on the number of impacting slabs involved, damage characteristics, and impact velocity. Due to the nature of the first impact, the first scenario is characterized by separate motion of the first impacting slab which is falling behind the other slabs. This slab gains speed until it meets the other falling slabs below at a certain altitude, and an intermediate collision occurs, not necessarily at a floor level. In the analyzed five-story building, the intermediate impact occurs after the third impact event, where the slabs are located slightly above the first story level. The intermediate impact elevates the velocity of the impacted slabs such that their impact with the first level slab is more severe and its motion toward hitting the ground level is faster.
Epidemiology and causes of intestinal obstruction in Ethiopia: A systematic review
Authors: Fekadu Gelana , Tolera Abebe , Beyene Bayissa Badhaasaa , Merga Bedasa Taye , Edessa Dumessa , Lamessa Adugna
Published: March 2022

Objective:

This systematic review was aimed to address the prevalence and causes of intestinal obstruction in Ethiopia.

Methods:

Systematic searches were conducted on PubMed, EMBASE, CINAHL, Scopus, African Journals Online, HINARI, and other supplementary sources, including Google Scholar. We conducted methodological quality assessments for the articles by employing a critical appraisal checklist of Joanna Briggs Institute.

Results:

The reported prevalence of intestinal obstruction in Ethiopia ranges from 18.6% to 50.7% among patients with acute abdomen. However, the prevalence varies from 4.3% to 34.6% among total surgical admissions. The leading causes of small intestinal obstruction were small bowel volvulus, intussusception, and adhesion. Sigmoid volvulus was the most commonly reported cause of large intestine obstruction, followed by colonic cancer.

Conclusion:

The highest reported prevalence of intestinal obstruction in Ethiopia was 50.7% among patients with acute abdomen and 34.6% among surgical admissions. Small intestine volvulus and sigmoid volvulus were the common causes of small and large bowel obstructions, respectively. Therefore, clinicians have to consider the common causes during the diagnosis and management of intestinal obstruction.