bluuebunny/crossref_metadata_2025 huggingface dataset:
Reweighting and validation of the hospital frailty risk score using electronic health records in Germany: a retrospective observational study
Authors: Kaier Klaus , Heidenreich Adrian , Jäckel Markus , Oettinger Vera , Maier Alexander , Hilgendorf Ingo , Breitbart Philipp , Hartikainen Tau , Keller Till , Westermann Dirk , von zur Mühlen Constantin
Published: June 2024

Background

In the hospital setting, frailty is a significant risk factor, but difficult to measure in clinical practice. We propose a reweighting of an existing diagnoses-based frailty score using routine data from a tertiary care teaching hospital in southern Germany.

Methods

The dataset includes patient characteristics such as sex, age, primary and secondary diagnoses and in-hospital mortality. Based on this information, we recalculate the existing Hospital Frailty Risk Score. The cohort includes patients aged ≥ 75 and was divided into a development cohort (admission year 2011 to 2013, N = 30,525) and a validation cohort (2014, N = 11,202). A limited external validation is also conducted in a second validation cohort containing inpatient cases aged ≥ 75 in 2022 throughout Germany (N = 491,251). In the development cohort, LASSO regression analysis was used to select the most relevant variables and to generate a reweighted Frailty Score for the German setting. Discrimination is assessed using the area under the receiver operating characteristic curve (AUC). Visualization of calibration curves and decision curve analysis were carried out. Applicability of the reweighted Frailty Score in a non-elderly population was assessed using logistic regression models.

Results

Reweighting of the Frailty Score included only 53 out of the 109 frailty-related diagnoses and resulted in substantially better discrimination than the initial weighting of the score (AUC = 0.89 vs. AUC = 0.80, p < 0.001 in the validation cohort). Calibration curves show a good agreement between score-based predictions and actual observed mortality. Additional external validation using inpatient cases aged ≥ 75 in 2022 throughout Germany (N = 491,251) confirms the results regarding discrimination and calibration and underlines the geographic and temporal validity of the reweighted Frailty Score. Decision curve analysis indicates that the clinical usefulness of the reweighted score as a general decision support tool is superior to the initial version of the score. Assessment of the applicability of the reweighted Frailty Score in a non-elderly population (N = 198,819) shows that discrimination is superior to the initial version of the score (AUC = 0.92 vs. AUC = 0.87, p < 0.001). In addition, we observe a fairly age-stable influence of the reweighted Frailty Score on in-hospital mortality, which does not differ substantially for women and men.

Conclusions

Our data indicate that the reweighted Frailty Score is superior to the original Frailty Score for identification of older, frail patients at risk for in-hospital mortality. Hence, we recommend using the reweighted Frailty Score in the German in-hospital setting.
Clinic-based evaluation of point-of-care dual HIV/syphilis rapid diagnostic tests at primary healthcare antenatal facilities in South Africa and Zambia
Authors: Kularatne Ranmini , Blondeel Karel , Kasaro Margaret , Maseko Venessa , Bosomprah Samuel , Silva Ronaldo , Laverty Maura , Kurbonov Firdavs , Mirandola Massimo , Peeling Rosanna W
Published: June 2024

Background

Southern African countries have the largest global burden of HIV and syphilis, with a high prevalence among women of reproductive age. Although antenatal screening is standard of care, syphilis screening has generally lagged behind HIV screening. We aimed to evaluate the performance and operational characteristics of two commercial dual HIV/syphilis point-of-care tests (POCTs) for simultaneous maternal HIV/syphilis screening.

Methods

A clinic-based evaluation of dual HIV/syphilis POCTs (SD Bioline and Chembio) was conducted at five primary healthcare centres (PHCs) in South Africa and Zambia. POCT results using capillary fingerprick blood were compared to reference laboratory syphilis and HIV serological assays.

