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Many firms, banks, or other economic agents embedded in a network of codependencies may experience a contemporaneous, sharp drop in functionality or productivity following a shock—even if that shock is localized or moderate in magnitude. We offer an extended review of motivating evidence that such fragility is a live concern in supply networks and in financial systems. We then discuss network models of fragility, focusing on the forces that make aggregate functionality especially sensitive to the economic environment. The key structural features of networks that determine their fragility are reviewed, with an emphasis on the importance of phase transitions. We then turn to endogenous decisions, both by market participants (e.g., firms investing in network formation and robustness) and by planners (e.g., authorities undertaking macroprudential regulation). Fragility has some distinctive implications for such decisions.

This article will provide an example of how the ‘Mobile Arts for Peace (MAP): Online psychosocial support through the arts in Rwanda’ project used digital art-based workshops to facilitate social and community cohesion and mental health provision. During the COVID-19 pandemic, there was an increased need for psychosocial support due to the economic and social pressures of lockdown and yet many individuals had less access to mental health provision. While many mental health services around the world went online, there was still a gap between the Global South and Global North in terms of digital literacy, access to smart phones and computers, and the variation between psychosocial support through individual vs. collective healing alongside Indigenous and traditional vs. western psychosocial approaches. Implications for the use of art-based digital methods as a tool for mental health provision during and after the wake of the pandemic are explored.

The intergenerational legacies of conflict and violence for children and young people are typically approached within research and interventions through the lens of trauma. Understandings of childhood and trauma are based on bio-psychological frameworks emanating from the Global North, often at odds with the historical, political, economic, social and cultural contexts in which interventions are enacted, and neglect the diversity of knowledge, experiences and practices. Within this paper we explore these concerns in the context of Rwanda and the aftermath of the 1994 Genocide Against the Tutsi. We reflect on two qualitative case studies: Connective Memories and Mobile Arts for Peace which both used arts-based approaches drawing on the richness of Rwandan cultural forms, such as proverbs and storytelling practices, to explore knowledge and processes of meaning-making about trauma, memory, and everyday forms of conflict from the perspectives of children and young people. We draw on these findings to argue that there is a need to refine and elaborate understandings of intergenerational transmission of trauma in Rwanda informed by: the historical and cultural context; intersections of structural and ‘everyday’ forms of conflict and social trauma embedded in intergenerational relations; and a reworking of notions of trauma ‘transmission’ to encompass the multiple connectivities between generations, temporalities and expressions of trauma.

Scalloping of radial and mixed flow turbocharger turbine rotors has been commonplace for many years as a means of inertia reduction and stress relief. The interest in turbine rotor inertia reduction is driven by transient loading requirements of turbocharged internal combustion engines, as this is a key factor in the time taken to meet transient engine torque requirements. Due to the high density materials used in turbine rotors, any material removal from the turbine wheel has a significant impact on turbocharger inertia, and thus the transient response of the engine. It is well known that scalloping not only reduces inertia, but also efficiency. This study aimed to identify if it was possible to produce a new scallop design which reduced the scalloping efficiency penalty without increasing inertia, or compromising mechanical constraints. This was carried out with the aim of developing design recommendations for scalloping where a complete minimization of inertia is not the design goal. A multipoint, multi-physics numerical optimization, with constraints on inertia and back disc stress, was carried out to determine what efficiency benefit could be realized by aerodynamically designing mixed flow turbine scalloping. An efficiency benefit was identified across the entire turbocharger operating line, with increased benefit at low engine load, whilst not exceeding the design constraints. Scalloping losses for the baseline design were found to be greatest at low engine load, where the turbine experienced low expansion ratio, mass flow and speed. This explains why an aerodynamic redesign yields the greatest benefit under those operating conditions. These performance predictions were experimentally validated on the cold flow test rig at Queen’s University Belfast, with good agreement between simulated and measured data. To conclude the study, a detailed loss audit was carried out to identify key loss generating flow structures, and to understand how changes in geometry affected the formation and development of these flow structures throughout the passage. A large vortex which entered the passage from the scalloped region and interacted with the tip leakage vortex along the suction surface of the blade was identified as the main source of loss due to scalloping. The optimized design was found to better control the location of entry of this vortex into the blade passage, thus reducing the associated loss, and facilitating a performance improvement. Geometric design guidelines were then proposed based on these findings.

