Complex Balance Research Articles

Being stressed in the family or married with work? A literature review and clustering of work-family conflict

PurposeWork-family conflict is an important topic which had an evolution, starting from a static definition, where work and family domains were divided, to a more dynamic and complex balance. COVID-19 has influenced society and created a significant distress among families and working activity, and this topic has been characterised by a major interest, considering some old definitions where this balance was considered problematic but not as an enriching opportunity.Design/methodology/approachThe authors used SCOPUS to find all records mentioning work-family conflict, by considering book, article and review, excluding conference paper and considering only records written in English language. After a duplicated and not pertinent record removal, the authors obtained a number of 675 records. The authors considered 437 records from SCOPUS to create a cluster map.FindingsUsing SCOPUS and VOSviewer the authors have clustered 5 different areas, which are regrouped in next clusters considering keywords with most co-occurrence and significancy: Work-life balance and burnout gender cluster job stress and performance social and family support job satisfaction.Research limitations/implicationsCluster map is origined only by SCOPUS database.Originality/valueThis work aims to find a state of art about this topic, creating hypothesis where this problem has been exacerbated by 2020 due to important society modifications created by COVID-19, where recent evolution of work-family balance has been complicated by papers which come back to consider this balance as problematic.

Understanding the Effect of Heterogeneous Particle Functionalization on Graft–Matrix Wetting and Structure in Polymer Nanocomposites Containing Grafted Nanoparticles Using Multiscale Modeling and Simulation

We use multiscale modeling and simulations to investigate the effect of heterogeneous grafted ligands that vary in chemistry, size, composition, and placement on the dispersion and aggregation of grafted nanoparticles in (matrix) oligomer solutions. Motivated by industrial formulations that contain nanoparticles in complex solutions, such as paints, coatings, varnishes, printing inks, toners, and cosmetics, we study nanoparticles of diameters roughly 10–25 nm grafted with hydrophobic and/or hydrophilic oligomer chemistries in oligomer solutions. We select poly(ethylene glycol) (denoted as “A”) and alkanes (denoted as “B”) as the model hydrophilic and hydrophobic graft and matrix chain chemistries, respectively. We simulate the A/B-grafted nanoparticles in A/B oligomer solution using coarse-grained (CG) models at two different length scales─ “monomer level” and “chain level”; in the "monomer-level" CG model, each CG bead represents a monomer or two in A and B chain chemistries, and in the "chain-level" CG model, each CG bead represents an entire A or B oligomer chain, with bonded and nonbonded interactions for both these generic CG models guided by atomistic simulations of oligomers of poly(ethylene glycol) and alkanes in explicit water. Using the "monomer-level" CG model, we simulate explicit A and B chains in the grafted layer interacting with A or B matrix chains in solution. We find that the graft–matrix wetting increases when the grafted layer is composed mainly of B chains that are shorter, stiffer, and more attractive toward A and B chains than A chains are and when A- and B-grafted chains are placed in segregated domains (i.e., patchy arrangement) on the particle. Comparison with analogous systems with only excluded volume interactions shows that the wetting trends with the grafted layer composition and placement are driven primarily by entropic driving forces, with the attractive interactions simply enhancing the entropically-driven grafted layer wetting. Using the "chain-level" CG model, we then simulate multiple grafted particles with particle diameter 10–20 times that of the graft/matrix chain size (i.e., twice the radius of gyration) in solutions containing matrix B chain CG beads. Simulations with this "chain-level" CG model show that when the particle surface is entirely functionalized homogeneously with chain A alone, the attractive A–B interactions and repulsive A–A interactions and particle translational entropy drive the grafted particles to remain dispersed in solutions of B matrix chains. In contrast, when the particle surfaces have heterogeneous functionalization of A and B chains, we observe particle aggregation with specific aggregated morphologies being a function of A and B graft placements. These results from the two different levels of CG models describe the complex balance of enthalpic and entropic driving forces that dictate grafted layer wetting and the dispersion/aggregation of grafted particles within complex formulations.

