Key features of effective yoga interventions in addition to standard medical treatment for rheumatoid arthritis: a systematic review and meta-analysis

Objective: This systematic review aimed to synthesise the content, structure, and delivery characteristics of effective yoga interventions in addition to standard medical treatment for rheumatoid arthritis (RA).Methods: JBI guidelines were followed. 17 databases were searched for randomised controlled trials (RCTs) assessing yoga’s effectiveness in treating RA outcomes - disease activity score, pain, and function. Meta-analyses and narrative synthesis were conducted.Results: Nine articles representing 5 RCTs were included and had low methodological quality scores. Yoga interventions, in addition to standard medical treatment, improved disease activity scores (standardised mean difference (SMD) -0.46; 95% confidence interval (CI) -0.73 to -0.18) and function (-0.42; -0.78 to -0.07) but did not effectively reduce pain (-1.06; -2.62 to 0.50) compared to standard medical treatment alone. All 5 RCTs found yoga’s beneficial effects on one or more outcomes. All yoga interventions included centre-based (supervised, group) sessions, and 2 included additional home-based (unsupervised, individual) sessions. All interventions incorporated 20 yogic poses (6 standing, 5 supine, 5 prone, and 4 seated), 7 breathing practices, and 4 meditation and relaxation practices. 2 interventions offered RA-specific yogic pose modifications. Centre-based sessions were delivered at least once weekly for 8 weeks median duration and around 68 minutes per session. Home-based yoga was recommended thrice weekly for a 10-week mean duration and 40 minutes per session. Conclusion: Yoga might be useful in addition to standard medical treatment for RA. Given previous studies’ methodological limitations, a high-quality RCT should be conducted based on our synthesised key features of effective yoga interventions. Keywords: meta-analysis; rheumatoid arthritis; systematic review; treatment; yoga PROSPERO registration number: CRD4202232033

Online Harmonic Reduction for Aircraft Electrical Power Distribution System With Global Phase-Shifted Carrier PWM

The penetration rate of power electronics converters (PEC) within onboard electrical power distribution systems (EPDS) has been rising for years due to the trend of moving towards more electric aircraft (MEA) and all electric aircraft (AEA). Digital control and pulse width modulation (PWM) of these devices give rise to the electrical harmonics within the EPDS. Phase-shifted carrier PWM (PSC-PWM) has been a well-established concept for cascaded/paralleled PECs to eliminate certain harmonic components. However, when multiple PECs work cooperatively with different power ratings in the EPDS, an exhaustive system-level analytical model accurate to switching behavior is difficult to acquire and solve in real-time. In this work, a Simulated Annealing-based global optimization method is proposed for further enhancing the waveform quality at the EPDS transmission bus by tuning the PSC offset angle of the PECs directly according to the total harmonic distortion (THD) value measured online. Simulation and experimental results are given with a three-port system to verify the proposed scheme

Investigation of support structure configurations for selective laser melting of In718

The Selective Laser Melting (SLM), as a widely used metallic Additive manufacturing (AM) process, relies heavily on support structures. This study investigated the impact of different support structure configurations on the quality of In718 samples fabricated through SLM. On the basis of a comprehensive review of existing support structures configurations from the literature, three typical configurations: block, cone, and lattice, were designed to support cantilever parts for performance comparison. A coupled thermo-structural finite element simulation using ANSYS was performed to evaluate the temperature, deformation, and thermal stress evolution during the printing process of the three supported cantilever structures. The residual stress and deformation of the printed In718 cantilevers with different support structures were measured for validation. The results showed that block support exhibits the best strength and heat dissipation capability, making it the most effective support configuration for the SLM of In718 material. This research provides a fundamental procedure for evaluating the supporting performances among various support structures for the SLM process

Sexual and reproductive health needs of women with severe mental illness in low- and middle-income countries: A scoping review