Introduction: Patients with chronic health conditions, particularly chronic kidney disease, are at heightened risk for psychiatric disorders; yet, there are limited data on those with primary glomerular disease. Methods: This study included patients with glomerular disease enrolled in the kidney research network multisite patient registry. Registry data include encounter, diagnoses, medication, laboratory, and vital signs data extracted from participants’ electronic health records. ICD-9/10 diagnosis codes were used to identify a subset of psychiatric disorders focused on anxiety, mood, and behavioral disorders. Time-varying Cox proportional hazard models were used to analyze time from the onset of kidney disease to diagnosis of psychiatric disorder. Adjusted models retained significant covariates from the full list of potential confounders, including age, sex, race, ethnicity, time-varying treatment, the estimated glomerular filtration rate, and proteinuria (urine protein-to-creatinine ratio [UPCR]). Analogous models examined diagnosis of psychiatric disorder as a predictor of time to end-stage kidney disease (ESKD). Results: Data were available for 950 participants, with a median of 58 months of follow-up. 110 (12%) participants were diagnosed with psychiatric disorder during the follow-up. The estimated rate of psychiatric diagnosis after kidney disease was 14.7 cases per 1,000 person-years and was highest among those of adolescent age at the time of kidney disease diagnosis. Adjusted analyses found adolescent age (vs. adult, hazard ratio [HR] = 3.11, 95% confidence interval [CI] 1.87–5.17) and Asian race (vs. white, HR = 0.34, 95% CI 0.16–0.71) were associated with psychiatric diagnosis. A higher UPCR per 1 log unit (HR 1.13, 95% CI 1.01–1.27) and a higher total number of oral medications were associated with psychiatric disorder (p < 0.001). Psychiatric diagnosis was also associated with progression to ESKD (HR = 2.45, 95% CI 1.53–3.92) in adjusted models. Discussion/Conclusion: Psychiatric disorders were documented in approximately one-eighth of patients with glomerular disease and correlated with clinical disease characteristics such as age, race, proteinuria, and oral medication burden. These findings suggest mental health screening is warranted in patients of all ages with glomerular disease.

Background and Objective: The use of electronic health record (EHR) data can facilitate efficient research and quality initiatives. The imprecision of ICD-10 codes for kidney diagnoses has been an obstacle to discrete data-defined diagnoses in the EHR. This manuscript describes the Kidney Research Network (KRN) registry and database that provide an example of a prospective, real-world data glomerular disease registry for research and quality initiatives. Methods: KRN is a multicenter collaboration of patients, physicians, and scientists across diverse health-care settings with a focus on improving treatment options and outcomes for patients with glomerular disease. The registry and data warehouse amasses retrospective and prospective data including EHR, active research study, completed clinical trials, patient reported outcomes, and other relevant data. Following consent, participating sites enter the patient into KRN and provide a physician-confirmed primary kidney diagnosis. Kidney biopsy reports are redacted and uploaded. Site programmers extract local EHR data including demographics, insurance type, zip code, diagnoses, encounters, laboratories, procedures, medications, dialysis/transplant status, vitals, and vital status monthly. Participating sites transform data to conform to a common data model prior to submitting to the Data Analysis and Coordinating Center (DACC). The DACC stores and reviews each site’s EHR data for quality before loading into the KRN database. Results: As of January 2021, 1,192 patients have enrolled in the registry. The database has been utilized for research, clinical trial design, clinical trial end point validation, and supported quality initiatives. The data also support a dashboard allowing enrolling sites to assist with clinical trial enrollment and population health initiatives. Conclusion: A multicenter registry using EHR data, following physician- and biopsy-confirmed glomerular disease diagnosis, can be established and used effectively for research and quality initiatives. This design provides an example which may be readily replicated for other rare or common disease endeavors.

This article will provide an overview of how the Arts and Humanities Research Council (AHRC) Global Challenges Research Fund (GCRF) project Mobile Arts for Peace (MAP) has attempted to explore the use of interdisciplinary art-based practices for peacebuilding in Rwanda. In particular, we will detail how performance has been used to create a two-way system of communication between young people and policy-makers based on the issues that young people face towards developing an approach to teaching and learning informed by and with young people.