Can agriculture and conservation be compatible in a coastal wetland? Balancing stakeholders’ narratives and interactions in the management of El Hondo Natural Park, Spain

Coastal wetlands are among the most productive and valuable ecosystems worldwide, although one of the main factors affecting their survival is the coexistence between agriculture and conservation. This paper analyses the complex balance between agriculture and conservation coexistence in El Hondo Natural Park (Alicante, Spain) coastal wetland by examining stakeholders’ narratives, perceptions, and interactions. The aim is to highlight the concurrence between socio-economic progress and socio-environmental justice perspectives by identifying those driving factors motivating stakeholders’ conflicts while expanding stakeholders’ behaviour and interaction when discussing the current and future management of this socio-ecological system. Data were collected between April and June 2019 from semi-structured interviews and questionnaires to river basin authorities, regional governments, municipalities, irrigation communities, union farms, regional and local ecologist groups, and social movements; and scrutinized through qualitative data analysis and descriptive statistics. Stakeholders discussed the main driving factors identified through the local newspapers to motivating current conflicts and confronting perspectives in El Hondo Natural Park: (1) the origin and evolution of the coastal wetland, (2) the provision and value of ecosystem services, (3) the management of water scarcity and water quality standards, (4) the guarantee and management of public and private investment, and (5) consequences of a natural park declaration. Likewise, the triple-loop analysis of stakeholders’ representativeness, relevance and collaboration highlighted examples of stakeholders’ underrepresentation and power imbalance, a negative assessment of the stakeholders’ actions, and how agreements are based on both stakeholders’ predisposition to collaborate and affinity.

Asylum seekers in South Africa and Covid-19: A catalyst for social security law reform?

This contribution interrogates selected social security law issues applicable to asylum-seekers. It does so from the perspective of among others the impact of Covid-19-related labour market and social security regulations and directives (issued in terms of the Disaster Management Act) and against the background of recent statutory and policy developments, and jurisprudential responses. The overarching objective of the article is to provide guidance as to the complex balance between, on the one hand, immigration law principles and, on the other, the imperatives embedded in a human rights-infused approach, with particular reference to the right to (access to) social security, other related fundamental rights, and the principles underlying the limitation of these rights. A set of guiding principles, responsive to Covid-19 regulatory realities, are developed and proposed.

Joint 3D-Location Planning and Resource Allocation for XAPS-Enabled C-NOMA in 6G Heterogeneous Internet of Things

The sixth generation (6G) communication creates a fully connected world of terrestrial wireless and satellite communications, which achieves global seamless coverage. To obtain the tripartite balance of spectrum efficiency, system throughput and complexity at the receiving end, clustered-NOMA (C-NOMA) is recommended. With Low Altitude Platform Station (LAPS) like UAV for strengthening communication in certain areas, and High Altitude Platform Station (HAPS) for ensuring wide coverage, we put forward the XAPS-enabled (including one HAPS and multiple UAVs) C-NOMA system in 6G heterogeneous Internet of things and investigate the joint 3D-location planning and resource allocation problem by optimizing four factors systematically, which are the spectrum allocation, power control, horizontal coordinate and hovering altitude optimization of UAVs to maximize the overall system uplink achievable sum rate. Due to the strong coupling among these factors, it is a mixed integer nonlinear programming (MINLP) problem, which is extremely difficult to solve. Therefore, we decompose it and propose a two-stage solution. Specifically, in the first stage we transfer resource allocation problem into a many-to-one spectrum matching game coupled with power control, where UAVs and subchannels are two groups of participants. Then we complete the second stage by optimizing UAVs’ 3D-locations, including horizontal coordinates and hovering altitudes. Finally, we repeat these two stages iteratively until the near-optimal result is obtained. Both theoretical analysis and simulations show that our proposed approach outperforms previous solutions in terms of system uplink sum rate with relatively low complexity.