Results

Three thousand four hundred twelve consenting pregnant women aged ≥ 18 years were enrolled. The prevalence of treponemal antibody seropositivity and HIV infection ranged from 3.7 to 9.9% (n = 253) and 17.8 to 21.3% (n = 643), respectively. Pooled sensitivity for syphilis compared to the reference assay was 66.0% (95%CI 57.7–73.4) with SD Bioline and 67.9% (95%CI 58.2–76.3) with Chembio. Pooled specificity for syphilis was above 98% with both POCTs. The sensitivities of SD Bioline and Chembio assays were 78.0% (95%CI 68.6–85.7) and 81.0% (95%CI 71.9–88.2), respectively compared to an active syphilis case definition of treponemal test positive with a rapid plasma reagin titre of ≥ 8. The negative predictive values (NPVs) based on various prevalence estimates for syphilis with both assays ranged from 97 to 99%. The pooled sensitivity for HIV was 92.1% (95%CI 89.4–94.2) with SD Bioline; and 91.5% (95%CI 88.2–93.9) with Chembio. The pooled specificities for HIV were 97.2% (95%CI 94.8–98.5) with SD Bioline and 96.7% (95%CI 95.1–97.8) with Chembio. The NPV based on various prevalence estimates for HIV with both assays was approximately 98%. Most participating women (91%) preferred dual POCTs over two single POCTs for HIV and syphilis, and healthcare providers gave favourable feedback on the utility of both assays at PHC level.

Conclusions

Based on the need to improve antenatal screening coverage for syphilis, dual HIV/syphilis POCTs could be effectively incorporated into antenatal testing algorithms to enhance efforts towards elimination of mother-to-child transmission of these infections.
Clinical efficacy and safety of switching from eculizumab to ravulizumab in adult patients with aHUS– real-world data
Authors: Schönfelder Kristina , Kühne Lucas , Schulte-Kemna Lena , Kaufeld Jessica , Rohn Hana , Kribben Andreas , Schröppel Bernd , Brinkkötter Paul T. , Gäckler Anja
Published: June 2024

Background

The complement factor 5 (C5)-inhibitor eculizumab has been established as standard-of-care for the treatment of atypical hemolytic uremic syndrome (aHUS). In 2021, the long-acting C5-inhibitor ravulizumab was approved, extending intervals of intravenous treatment from two to eight weeks resulting in improvement of quality of life for patients and lowering direct and indirect therapy associated costs.

Methods

This multicenter, retrospective data analysis of 32 adult patients with aHUS (including 10 kidney transplant recipients) treated with eculizumab for at least three months and switched to ravulizumab aims to evaluate the safety and efficacy of switching medication in the real-world setting. Hematologic parameters, kidney function, concurrent therapy and aHUS associated events were evaluated three months before and until up to 12 months after switching to ravulizumab.

Results

Mean age (range) at ravulizumab initiation was 41 years (19–78 years) and 59% of the patients were female. Genetic analysis was available for all patients with 72% showing a pathogenic variant. Median time (range) on eculizumab before switching was 20 months (3–120 months). No new events of TMA or worsening of renal function were reported during up to 12 months of follow-up during ravulizumab treatment.

Conclusions

This is the largest, non-industry derived, multi-center retrospective analysis of adult patients with aHUS switching C5-inhibitor treatment from eculizumab to ravulizumab in the real-world setting. Switching to ravulizumab was safe and efficient resulting in sustained hematological stability and preservation of renal function.
Basement membrane-related MMP14 predicts poor prognosis and response to immunotherapy in bladder cancer
Authors: Zhang Xuezhou , Hong Baoan , Li Hongwei , Zhao Jiahui , Li Mingchuan , Wei Dechao , Wang Yongxing , Zhang Ning
Published: June 2024

Background

Basement membrane (BM) is an important component of the extracellular matrix, which plays an important role in the growth and metastasis of tumor cells. However, few biomarkers based on BM have been developed for prognostic assessment and prediction of immunotherapy in bladder cancer (BLCA).

Methods

In this study, we used the BLCA public database to explore the relationship between BM-related genes (BMRGs) and prognosis. A novel molecular typing of BLCA was performed using consensus clustering. LASSO regression was used to construct a signature based on BMRGs, and its relationship with prognosis was explored using survival analysis. The pivotal BMRGs were further analyzed to assess its clinical characteristics and immune landscape. Finally, immunohistochemistry was used to detect the expression of the hub gene in BLCA patients who underwent surgery or received immune checkpoint inhibitor (ICI) immunotherapy in our hospital.