This article investigates stable and efficient networks in the context of risk sharing, when it is costly to establish and maintain relationships that facilitate risk sharing. We find a novel trade-off between efficiency and equality: the most stable efficient networks also generate the most inequality. We then suppose that individuals can be split into groups, assuming that incomes across groups are less correlated than within a group but relationships across groups are more costly to form. The tension between efficiency and equality extends to these correlated income structures. More-central agents have stronger incentives to form across-group links, reaffirming the efficiency benefits of having highly central agents. Our results are robust to many extensions. In general, endogenously formed networks in the risk-sharing context tend to exhibit highly asymmetric structures, which can lead to stark inequalities in consumption levels.

This article examines Hisaye Yamamoto’s short story “Wilshire Bus” in light of its pedagogical effectiveness in the contemporary cultural moment. The author argues that “Wilshire Bus,” published in 1950, resonates with many students today by evoking issues such as bullying, racist stereotyping, bystander responsibility, and post-traumatic stress disorder.

Rationale & Objective: The objective of the study was to estimate the prevalence of hypertension in patients with proteinuric kidney disease and evaluate blood pressure (BP) control. Study Design: Retrospective cohort study. Setting & Participants: Data from adults and children with proteinuric kidney disease enrolled in the multicenter Kidney Research Network Registry were used for this study. Exposure: Proteinuric kidney disease. Outcomes: Hypertension and BP control. Analytical Approach: Patients with white-coat hypertension were excluded. Patients were censored at end-stage kidney disease onset. Patients were defined as hypertensive either by hypertension diagnosis code, having 2 or more encounters with elevated BPs, or treatment with antihypertensive therapy excluding renin-angiotensin-aldosterone system blockade. Elevated BP was defined as greater than 95th percentile for children and >140/90 mm Hg in adults. Sustained BP control was defined as 2 or more consecutive encounters with BPs lower than 95th percentile for children and

Focal segmental glomerulosclerosis (FSGS) is a common cause of end-stage kidney disease (ESKD) across the lifespan. While 10% to 15% of children and 3% of adults who develop ESKD have FSGS, it remains uncertain whether the natural history differs in pediatric vs adult patients, and this uncertainty contributes to the exclusion of children and adolescents in clinical trials.To examine whether there are differences in the kidney health outcomes among children, adolescents, and adults with FSGS.This cohort study used pooled and parallel analyses, completed July 5, 2022, from 3 complimentary data sources: (1) Nephrotic Syndrome Rare Disease Clinical Research Network (NEPTUNE); (2) FSGS clinical trial (FSGS-CT); and (3) Kidney Research Network (KRN). NEPTUNE is a multicenter US/Canada cohort study; FSGS-CT is a multicenter US/Canada clinical trial; and KRN is a multicenter US electronic health record-based registry from academic and community nephrology practices. NEPTUNE included 166 patients with incident FSGS enrolled at first kidney biopsy; FSGS-CT included 132 patients with steroid-resistant FSGS randomized to cyclosporine vs dexamethasone with mycophenolate; and KRN included 184 patients with prevalent FSGS. Data were collected from November 2004 to October 2019 and analyzed from October 2020 to July 2022.Age: children (age13 years) vs adolescents (13-17 years) vs adults (≥18 years). Covariates of interest included sex, disease duration, APOL1 genotype, urine protein-to-creatinine ratio, estimated glomerular filtration rate (eGFR), edema, serum albumin, and immunosuppressive therapy.ESKD, composite outcome of ESKD or 40% decline in eGFR, and complete and/or partial remission of proteinuria.The study included 127 (26%) children, 102 (21%) adolescents, and 253 (52%) adults, including 215 (45%) female participants and 138 (29%) who identified as Black, 98 (20%) who identified as Hispanic, and 275 (57%) who identified as White. Overall, the median time to ESKD was 11.9 years (IQR, 5.2-19.1 years). There was no difference in ESKD risk among children vs adults (hazard ratio [HR], 0.67; 95% CI, 0.43-1.03) or adolescents vs adults (HR, 0.85; 95% CI, 0.52-1.36). The median time to the composite end point was 5.7 years (IQR 1.6-15.2 years), with hazard ratio estimates for children vs adults of 1.12 (95% CI, 0.83-1.52) and adolescents vs adults of 1.06 (95% CI, 0.75-1.50).In this study, the association of FSGS with kidney survival and functional outcomes was comparable at all ages.