Nitrogen cycling in muddy sediments of Great Peconic Bay, USA: Seasonal N reaction balances and multi-year flux patterns

To better understand the capacity of sediments to serve as both source and sink of nitrogen (N) and to identify any evidence of evolving changes in sedimentary N cycling, N2production, N remineralization, and N2fixation were studied over a multi-year period (2010–2015) in bioturbated mud of Great Peconic Bay, a temperate northeastern U. S. estuary. Benthic fluxes and rates of organic matter remineralization were measured using in situ and ex situ incubations. Net annual NH+4, NO–3/NO–2, and N2–N fluxes (μ = 1.1, 0.03, and 1.2 mmol m–2d–1) were close to averages for comparable sedi- mentary environments from surveys of published field studies. Net N2fluxes (by membrane inlet mass spectrometry) were influenced in different periods by temperature, oxygenation of sediment, pulsed Corg, and the activity of benthic macrofauna and benthic microalgae, although no single physical or biogeochemical variable showed a strong, direct relationship with net N2fluxes over all sampling periods. In situ measurements sometimes showed more dynamic and higher amplitude diurnal N flux cycles than did ex situ incubations, suggesting ex situ incubations did not fully capture impacts of bioirrigation or benthic photosynthesis.15N tracer experiments indicated anammox was < 7% of total N2production. Acetylene reduction assays demonstrated C2H4production to depths ≥ 15 cm and suggested N2fixation may have approached 25% of gross N2production(3:1 C2H4: N2). Mass balances incorporating independently measured N remineralization estimates were consistent with measured levels of N2fixation. Overall, complex balances of competing processes governed sedimentary N cycling seasonally, and N2production dominated N2fixation. Measured N2fixation was consistent with constraints from N remineralization rates and net N fluxes except in episodic conditions (e. g., algal blooms). There was no indication of progressive changes in N cycling magnitudes or relative N reaction balances over the study period.

MANAGEMENT OF TYPE A DISSECTION IN PREGNANCY: SITE AND TEAM CAN MAKE THE DIFFERENCE

Introduction Aortic dissection is rare in pregnancy but associated with poor maternal and neonatal outcomes. We present a case of delayed diagnosis of type A aortic dissection in pregnancy in a previously healthy woman to raise awareness and highlight the value of an integrated, multidisciplinary approach. Methods A 38-year-old, G1P0 woman was transferred to our hospital with a type A aortic dissection diagnosed at 30 weeks of pregnancy. The patient had no significant medical history and her pregnancy was uneventful. At 29 weeks gestation, however, she developed central chest pain. Her local hospital excluded a diagnosis of pulmonary embolism and discharged her home. She represented 3 days later with shortness of breath and orthopnoea. On the second day of this admission, Type A aortic dissection was diagnosed on computed tomography of the chest. She was transferred to our hospital for access to multiple specialist services including cardiothoracic surgery and high-risk obstetrics, neonatal and adult critical care. On arrival, an ad hoc MDT convened in the emergency department by a senior team of cardiothoracic surgeons, obstetricians, anaesthetists and neonatologists agreed immediate intervention was required. She went directly to theatres for delivery of the baby and dissection repair. Awake establishment of invasive blood pressure monitoring was followed by an opiate-based cardiostable induction of anaesthesia and intubation in a head-up position. The caesarian section was uneventful and exceptional measures to minimise blood loss were not required. The ascending aorta and hemi-arch were repaired on cardio-pulmonary by-pass with circulatory arrest time of 19 minutes without intraoperative complications. The baby was electively intubated and transferred to neonatal ICU in stable condition. Mother and baby were both extubated the following day and discharged home after a week. Discussion Acute aortic dissection should always be included in the differential of acute chest pain in pregnant women. It most commonly occurs during the third trimester or the early postpartum period and it can sometimes present in women with no previous history of aortopathy. High clinical suspicion, careful history taking and examination, CT, MRI or echocardiography can establish the diagnosis. Optimum management to ensure the survival of both mother and fetus varies with gestational age and planning to ensure this requires a complex balance of expertise between specialities. In the third trimester, emergency delivery followed by surgical aortic repair probably offers the best survival chances for both. Institutions which offer senior input from multiple specialities are crucial for the timely management of these complex cases. This need for urgent intervention from outside cardiothoracic surgery in cases with multiple issues must be considered when regional care models for the management of aortic dissection cases are being designed.

Can Studying Genetically Predisposed Individuals Inform Prevention Strategies for RA?

