Obstetric violence is a structural form of gender, medical, and sexual violence perpetrated by health providers and institutions during pregnancy, birth, and postpartum. It can produce physical, psychological, and symbolic harm to pregnant/birthing people and their families. Obstetric violence results from structural conditions in the technocratic model of birth and the acceptance of biomedicine as the authoritative knowledge in health care. This phenomenon produces patients’ loss of autonomy and capacity to provide informed consent, which increases their vulnerability to unjustified medical procedures, resulting in negative birth experiences. In this paper, I argue that individual autonomy is necessary but not sufficient for legitimately consenting to obstetric care and preventing violence. The liberal framework of individual autonomy often ignores that childbirth is a social event where multiple individuals and cultural factors influence the consent process. Consequently, I discuss the role of relational autonomy in obstetric decision-making and describe some structural barriers that negatively intervene in this process. Finally, I propose that doulas and midwives can help nurture autonomy and caregiving skills in obstetric patients and health providers. This strategy protects the informed consent process, prevents obstetric violence, and can be effective in recentering childbirth in pregnant people and their families.

The so-called Flyvbjerg database is the largest source of data on the performance of major investment projects. It has generated influential analyses of the magnitude of and reasons for cost overruns and demand shortfalls in major projects. Those analyses have demonstrated, among other things, the systematic presence of large forecast errors in both construction costs and in user demand in the first year of operation. They have also linked those results to the social welfare consequences of the underlying projects, suggesting that the large and systematic forecast errors are indicative of welfare destruction. Given how influential those analyses have been, this paper examines the link between the database, empirical analyses thereof, and social benefit–cost analysis (BCA). To that end, both the measurement of variables in the database and the estimation of forecast errors are contrasted against BCA. The conditions for the estimated forecast errors to approximate those obtained from a BCA are spelled out, and the scope for drawing welfare conclusions based on those estimates is discussed. Furthermore, numerical simulations are presented to explore whether the estimated forecast errors do indeed imply likely welfare destruction. The simulations suggest that as large as the forecast errors are, welfare destruction is no foregone conclusion.

This study investigates the influence of perceived organizational support (POS) on employees’ intentions to recommend their employer or leave the organization. Based on social exchange theory, it explores how POS affects employee well-being and shapes behaviors such as loyalty and advocacy. An online survey gathered data from 604 French employees across various sectors, analyzing variables like POS, positive and negative well-being, and intentions to leave or recommend the employer. Structural equation modeling was used to examine the relationships among these variables and to test the mediating role of well-being. Results show that POS positively influences employee well-being. High POS is associated with improved positive well-being, which decreases the intention to leave and increases the intention to recommend. Similarly, reduced negative well-being linked to high POS lowers the desire to leave and lessens negative effects on recommendation intentions. The study confirms the mediating role of well-being between POS and employee intentions. The study provides new insights into the impact of POS on employee intentions by highlighting the pathways of positive and negative well-being. For human resource practices, strengthening POS is essential to boost employee retention and encourage positive behaviors, thereby enhancing the organization’s reputation and attractiveness.

Across the world, political parties are incorporating social movement strategies and frames. In this study, we pivot from the dominant focus on party characteristics to analyze drivers of support for movement parties in six European countries. We report results from a choice-based conjoint survey experiment showing that contrary to previous research, movement party voters favor neither candidates who are institutional outsiders nor those who actively participate in protests. Candidate policy positions are the most important driver of the vote for movement parties. Movement party voters, additionally, prefer candidates who either display anti-elitist sentiments or who want to ensure the smooth running of the current political system. These insights invite renewed attention to movement parties as an electoral vehicle whose voters prioritize decisive policy change.

The AIMTB rapid test assay is an emerging test, which adopted a fluorescence immunochromatographic assay to measure interferon-γ (IFN-γ) production following stimulation of effector memory T cells in whole blood by mycobacterial proteins. The aim of this article was to explore the ability of AIMTB rapid test assay in detecting Mycobacterium tuberculosis (MTB) infection compared with the widely applied QuantiFERON-TB Gold Plus (QFT-Plus) test among rural doctors in China. In total, 511 participants were included in the survey. The concordance between the QFT-Plus test and the AIMTB rapid test assay was 94.47% with a Cohen’s kappa coefficient (κ) of 0.84 (95% CI, 0.79–0.90). Improved concordance between the two tests was observed in males and in participants with 26 or more years of service as rural doctors. The quantitative values of the QFT-Plus test was higher in individuals with a result of QFT-Plus-/AIMTB+ as compared to those with a result of QFT-Plus-/AIMTB- (p < 0.001). Overall, our study found that there was an excellent consistency between the AIMTB rapid test assay and the QFT-Plus test in a Chinese population. As the AIMTB rapid test assay is fast and easy to operate, it has the potential to improve latent tuberculosis infection testing and treatment at the community level in resource-limited settings.