Results

We comprehensively analyzed the relationship between BMRGs and BLCA, and established a prognostic-related signature which was an independent influence on the prognostic prediction of BLCA. We further screened and validated the pivotal gene-MMP14 in public database. In addition, we found that MMP14 expression in muscle invasive bladder cancer (MIBC) was significantly higher and high MMP14 expression had a poorer response to ICI treatment in our cohort.

Conclusions

Our findings highlighted the satisfactory value of BMRGs and suggested that MMP14 may be a potential biomarker in predicting prognosis and response to immunotherapy in BLCA.
Exploring the interplay of depression, sleep quality, and hearing in tinnitus-related handicap: insights from polysomnography and pure-tone audiometry
Authors: Chang Ting-Gang , Yao Yi-Ting , Hsu Chiann-Yi , Yen Ting-Ting
Published: June 2024

Background

Tinnitus affects approximately 740 million adults globally, involving hearing, emotion, and sleep systems. However, studies using polysomnography and pure-tone audiometry (PTA) are limited. We aimed to assess the correlation between tinnitus and hearing, sleep quality, characteristics, and depression using polysomnography and PTA.

Methods

In this cross-sectional study, we divided participants into tinnitus and non-tinnitus groups. We included 100 outpatients (65 with tinnitus, 35 without) from a medical center in Taiwan, who underwent polysomnography and completed rating scales including the Patient Health Questionnaire-9 (PHQ-9), Chinese version of the Pittsburgh Sleep Quality Index (PSQI), and Chinese-Mandarin version of the Tinnitus Handicap Inventory (THI-CM). We analyzed correlations, conducted group comparisons, assessed factors related to THI-CM scores, constructed ROC curves to predict depression in the tinnitus group, and performed multinomial and logistic regression to explore associations.

Results

Descriptive statistics identified a cohort with mean age 53.9 ± 12.80 years, 63% exhibited PHQ-9 scores ≥ 10, and 66% had Apnea–Hypopnea Index (AHI) > 5. The ratio of rapid eye movement and deep sleep to stage 1 + 2 sleep was relatively low and non-significant. Likewise, leg movements was higher in the tinnitus group but not statistically significant. In the tinnitus group, 63.08% had depression, and 81.54% had AHI > 5. Univariate logistic regression linked tinnitus to AHI > 5 (Odds ratio (OR) 2.67, p = 0.026) and male sex (OR 2.49, p = 0.034). A moderate positive correlation was found between the THI-CM score and PHQ-9 score (rs = 0.50, p < 0.001). Further adjustment for obstructive sleep apnea showed associations between PHQ-9 (total score) or depression and THI-CM Grade 3–5 (OR = 1.28; OR = 8.68). Single- and multifactor regression analyses highlighted significant associations of PSQI scores > 13 (OR 7.06, p = 0.018) and THI-CM scores > 47 (OR 7.43, p = 0.002) with depression.

Conclusions

Our study recruited tinnitus participants with slight or mild hearing loss and mild tinnitus handicap. Depression was identified as a predominant factor in tinnitus-related handicap. The mild tinnitus handicap in tinnitus participants may explain the lack of significant differences in depression, sleep quality, and polysomnographic sleep characteristics between tinnitus and non-tinnitus groups. Further extensive and prospective studies are needed to elucidate the complex links among depression, sleep, and tinnitus.
Only 9% of mothers have eight and more ANC visit in 14 sub-saharan African countries; evidence from the most recent DHS 2018–2023: a multilevel analysis
Authors: Demissie Kaleb Assegid , Jejaw Melak , Wondimu Befikir Gezahegn , Mersha Yekunuamlak Teshome , Demsash Eyuale Sitotaw , Dessie Samuel Getachew , Teshome Asteway Gashaw , Geberu Demiss Mulatu , Tiruneh Misganaw Guadie
Published: June 2024

Background

The world health organization’s global health observatory defines maternal mortality as annual number of female deaths, regardless of the period or location of the pregnancy, from any cause related to or caused by pregnancy or its management (aside from accidental or incidental causes) during pregnancy and childbirth or within 42 days of termination of pregnancy and an estimated 287 000 women worldwide passed away from maternal causes between 2016 and 2020, that works out to be about 800 deaths per day or about one every two minutes.