Rheumatoid arthritis (RA) is a prevalent autoimmune disorder in which complex genetic predisposition interacts with multiple environmental factors to precipitate chronic and progressive immune-mediated joint inflammation. Currently, in most affected individuals, ongoing suppression of the inflammation is required to prevent irreversible damage and functional loss. The delineation of a protracted preclinical period in which autoimmunity is initially established and then evolves to become pathogenic provides unprecedented opportunities for interventions that have the potential to prevent the onset of this lifelong disease. Clinical trials aimed at assessing the impact of specific prevention strategies require the identification of individuals who are at high risk of future RA development. Currently, these risk factors include a strong family history of RA, and the detection of circulating RA-associated autoantibodies, particularly anti-citrullinated protein antibodies (ACPA). Yet, even in such individuals, there remains considerable uncertainty about the likelihood and the timeframe for future disease development. Thus, individuals who are approached to participate in such clinical trials are left weighing the risks and benefits of the prevention measures, while having large gaps in our current understanding. To address this challenge, we have undertaken longitudinal studies of the family members of Indigenous North American RA patients, this population being known to have a high prevalence of RA, early age of onset, and familial clustering of cases. Our studies have indicated that the concepts of “risk” and “prevention” need to be communicated in a culturally relevant manner, and proposed prevention interventions need to have an appropriate balance of effectiveness, safety, convenience, and cultural acceptability. We have focused our proposed prevention studies on immunomodulatory/anti-inflammatory nutritional supplements that appear to strike such a complex balance.

Maternal but not fetoplacental health can be improved by metformin in a murine diet-induced model of maternal obesity and glucose intolerance.

Maternal obesity is a global problem that increases the risk of short- and long-term adverse outcomes for mother and child, many of which are linked to gestational diabetes mellitus. Effective treatments are essential to prevent the transmission of poor metabolic health from mother to child. Metformin is an effective glucose lowering drug commonly used to treat gestational diabetes mellitus; however, its wider effects on maternal and fetal health are poorly explored. In this study we used a mouse (C57Bl6/J) model of diet-induced (high sugar/high fat) maternal obesity to explore the impact of metformin on maternal and feto-placental health. Metformin (300 mg/kg/day) was given to obese females via the diet and was shown to achieve clinically relevant concentrations in maternal serum (1669±568 nM in late pregnancy). Obese dams developed glucose intolerance during pregnancy and had reduced uterine artery compliance. Metformin treatment of obese dams improved maternal glucose tolerance, reduced maternal fat mass, and restored uterine artery function. Placental efficiency was reduced in obese dams, with increased calcification and reduced labyrinthine area. Consequently, fetuses from obese dams weighed less (p<0.001) at the end of gestation. Despite normalisation of maternal parameters, metformin did not correct placental structure or fetal growth restriction. Metformin levels were substantial in the placenta and fetal circulation (109.7±125.4 nmol/g in the placenta and 2063±2327 nM in fetal plasma). These findings reveal the distinct effects of metformin administration during pregnancy on mother and fetus and highlight the complex balance of risk versus benefits that are weighed in obstetric medical treatments.

Living in mixed species groups promotes predator learning in degraded habitats

Living in mix-species aggregations provides animals with substantive anti-predator, foraging and locomotory advantages while simultaneously exposing them to costs, including increased competition and pathogen exposure. Given each species possess unique morphology, competitive ability, parasite vulnerability and predator defences, we can surmise that each species in mixed groups will experience a unique set of trade-offs. In addition to this unique balance, each species must also contend with anthropogenic changes, a relatively new, and rapidly increasing phenomenon, that adds further complexity to any system. This complex balance of biotic and abiotic factors is on full display in the exceptionally diverse, yet anthropogenically degraded, Great Barrier Reef of Australia. One such example within this intricate ecosystem is the inability of some damselfish to utilize their own chemical alarm cues within degraded habitats, leaving them exposed to increased predation risk. These cues, which are released when the skin is damaged, warn nearby individuals of increased predation risk and act as a crucial associative learning tool. Normally, a single exposure of alarm cues paired with an unknown predator odour facilitates learning of that new odour as dangerous. Here, we show that Ambon damselfish, Pomacentrus amboinensis, a species with impaired alarm responses in degraded habitats, failed to learn a novel predator odour as risky when associated with chemical alarm cues. However, in the same degraded habitats, the same species learned to recognize a novel predator as risky when the predator odour was paired with alarm cues of the closely related, and co-occurring, whitetail damselfish, Pomacentrus chrysurus. The importance of this learning opportunity was underscored in a survival experiment which demonstrated that fish in degraded habitats trained with heterospecific alarm cues, had higher survival than those we tried to train with conspecific alarm cues. From these data, we conclude that redundancy in learning mechanisms among prey guild members may lead to increased stability in rapidly changing environments.