Bariatric surgery has significantly increased globally as an effective treatment for severe obesity. Nutritional deficits are common among candidates for bariatric surgery, and follow-up of nutritional status is critically needed for post-surgery healthcare management. This observational prospective study was conducted at King Khalid University Hospital in Riyadh. Samples were collected pre- and post-laparoscopic sleeve gastrectomy (LSG), with the visit intervals divided into four visits: pre-surgery (0M), 3 months (3M), 6 months (6M) and 12 months (12M). Food intake and eating patterns significantly changed during the first year (P < 0·001). The mean energy intake at 3M post-surgery was 738·3 kcal, significantly lower than the pre-surgery energy intake of 2059 kcal. Then, it increased gradually at 6M and 12M to reach 1069 kcal (P < 0·00). The intake of Fe, vitamin B12 and vitamin D was below the dietary reference intake recommendations, as indicated by the 24-hour dietary recall. The prevalence of 25 (OH) vitamin D deficiency improved significantly from pre- to post-surgery (P < 0·001). Vitamin B12 deficiency was less reported pre-LSG and improved steadily towards a sufficient post-surgery status. However, 35·7 % of participants were deficient in Fe status, with 28·6% being female at higher levels than males. While protein supplementation decreased significantly over the 12M follow-up, the use of vitamin supplements dramatically increased at 3 and 6M before declining at 12M. Fe and vitamin B12 were the most popular supplements after vitamin D. This study confirms the necessity for individualised dietary plans and close monitoring of candidates’ nutritional status before and after bariatric surgery.

We develop techniques to construct isomorphisms between simple affine W-algebras and affine vertex algebras at admissible levels. We then apply these techniques to obtain many new, and conjecturally all, admissible collapsing levels for affine W-algebras. In short, if a simple affine W-algebra at a given level is equal to its affine vertex subalgebra generated by the centraliser of an ${\mathfrak {sl}}_2$-triple associated with the underlying nilpotent orbit, then that level is said to be collapsing. Collapsing levels are important both in representation theory and in theoretical physics. Our approach relies on two fundamental invariants of vertex algebras. The first one is the associated variety, which, in the context of admissible level simple affine W-algebras, leads to the Poisson varieties known as nilpotent Slodowy slices. We exploit the singularities of these varieties to detect possible collapsing levels. The second invariant is the asymptotic datum. We prove a general result asserting that, under appropriate hypotheses, equality of asymptotic data implies isomorphism at the level of vertex algebras. Then we use this to give a sufficient criterion, of combinatorial nature, for an admissible level to be collapsing. Our methods also allow us to study isomorphisms between quotients of W-algebras and extensions of simple affine vertex algebras at admissible levels. Based on such examples, we are led to formulate a general conjecture: for any finite extension of vertex algebras, the induced morphism between associated Poisson varieties is dominant.

The construction industry is experiencing high demand for workers. Apprenticeship programmes are essential pipelines of skilled workers into the construction industry; however, apprenticeship completion rates are only around 25%. To promote apprenticeship retention and increase the number of apprentices, it is necessary to identify factors that relate to cancellation from apprenticeship programmes (i.e., leaving prior to programme completion). Using data from the Registered Apprenticeship Partners Information Database System, we descriptively characterised completion and cancellation, then conducted a time-to-event analysis of n = 335,212 construction apprentices from 2012 to 2023 to examine factors related to cancellation. Among all apprentices, 40.1% cancelled from their apprenticeship programmes, while 24.8% completed and 35.0% were actively registered at the end of the study period. Results from the time-to-event analysis show females had significantly higher odds of cancellation than males (OR: 1.11; 95% CI: 1.08, 1.15). Compared to White apprentices, American Indian/Alaska Native (OR: 1.13; 95% CI: 1.08, 1.18), Black/African American (OR: 1.41; 95% CI: 1.39, 1.44), and multiracial apprentices (OR: 1.09; 95% CI: 1.02, 1.17) had significantly higher odds of cancellation, while Asian apprentices had significantly lower odds of cancellation (OR: 0.79; 95% CI: 0.75, 0.83). Non-unionised workers were significantly more likely to cancel their apprenticeship programmes (OR: 1.77; 95% CI: 1.74, 1.80). These results indicate that individual demographic and organisational factors can influence apprenticeship cancellation. Reducing barriers to apprenticeship completion can help address the current skilled worker shortage, and identifying factors that impact entry into the industry for minoritised groups can promote equity within the industry.