Young People as Legislators is the result of a six-month Legislative Theatre project with Collective Encounters Youth Theatre, Youth Focus NW and Youth Parliament UK. The project formed part of a wider scheme of practice as research that explored youth theatre practice as political engagement for young people. Legislative Theatre practice was utilized to work alongside the Youth Parliament’s Make Your Mark scheme, an annual poll for young people to decide on campaigning issues. In this article, I consider three elements: tokenism in youth engagement, differing experiences between artistic process and product, and applied theatre’s inability to develop long-term effects. Employing the critical theories of Paulo Freire, the article regards the practice as a failed attempt to develop critical youth theatre practice. I argue that the Legislative Theatre project led to uncritical engagement and no political change due to partner organizations regarding the theatre practice as a service to satisfy their own targets and requirements.

U.S. farmer cooperatives are increasing in size but decreasing in number because of merger and acquisition (M&A) activity. However, the empirical literature on cooperative M&A activity is scarce and has only considered capital structure characteristics as possible explanations. We contribute to the existing literature by exploring the relationship of capital capacity, spatial competition, and strategic orientation to M&A activity by the largest 1000 U.S. farmer cooperatives in the 2014–2016 period. Using probit and negative binomial regressions, we find equity constraints did not inform recent M&A activity in the U.S. farmer cooperative sector. Rather, we find M&A activity increased in size and decreased in leverage. In addition, we find farmer cooperatives with larger market shares are less likely to pursue M&A activity, but proximity to other farmer cooperatives in the same sector increases the probability of external growth behavior. Also, farmer cooperatives which pursue differentiation are less likely to grow externally, suggesting recent M&As have been motivated by tangible as opposed to intangible asset acquisitions.

The recent emergence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), the underlying cause of Coronavirus Disease 2019 (COVID-19), has led to a worldwide pandemic causing substantial morbidity, mortality, and economic devastation. In response, many laboratories have redirected attention to SARS-CoV-2, meaning there is an urgent need for tools that can be used in laboratories unaccustomed to working with coronaviruses. Here we report a range of tools for SARS-CoV-2 research. First, we describe a facile single plasmid SARS-CoV-2 reverse genetics system that is simple to genetically manipulate and can be used to rescue infectious virus through transient transfection (without in vitro transcription or additional expression plasmids). The rescue system is accompanied by our panel of SARS-CoV-2 antibodies (against nearly every viral protein), SARS-CoV-2 clinical isolates, and SARS-CoV-2 permissive cell lines, which are all openly available to the scientific community. Using these tools, we demonstrate here that the controversial ORF10 protein is expressed in infected cells. Furthermore, we show that the promising repurposed antiviral activity of apilimod is dependent on TMPRSS2 expression. Altogether, our SARS-CoV-2 toolkit, which can be directly accessed via our website at https://mrcppu-covid.bio/, constitutes a resource with considerable potential to advance COVID-19 vaccine design, drug testing, and discovery science., To help meet the ensuing demand for COVID-19 reagents, this article presents an openly available ‘coronavirus toolkit’ (https://mrcppu-covid.bio) and describes the generation and validation of these tools, including a simple SARS-CoV-2 reverse genetics system and a near-comprehensive panel of SARS-CoV-2 antibodies.

Gemlike objects are a nearly ubiquitous phenomenon in the medium of glass, although culturally specific studies remain scarce. This dissertation considers the production of such works in the early medieval period, primarily in association with Abbasid rule. The first half attends to several accessory issues, including glass-related terminology, glass-coloring treatises, the lives of glassworkers, gemstone connoisseurship, and the legal status of such products. These demonstrate a range of coexisting attitudes, including the desirability of such works for their own sake rather than as surreptitious substitutes for “true” gemstones. The second half focuses on an exemplary object, an opaque turquoise glass bowl from the Treasury of San Marco in Venice, which I propose was produced in Baghdad for the caliph al-Mutawakkil just after the year 850. I then consider this work’s changing reception from late medieval Venice to modern scholarship, including ways in which “correct” interpretations of its material and/or origin have been repeatedly supplanted by false leads. The fundamental argument is that gemlike vessels like the San Marco turquoise were not deceptive stand-ins but rather intended to exercise complex discursive practices, both political and connoisseurial in nature, a function that ultimately remains in effect today.