Intracavity incoherent supercontinuum dynamics and rogue waves in a broadband dissipative soliton laser

Understanding dynamical complexity is one of the most important challenges in science. Significant progress has recently been made in optics through the study of dissipative soliton laser systems, where dynamics are governed by a complex balance between nonlinearity, dispersion, and energy exchange. A particularly complex regime of such systems is associated with noise-like pulse multiscale instabilities, where sub-picosecond pulses with random characteristics evolve chaotically underneath a much longer envelope. However, although observed for decades in experiments, the physics of this regime remains poorly understood, especially for highly-nonlinear cavities generating broadband spectra. Here, we address this question directly with a combined numerical and experimental study that reveals the physical origin of instability as nonlinear soliton dynamics and supercontinuum turbulence. Real-time characterisation reveals intracavity extreme events satisfying statistical rogue wave criteria, and both real-time and time-averaged measurements are in quantitative agreement with modelling.

Постпрандіальний гіпоглікемічний синдром

Постпрандіальний гіпоглікемічний синдром, або реактивна гіпоглікемія, — вегетативні симптоми, такі як слабкість, втома, голод, нудота, серцебиття, занепокоєння, тремор, пітливість, що виникають через одну-дві години після прийому їжі. Синдром досить слабо висвітлений у літературі, більшість відомостей є розрізненими. Лабораторні критерії діагностики постпрандіальної реактивної гіпоглікемії досить контроверсивні, але більшість авторів схиляються до того, що це рівень глюкози крові нижче тощакової або ≤ 3,9 ммоль/л протягом двох годин після прийому їжі. Гіпоглікемія є результатом дисбалансу між надходженням глюкози в кров (від ендогенної продукції глюкози або екзогенної доставки) і використанням глюкози тканинами. Баланс між надходженням і витрачанням глюкози контролюється складною рівновагою глікорегулюючих гормонів. Інсулін, глюкагон і адреналін діють протягом кількох хвилин, а кортизол і гормон зросту — кілька годин. Це пояснює наявність негайних і відстрочених різноманітних ефектів: адренергічного, нейроглікопенічного, гастроінтестинального дискомфорту. Відомо, що в генезі постпрандіального синдрому лежать механізми, подібні до постгастректомічних у пацієнтів, оперованих з приводу морбідного ожиріння. Найбільш імовірним чинником формування реактивної гіпоглікемії є постпрандіальна гіперсекреція інсуліну під впливом глюкози і глюкагоноподібного пептиду (GLP-1), що є компонентом ентероендокринної системи, основна дія якого спрямована на цефалічну фазу формування насичення. Як у оперованих пацієнтів, так і у відносно здорових осіб симптоми виникають після прийому їжі, багатої простими вуглеводами. Симптоми досить ефективно лікуються прийомом їжі з вживанням вуглеводів із низьким глікемічним індексом і харчовими волокнами. При недостатності ефекту використовують препарати акарбози, інгібуючої α-глюкозидази тонкого кишечника, що є основним стимулом для секреції GLP-1. Таким чином, при епідемічній швидкості поширення ожиріння в умовах неадекватних харчових пріоритетів у дитячій популяції ймовірність значної поширеності постпрандіального синдрому досить вірогідна, що вимагає додаткового дослідження. При цьому зниження в раціоні простих вуглеводів може істотно поліпшити якість життя дітей із постпрандіальним дискомфортом.