Background This scoping review aimed to understand the extent and type of evidence in relation to sexual and reproductive health needs of women with severe mental illness (SMI) in low- and middle-income countries (LMIC) and to summarise those needs. Methods Inclusion criteria were 1) focus on sexual and reproductive health needs 2) women or girls with SMI, professionals, caregivers of women with SMI and community members 3) study set in a LMIC 4) peer reviewed literature (no restriction on study date or design). Studies were identified from comprehensive searches of Medline, EMBASE, CINAHL and PsycINFO (to July 2023). Results The review included 100 papers. Most studies were cross-sectional and set in hospital outpatient departments. Only 20 of 140 LMIC countries were included in this review and only 15 studies were set-in low-income countries (LIC). Included studies often had multiple focus areas and were grouped by frequency of topic into categories of HIV (prevalence, risk behaviour and knowledge), other sexually transmitted infections (STIs), sexual function, contraception use and family planning, sexual violence, fertility, pregnancy and postpartum.Included studies indicated women with SMI have worse outcomes and worse sexual and reproductive health compared to both women without SMI and men with SMI. Women with SMI were shown to have higher rates of HIV and low levels of contraception knowledge and use, with little advice offered by professionals. Conclusions This review highlights the need for a greater diversity of study methodology, robustness of ethical and consensual reporting when researching vulnerable populations and for further research on interventions and models of care aimed at addressing stigma, discrimination and improving the sexual and reproductive health of women with SMI. Future research should better represent the breadth of LMIC, investigate cultural adaptability of interventions and consider sexual health needs across the life course

The best of times, the worst of times: Continuities in school leaders' work in uncertain times

The COVID 19 pandemic created new challenges for school leaders. They worked very long hours in difficult circumstances. Improvising and responding quickly to poorly timed central guidelines had an adverse effect on their health and wellbeing. Our mixed methods studies show that leaders’ pandemic work was largely directed to establishing new management routines as well as dealing with people. Henri Lefebvre's rhythmanalysis allows us to see that leaders managed their pre-, during and post-pandemic work by working ‘after hours’. The analysis suggests that tackling wellbeing and workload and developing more sustainable leadership careers requires a fundamental redesign of the ways in which leaders’ work is carried out

Connecting the circular and drifted Rindler Unruh effects

In Minkowski spacetime quantum field theory, each stationary motion is associated with an effective, energy-dependent notion of temperature, which generalizes the familiar Unruh temperature of uniform linear acceleration. Motivated by current experimental interest in circular motion, we analyze the effective temperature for drifted Rindler motion, generated by a boost and a spacelike translation (drift), and the way in which drifted Rindler motion can be smoothly (and in fact real analytically) deformed to circular motion through a third type of motion known as parator. For an Unruh-DeWitt detector coupled linearly to a massless scalar field in 2+1 and 3+1 spacetime dimensions, we establish analytic results in the limits of large gap, small gap and large drift speed. For fixed proper acceleration, the drifted Rindler temperature remains bounded in the large gap limit, in contrast to the circular motion temperature, which can be arbitrarily large in this limit. Finally, in 2+1 dimensions, we trace the vanishing of the circular motion temperature in the small gap limit to the weak decay of the Wightman function, and we show that, among all types of stationary motion in all dimensions, this phenomenon is unique to 2+1 dimensions and therein to circular and parator motion