We develop realizability models of intensional type theory, based on groupoids, wherein realizers themselves carry non-trivial (non-discrete) homotopical structure. In the spirit of realizability, this is intended to formalize a homotopical BHK interpretation, whereby evidence for an identification is a path. Specifically, we study partitioned groupoidal assemblies. Categories of such are parameterized by “realizer categories” (instead of the usual partial combinatory algebras) that come equipped with an interval qua internal cogroupoid. The interval furnishes a notion of homotopy as well as a fundamental groupoid construction. Objects in a base groupoid are realized by points in the fundamental groupoid of some object from the realizer category; isomorphisms in the base groupoid are realized by paths in said fundamental groupoid. The main result is that, under mild conditions on the realizer category, the ensuing category of partitioned groupoidal assemblies models intensional (1-truncated) type theory without function extensionality. Moreover, when the underlying realizer category is “untyped,” there exists an impredicative universe of 1-types (the modest fibrations). This is a groupoidal analog of the traditional situation.

Recent developments have indicated a potential association between tinnitus and COVID-19. The study aimed to understand tinnitus following COVID-19 by examining its severity, recovery prospects, and connection to other lasting COVID-19 effects. Involving 1331 former COVID-19 patients, the online survey assessed tinnitus severity, cognitive issues, and medical background. Of the participants, 27.9% reported tinnitus after infection. Findings showed that as tinnitus severity increased, the chances of natural recovery fell, with more individuals experiencing ongoing symptoms (p < 0.001). Those with the Grade II mild tinnitus (OR = 3.68; CI = 1.89–7.32; p = 0.002), Grade III tinnitus (OR = 3.70; CI = 1.94–7.22; p < 0.001), Grade IV (OR = 6.83; CI = 3.73–12.91; p < 0.001), and a history of tinnitus (OR = 1.96; CI = 1.08–3.64; p = 0.03) had poorer recovery outcomes. Grade IV cases were most common (33.2%), and severe tinnitus was strongly associated with the risk of developing long-term hearing loss, anxiety, and emotional disorders (p < 0.001). The study concludes that severe post-COVID tinnitus correlates with a worse prognosis and potential hearing loss, suggesting the need for attentive treatment and management of severe cases.

Eight major supply chains contribute to more than 50% of the global greenhouse gas emissions (GHG). These supply chains range from raw materials to end-product manufacturing. Hence, it is critical to accurately estimate the carbon footprint of these supply chains, identify GHG hotspots, explain the factors that create the hotspots, and carry out what-if analysis to reduce the carbon footprint of supply chains. Towards this, we propose an enterprise decarbonization accelerator framework with a modular structure that automates carbon footprint estimation, identification of hotspots, explainability, and what-if analysis to recommend measures to reduce the carbon footprint of supply chains. To illustrate the working of the framework, we apply it to the cradle-to-gate extent of the palm oil supply chain of a leading palm oil producer. The framework identified that the farming stage is the hotspot in the considered supply chain. As the next level of analysis, the framework identified the hotspots in the farming stage and provided explainability on factors that created hotspots. We discuss the what-if scenarios and the recommendations generated by the framework to reduce the carbon footprint of the hotspots and the resulting impact on palm oil tree yield.

The site of Guiengola is an example of one of the settlements built by the Zapotecs during their fourteenth- to fifteenth-century migration to the Southern Isthmus of Tehuantepec. Although Guiengola is well known in the ethnohistorical record as being the place where the Mexica armies were defeated by Zapotec forces during the late fifteenth century, the full extension of the site was previously unknown. Despite evidence of a dense population at the site, it has been mistakenly characterized as a fortress for housing soldiers and troops from the nearby town of Tehuantepec. Here, I present the research of the Guiengola Archeological Project, which conducted a lidar scan and archaeological surveys between 2018 and 2023. In this article, I share a comprehensive map of Guiengola, a Postclassic Mesoamerican city. My analysis identifies a large settlement that covered 360 ha and included a walled system of fortifications, an internal road network, and a hierarchically organized city. The findings of this project expand our understanding of the variations and social divisions in the city's internal urban organization, which in turn, allow us to deepen our comprehension of the transition to the Early Colonial barrio organization of Tehuantepec.