CS-Net: Instance-aware cellular segmentation with hierarchical dimension-decomposed convolutions and slice-attentive learning

Cellular segmentation in kinds of microscopy images is a fundamental prerequisite in the workflow of many biomedical applications. However, accurate segmentation of plenty of cellular instances faces several challenges, including instance-size imbalance, clustered cellular instances, fuzzy boundaries, and cell types’ heterogeneity. Moreover, both 2D and 3D data should be processed with scalability. To address these challenges, we present a lightweight slice-wise CS-Net building on novel hierarchical dimension-decomposed (HDD) convolutions and a novel instance-aware loss for both 2D and 3D microscopy image segmentation. To capture inter-slice contexts in 3D data, we exploit both 2.5D input and 2.5D supervision, and introduce CS-Net (2.5D++) for 3D segmentation tasks. Specifically, we devise a slice-aware encoder to extract diverse and multiscale contexts from multi-slice input and a slice-attentive decoder to take advantage of slice-wise 2.5D supervision. To separate clustered instances, we augment the segmentation task with an edge prediction task, the output of which is used to separate touching instances. Extensive experiments on 3D multi-tissue electron microscopy (EM) data and 2D histology images demonstrate that our 2D and 2.5D methods achieve state-of-the-art performance with scalability to diverse data. The comparative results with top-performing lightweight models also indicate that the proposed model shows a better balance of segmentation performance and computational complexity.

A New Low Complexity Bit-truncation Based Motion Estimation and Its Efficient VLSI Architecture

A new motion estimation method and its hardware implementation are presented in this paper. In this method, all the frames are firstly gray coded. After that, the two most significant bits from the current frame and reference frame are used to compute the motion vector. Besides, a diamond search algorithm is used in place of the full-search algorithm. The motion estimation scheme proposed in the present paper is also verified to work on various standard video sequences. The experimental results thus obtained show that the proposed algorithm has an excellent balance of performance and computational complexity. External memory access has been reduced drastically by incorporating search pixel reuse. The resulting architecture is simple in terms of the hardware cost and power requirements while being faster than a recently reported similar architecture. The proposed architecture requires less hardware than comparable systems without compromising performance. The proposed architecture is therefore suited to be used in portable consumer electronic devices with real-time video applications in which power consumption is a concern.

Why municipalities grow: The influence of fiscal incentives on municipal land policies in Germany and the Netherlands

It is generally assumed that municipalities attract residents and businesses as a result of intermunicipal competition for tax revenues. This growth-oriented behaviour poses a serious problem considering internationally acknowledged goals to limit land take. Nonetheless, research on how fiscal incentives affect municipal land policies is scarce. Adapting a neoinstitutionalist approach, we compare the two contrasting fiscal systems of Germany and the Netherlands. While clear incentives can be deducted from the different sources of municipal income, complex balancing measurements and consequential infrastructure investments make it difficult to predict a project’s profitability. According to the perspective of planning practitioners in municipalities around the growth centres of Utrecht and Berlin interviewed for this study, local pressures force them to keep allocating new building sites. In order to create effective policies to limit land take, it is important to understand not only the influence of fiscal incentives but also of place-specific pressures on municipal land policies.

Menopausal hormone therapy and women's health: An umbrella review.