Teacher Practices and Student Understandings in 2D Drawings of 3D Shapes

Geometry holds a pivotal position within the realm of mathematics, yet many students struggle to grasp its concepts, posing challenges for their teachers. In the Republic of Türkiye, the Ministry of National Education has recently recommended the adoption of constructivist approaches to teach geometry. To gauge the efficacy of this instructional approach in actual classrooms, we investigated the practices of Turkish middle school mathematics teachers and their students' experiences in constructing two-dimensional drawings of three-dimensional geometrical shapes during regular lessons. The study involved four teachers from two schools and 199 students aged 12 to 14 years. Multiple data sources, including lesson observations, student worksheets and interviews with teachers and students, were utilized to gain insights into student understandings and whether the pedagogical practices they encountered were associated with this. Based on these findings, we argue that teachers may require additional support for their classrooms to transition into student-centred environments to permit students to actively engage in enriching mathematical exercises, exercise agency, and have opportunities to utilize provided manipulatives and digital tools. Öz Geometri, matematik alanında önemli bir konumu kaplamakla birlikte, birçok öğrenci geometrik kavramları anlamakta zorlanmaktadır, bu da öğretmenler için zorluklar doğurmaktadır. Türkiye Cumhuriyeti Milli Eğitim Bakanlığı, geometriyi öğretmek için yapılandırmacı yaklaşımların benimsenmesini önermiştir. Bu çalışmada, bu öğretim yaklaşımının sınıflardaki etkinliğini değerlendirmek amacıyla, Türk ortaokulu matematik öğretmenlerinin uygulamaları ve düzenli derslerde öğrencilerinin üç boyutlu geometrik şekillerin iki boyutlu çizimlerini oluştururken yaşadıkları deneyimler araştırılmıştır. Çalışmaya iki okuldan dört öğretmen ve 12-14 yaş arasındaki 199 öğrenci katılmıştır. Ders gözlemleri, öğrenci çalışma kağıtları ve öğretmenler ve öğrencilerle yapılan görüşmeler gibi çeşitli veri kaynakları, öğrenci anlayışlarına ve bu anlayışların ilişkilendirildiği pedagojik uygulamalara dair içgörüler elde etmek için kullanılmıştır. Bu bulgulara dayanarak, öğretmenlerin sınıflarında öğrenci odaklı ortamlara geçebilmeleri için ek desteklere ihtiyaç duyabilecekleri savunulmaktadır. Bu, öğrencilere matematiksel alıştırmalara etkin bir şekilde katılmalarına, etki alanı oluşturmalarına ve sağlanan manipülatifleri ve dijital araçları kullanma fırsatlarına sahip olmalarına izin vermek için gereklidir

On the Voltage Stress Reduction in Hairpin Windings: Guidelines and Critical Aspects

Transportation electrification roadmaps are pushing for step-change increase in power densities of electric drives, leading to rapidly growing developments of high-switching frequency wide-bandgap semiconductor based inverters. Meanwhile, induced high dV/dt can challenge the reliability of the stator winding insulation system. This study provides guidelines to mitigate the winding voltage stress through implementation of an improved modular hairpin winding layout featuring a multi-branch design, reconfigurable by simply reconnecting phase terminals and neutral points. This enables comparison of voltage distributions across different winding layout patterns. A high frequency electrical lumped parameter network for prediction of voltage stress distribution is further adopted, and validated through experimental tests carried out on different configurations. The downselected configuration reduces by 35% the maximum interturn voltage. Further sensitivity analyses at different rise times revealed that improvement could be limited to only 10-15% when rise times are in the range of tens of nanoseconds. Under these conditions, the first series turns connected to the inverter side are very sensitive to sudden voltage spikes and experience the highest voltage stress, even though they have fewer connecting conductors between them and adjacent layers. In general, the paper provides reliability-oriented hairpin winding design guidelines that address the integrity of the insulation system

The Effect Modification of the Risk of Suicide Following Self-Harm by Age and Sex: A Population-Based Nationally Representative Study from England 2001-2019

ObjectiveTo Quantify the risk of suicide following self-harm within the various healthcare settings to which patients present to help understand the risk factors involved.MethodA matched case-control study using electronic records for primary care, secondary care (hospitals) and national mortality registries in England between 2001–2019 (N = 594674). Cases with a death attributed to suicide were compared with a randomly selected control population.ResultsThe one-year suicide risk, adjusted for age and sex, was higher after recorded self-harm in primary care (odds ratio OR: 83, 95% confidence intervals CI: 76–91) and secondary care data (OR 124; 95% CI: 111–138) compared to those with no self-harm records. Suicide risk was highest in the first month after self-harm in primary care (OR 310; 95% CI: 244–393) and secondary care data (OR 458; 95% CI: 331–633). Suicide risk increased with the number of self-harm admissions in the final year (OR for patients with ≥3 self-harm attempts 505; 95% CI: 227–1123: p < 0.0001 for trend). While suicide risk following self-harm was increased across all age-groups and sexes, it was higher in females and older individuals compared to their counterparts with no self-harm records (p < 0.05).ConclusionIn both the primary care and secondary care datasets, the one-year relative suicide risk following self-harm was high, which is consistent with previous studies. The increased risk of suicide mortality following self-harm in older individuals and females may inform risk-stratification after a self-harm event