This study explores what kinds of moral potency profiles can be identified among three different samples: Top sports, Leaders, and Followers. Based on the social norm theory, we examine whether and how the experienced strength of ethical organizational culture is associated with the probability to be identified into different moral potency profiles. Based on ratings of 188 top sport representatives, 237 leaders and their 202 followers, a person-centered approach was used to identify three moral potency profiles: morally hesitant, moderate moral potency, and morally confident. A fourth profile was identified based on the followers’ evaluations of their leaders: morally void. Low evaluations of ethical culture increased the likelihood of being classified into the morally hesitant profile. As the followers were somewhat more critical in evaluating their leaders’ moral potency than the leaders themselves, our findings highlight the value of including other-rated indicators when examining moral actions within organizations.

Stroke causes neurological and physical impairment in millions of people around the world every year. To better comprehend the upper-limb needs and challenges stroke survivors face and the issues associated with existing technology and formulate ideas for a technological solution, the authors conversed with 153 members of the ecosystem (60 neuro patients, 30 caregivers, and 63 medical providers). Patients fell into two populations depending on their upper-limb impairment: spastic (stiff, clenched hands) and flaccid (limp hands). For this work, the authors chose to focus on the second category and developed a set of design constraints based on the information collected through customer discovery. With these in mind, they designed and prototyped a 3D-printed powered wrist–hand grasping orthosis (exoskeleton) to aid in recovery. The orthosis is easily custom-sized based on two parameters and derived anatomical relationships. The researchers tested the prototype on a survivor of stroke and modeled the kinematic behavior of the orthosis with and without load. The prototype neared or exceeded the target design constraints and was able to grasp objects consistently and stably, as well as exercise the patients’ hands. In particular, donning time was only 42 s, as compared to the next fastest time of 3 min reported in literature. This device has the potential for effective neurorehabilitation in a home setting, and it lays the foundation for clinical trials and further device development.

Long-term health and developmental impact after in utero opioid and other substance exposures is unclear. There is an urgent need for well-designed, prospective, long-term observational studies. The HEALthy Brain and Child Development Study aims to address this need. It will require optimizing recruitment and retention of caregivers and young children in long-term research. Therefore, a scoping review of original research articles, indexed in the PubMed database and published in English between January 1, 2010, and November 23, 2023, was conducted on recruitment and retention strategies of caregiver–child (≤6 years old) dyads in observational, cohort studies. Among 2,902 titles/abstracts reviewed, 37 articles were found eligible. Of those, 29 (78%) addressed recruitment, and 18 (49%) addressed retention. Thirty-four (92%) articles focused on strategies for facilitating recruitment and/or retention, while 18 (49%) described potentially harmful approaches. Recruitment and retention facilitators included face-to-face and regular contact, establishing a relationship with study personnel, use of technology and social platforms, minimizing inconveniences, and promoting incentives. This review demonstrates that numerous factors can affect engagement of caregivers and their children in long-term cohort studies. Better understanding of these factors can inform researchers about optimal approaches to recruitment and retention of caregiver–child dyads in longitudinal research.

Effusion cooling is the state-of-the-art cooling technology for gas turbine hot-gas path components. Typically, effusion cooling holes across the entire combustor liner are aligned with the combustor axis, rendering a nominal zero compound angle between highly directional miniature effusion cooling jets and the main flow direction. The pitch of effusion cooling holes is optimised accordingly. However, the swirling main flow results in a non-zero compound angle and an effectively different pitch from the design. The directional effect of effusion cooling as a result of swirling main flow on the adiabatic film cooling effectiveness (AFE) is a combined effect of a non-zero compound angle and a varied pitch. The current experimental study aims to investigate the isolated effects of compound angle on AFE by excluding the influences of varying pitch. With an improved understanding of the sole effects of non-zero compound angles on AFE, the roles that a varied pitch plays in modifying AFE are further discussed to guide future effusion cooling designs under swirling main flow conditions. Binary pressure sensitive paint (PSP) was used to determine AFE experimentally.

The goal of this article is to outline a new account of the virtue of patience. To help build the account, we focus on five important issues pertaining to patience: (i) goals and time, (ii) emotion, (iii) continence versus virtue, (iv) motivation, and (v) good ends. The heart of the resulting account is that patience is a cross-situational and stable disposition to react, both internally and externally, to slower than desired progress toward goal achievement with a reasonable level of calmness. The article ends with an application of the account to better understanding the vices associated with patience.