There remains uncertainty about the impact of menopausal hormone therapy (MHT) on women's health. A systematic, comprehensive assessment of the effects on multiple outcomes is lacking. We conducted an umbrella review to comprehensively summarize evidence on the benefits and harms of MHT across diverse health outcomes. We searched MEDLINE, EMBASE, and 10 other databases from inception to November 26, 2017, updated on December 17, 2020, to identify systematic reviews or meta-analyses of randomized controlled trials (RCTs) and observational studies investigating effects of MHT, including estrogen-alone therapy (ET) and estrogen plus progestin therapy (EPT), in perimenopausal or postmenopausal women in all countries and settings. All health outcomes in previous systematic reviews were included, including menopausal symptoms, surrogate endpoints, biomarkers, various morbidity outcomes, and mortality. Two investigators independently extracted data and assessed methodological quality of systematic reviews using the updated 16-item AMSTAR 2 instrument. Random-effects robust variance estimation was used to combine effect estimates, and 95% prediction intervals (PIs) were calculated whenever possible. We used the term MHT to encompass ET and EPT, and results are presented for MHT for each outcome, unless otherwise indicated. Sixty systematic reviews were included, involving 102 meta-analyses of RCTs and 38 of observational studies, with 102 unique outcomes. The overall quality of included systematic reviews was moderate to poor. In meta-analyses of RCTs, MHT was beneficial for vasomotor symptoms (frequency: 9 trials, 1,104 women, risk ratio [RR] 0.43, 95% CI 0.33 to 0.57, p < 0.001; severity: 7 trials, 503 women, RR 0.29, 95% CI 0.17 to 0.50, p = 0.002) and all fracture (30 trials, 43,188 women, RR 0.72, 95% CI 0.62 to 0.84, p = 0.002, 95% PI 0.58 to 0.87), as well as vaginal atrophy (intravaginal ET), sexual function, vertebral and nonvertebral fracture, diabetes mellitus, cardiovascular mortality (ET), and colorectal cancer (EPT), but harmful for stroke (17 trials, 37,272 women, RR 1.17, 95% CI 1.05 to 1.29, p = 0.027) and venous thromboembolism (23 trials, 42,292 women, RR 1.60, 95% CI 0.99 to 2.58, p = 0.052, 95% PI 1.03 to 2.99), as well as cardiovascular disease incidence and recurrence, cerebrovascular disease, nonfatal stroke, deep vein thrombosis, gallbladder disease requiring surgery, and lung cancer mortality (EPT). In meta-analyses of observational studies, MHT was associated with decreased risks of cataract, glioma, and esophageal, gastric, and colorectal cancer, but increased risks of pulmonary embolism, cholelithiasis, asthma, meningioma, and thyroid, breast, and ovarian cancer. ET and EPT had opposite effects for endometrial cancer, endometrial hyperplasia, and Alzheimer disease. The major limitations include the inability to address the varying effects of MHT by type, dose, formulation, duration of use, route of administration, and age of initiation and to take into account the quality of individual studies included in the systematic reviews. The study protocol is publicly available on PROSPERO (CRD42017083412). MHT has a complex balance of benefits and harms on multiple health outcomes. Some effects differ qualitatively between ET and EPT. The quality of available evidence is only moderate to poor.

Dual task gait deteriorates gait performance in cervical dystonia patients: a pilot study

Day-to-day walking-related activities frequently involve the simultaneous performance of two or more tasks (i.e., dual task). Dual task ability is influenced by higher order cognitive and cortical control mechanisms. Recently, it has been shown that the concomitant execution of an attention-demanding task affected postural control in subject with cervical dystonia (CD). However, no study has investigated whether dual tasking might deteriorate gait performance in CD patients. To investigate whether adding a concomitant motor and cognitive tasks could affect walking performance in CD subjects.17 CD patients and 19 healthy subjects (HS) participated in this pilot case–control study. Gait performance was evaluated during four walking tasks: usual, fast, cognitive dual task and obstacle negotiation. Spatiotemporal parameters, dual-task cost and coefficients of variability (CV%) were measured by GaitRite® and were used to detect differences between groups. Balance performance was also assessed with Mini-BEST and Four Step Square tests. In CD participants, correlation analysis was computed between gait parameters and clinical data. Significant differences in complex gait and balance performance were found between groups. CD patients showed lower speed, longer stance time and higher CV% and dual-task cost compared to HS. In CD, altered gait parameters correlated with balance performance and were not associated with clinical features of CD. Our findings suggest that complex walking performance is impaired in patients with CD and that balance and gait deficits might be related

Unraveling the ecological processes modulating the population structure of Escherichia coli in a highly polluted urban stream network

Escherichia coli dynamics in urban watersheds are affected by a complex balance among external inputs, niche modulation and genetic variability. To explore the ecological processes influencing E. coli spatial patterns, we analyzed its abundance and phylogenetic structure in water samples from a stream network with heterogeneous urban infrastructure and environmental conditions. Our results showed that environmental and infrastructure variables, such as macrophyte coverage, DIN and sewerage density, mostly explained E. coli abundance. Moreover, main generalist phylogroups A and B1 were found in high proportion, which, together with an observed negative relationship between E. coli abundance and phylogroup diversity, suggests that their dominance might be due to competitive exclusion. Lower frequency phylogroups were associated with sites of higher ecological disturbance, mainly involving simplified habitats, higher drainage infrastructure and septic tank density. In addition to the strong negative relationship between phylogroup diversity and dominance, the occurrence of these phylogroups would be associated with increased facilitated dispersal. Nutrients also contributed to explaining phylogroup distribution. Our study proposes the differential contribution of distinct ecological processes to the patterns of E. coli in an urban watershed, which is useful for the monitoring and management of fecal pollution.