Management of the COVID-19 pandemic has proven to be a significant challenge to policy makers. This is in large part due to uneven reporting and the absence of open-access visualization tools to present local trends and infer healthcare needs. Here we report the development of CovidCounties.org, an interactive web application that depicts daily disease trends at the level of US counties using time series plots and maps. This application is accompanied by a manually curated dataset that catalogs all major public policy actions made at the state-level, as well as technical validation of the primary data. Finally, the underlying code for the site is also provided as open source, enabling others to validate and learn from this work.

Mixed flow turbines have reached a level of maturity where iterative performance improvements are very small, with real performance benefits coming from better matching to a given application as opposed to improvements in technology. One ubiquitous design feature of mixed flow turbines used to control stress within the wheel is the radial fibre constraint, wherein blade material is stacked radially outward along the entirety of the blade. While this constraint yields a mechanical benefit, it constrains the aerodynamic design significantly, with the blade shape defined by one camberline. One potential means of realizing a performance improvement is the use of 3D blading, where the blade is not constrained to a radially fibred structure. In such a design, the blade shape could be freely modified to better control blade loading and secondary flows. This study investigated the viability of such 3D blading through optimization of a state of the art mixed flow turbine. An equivalent design was ensured by maintaining the meridional shape and operating conditions of the baseline wheel, thus facilitating a fair comparison between the radial and 3D wheels. The paper details the optimization including an innovative constraint-driven geometry modification tool, experimental validation of performance predictions, and an investigation into why 3D blading facilitated a performance improvement. The optimization process identified a performance improvement across the entire turbocharger operating line. With performance improvements facilitated through a reduction in tip leakage loss, and improved pressure recovery within the conical diffuser. Importantly, the optimized design met targets for mass flow, maximum stress levels, and modal behaviour, through the use of the novel geometry modification process.

Systems contradictions present challenges that need to be effectively managed, e.g. due to conflicting rules and advice, goal conflicts, and mismatches between demand and capacity. We apply FRAM (Functional Resonance Analysis Method) to intravenous infusion practices in an intensive care unit (ICU) to explore how tensions and contradictions are managed by people. A multi-disciplinary team including individuals from nursing, medical, pharmacy, safety, IT and human factors backgrounds contributed to this analysis. A FRAM model investigation resulting in seven functional areas are described. A tabular analysis highlights significant areas of performance variability, e.g. administering medication before a prescription, prioritising drugs, different degrees of double checking and using sites showing early signs of infection for intravenous access. Our FRAM analysis has been non-normative: performance variability is not necessarily wanted or unwanted, it is merely necessary where system contradictions cannot be easily resolved and so adaptive capacity is required to cope.

Management of the COVID-19 pandemic has proven to be a significant challenge to policy makers. This is in large part due to uneven reporting and the absence of open-access visualization tools to present local trends and infer healthcare needs. Here we report the development of CovidCounties.org, an interactive web application that depicts daily disease trends at the level of US counties using time series plots and maps. This application is accompanied by a manually curated dataset that catalogs all major public policy actions made at the state-level, as well as technical validation of the primary data. Finally, the underlying code for the site is also provided as open source, enabling others to validate and learn from this work.

We model the production of complex goods in a large supply network. Each firm sources several essential inputs through relationships with other firms. Individual supply relationships are at risk of idiosyncratic failure, which threatens to disrupt production. To protect against this, firms multisource inputs and strategically invest to make relationships stronger, trading off the cost of investment against the benefits of increased robustness. A supply network is called fragile if aggregate output is very sensitive to small aggregate shocks. We show that supply networks of intermediate productivity are fragile in equilibrium, even though this is always inefficient. The endogenous configuration of supply networks provides a new channel for the powerful amplification of shocks. (JEL D21, G31, L14)