Combustion dynamics of multi-element lean-premixed hydrogen-air flame ensemble

The crux of the technical issues facing the development of hydrogen gas turbine engines is the problem of how to enable low NOx, low dynamics combustor operations without detrimental flashback events in extremely fast lean-premixed hydrogen flames. While flashback mechanisms and nitrogen oxides emissions have been investigated extensively for high hydrogen content flames, the self-excited dynamics of lean-premixed pure hydrogen flame ensembles remain unclear. Here we use phase-resolved OH* chemiluminescence and OH PLIF imaging in a series of experiments in a multi-element injector configuration consisting of 293 small-scale injectors with an inner diameter of 3.0 mm. We collect a large experimental dataset to explore a variety of collective phenomena of the lean-premixed hydrogen-air flame ensemble, and perform systematic investigations of self-induced combustion instabilities. Our observations demonstrate that ultra-compact pure hydrogen flames generate high-amplitude pressure perturbations over a broad range of characteristic frequencies between 400 and 1800 Hz, corresponding to the third to tenth order eigenmodes. Low-frequency flame dynamics developed under relatively low equivalence ratio conditions involve a complex balance among several coexisting phenomena, including strong vortex interactions and periodic extinction-reignition processes, giving rise to large-scale asymmetric oscillations of the entire reaction zone. By contrast, the flame surface dynamics at an intermediate frequency of ~600 Hz exhibit prominent symmetric oscillations accompanied by merging and pinch-off of the constituent flames. Unexpectedly, high-frequency instabilities at approximately 1720 Hz (screech tones) are not influenced by such structurally complex flame dynamics, but by exceptionally simple, seemingly linear, flame surface motion without sudden flame area annihilation events like those observed for lower frequency cases. Despite the extremely low level of heat release rate fluctuations, on the order of less than 1%, the clustered premixed hydrogen flames are capable of producing disproportionately large pressure perturbations in excess of 12 kPa, originating from the synchronous phase dynamics of acoustic pressure and clustered flames’ heat release rate oscillations. These findings provide new insight into the driving mechanisms underlying high-frequency combustion dynamics of densely arranged pure hydrogen-air flames.

Assessment of Structural Transformations Factors in the Agro-food Complex of Russia

The article analyzes the factors that influence structural changes in the value chains of the national agro-food system. The analysis of the dynamic and structural functioning characteristics of the agro-food complex of Russia made it possible to assess the impact of the identified factors on the status of food security, the competitiveness of national producers, and the effectiveness of the state regulatory system. The positive dynamics of agricultural and food production have stabilized the situation on the national food market and increased the level of self-sufficiency in basic food products.The material and financial balance of the agro-food complex is justified as an important factor of its sustainable development in changing economic conditions. The authors have analyzed the causes of the mismatch of material and financial proportions in the agro-food complex of Russia and revealed a significant impact of the growth of world prices for agricultural raw materials and food products in 2020 on the formation of the material and financial balance proportions of intersectoral food chains. The uneven dynamics of prices in the agricultural sector, processing industries, and industries that produce means of production for the agro-food complex contributed to the violation of the parity of intersectoral relations in the food chains of the Russian agro-food complex.The assessment of the level of protection of national producers based on the indicators used by the OECD (Organization for Economic Co-operation and Development) and FAO (Food and Agricultural Organization) allowed revealing a steady trend of declining support for agriculture in Russia, while the level of support for the agricultural sector in the USA and the European Union is constantly growing. This has an impact on the competitiveness of national producers, as well as trends in the modernization of the agro-food complex structure.The identified factors allow substantiating the short-term and long-term strategic priorities for the development of the Russian agro-food complex, ways to implement them taking into account national development goals, as well as opportunities for the full use of their competitive potential.