Method

The most recent 2018–2023 DHS data set of 14 SSA countries was used a total of 89,489 weighted mothers who gave at list one live birth 3 years preceding the survey were included, a multilevel analysis was conducted. In the bi-variable analysis variables with p-value ≤ 0.20 were included in the multivariable analysis, and in the multivariable analysis, variables with p-value less than ≤ 0.05 were considered to be significant factors associated with having eight and more ANC visits.

Result

The magnitude of having eight and more ANC visits in 14 sub-Saharan African countries was 8.9% (95% CI: 8.76–9.13) ranging from 3.66% (95% CI: 3.54–3.79) in Gabon to 18.92% (95% CI: 18.67–19.17) in Nigeria. The multilevel analysis shows that maternal age (40–44, AOR;2.09, 95%CI: 1.75–2.53), maternal occupational status (AOR;1.14, 95%CI; 1.07–1.22), maternal educational level (secondary and above, AOR;1.26, 95%CI; 1.16–1.38), wealth status(AOR;1.65, 95%CI; 1.50–1.82), media exposure (AOR;1.20, 95%CI; 1.11–1.31), pregnancy intention (AOR;1.12, 95%CI; 1.05–1.20), ever had terminated pregnancy (AOR;1.16 95%CI; 1.07–1.25), timely initiation of first ANC visit (AOR;4.79, 95%CI; 4.49–5.10), empowerment on respondents health care (AOR;1.43, 95%CI; 1.30–1.56), urban place of residence (AOR;1.33, 95%CI; 1.22–1.44) were factors highly influencing the utilization of AN. On the other hand higher birth order (AOR;0.54, 95%CI; 0.53–0.66), not using contraceptive (AOR;0.80, 95%CI; 0.75–0.86) and survey year (AOR;0.47, 95%CI; 0.34–0.65) were factors negatively associated with having eight and more ANC visits.

Conclusion

In the 14 SSA included in this study, there is low adherence to WHO guidelines of eight and more ANC visits. Being educated, having jobs, getting access to media being from rural residence and rich wealth group contribute to having eight and more ANC visits, so we highly recommend policy implementers to advocate this practices.
Telling the truth to patients before hip fracture surgery
Authors: Masarwa Rawan , Ben Natan Merav , Berkovich Yaron
Published: June 2024

Background

Hip fracture repair surgery carries a certain mortality risk, yet evidence suggests that orthopedic surgeons often refrain from discussing this issue with patients prior to surgery.

Aim

This study aims to examine whether orthopedic surgeons raise the issue of one-year post-surgery mortality before hip fracture repair surgery and to explore factors influencing this decision.

Method

The study employs a cross-sectional design, administering validated digital questionnaires to 150 orthopedic surgeons.

Results

A minority of orthopedic surgeons reported always informing patients about the risk of mortality in the year following hip fracture surgery. The main reasons for not discussing this risk were a desire to avoid frightening patients, time constraints, and concerns about undermining patient hope. Orthopedic surgeons reported a medium-high level of perceived self-efficacy, with higher self-efficacy associated with a reduced likelihood of discussing one-year mortality risk. Conversely, older age and holding a specialist status in orthopedic surgery were associated with an increased likelihood of discussing this risk with patients.

Conclusions

These findings suggest a need for interventions to address communication barriers and ensure consistent provision of essential information to patients undergoing hip fracture surgery. Additionally, they highlight the importance of considering individual factors such as self-efficacy, age, and expertise in designing strategies to improve patient-provider communication in orthopedic care settings.

Trial registration

: The study doesn`t report the results of a health care intervention.
Quantitative prediction of postpartum hemorrhage in cesarean section on machine learning
Authors: Wang Meng , Yi Gao , Zhang Yunjia , Li Mei , Zhang Jin
Published: June 2024

Background

Cesarean section-induced postpartum hemorrhage (PPH) potentially causes anemia and hypovolemic shock in pregnant women. Hence, it is helpful for obstetricians and anesthesiologists to prepare pre-emptive prevention when predicting PPH occurrence in advance. However, current works on PPH prediction focus on whether PPH occurs rather than assessing PPH amount. To this end, this work studies quantitative PPH prediction with machine learning (ML).

Methods

The study cohort in this paper was selected from individuals with PPH who were hospitalized at Shijiazhuang Obstetrics and Gynecology Hospital from 2020 to 2022. In this study cohort, we built a dataset with 6,144 subjects covering clinical parameters, anesthesia operation records, laboratory examination results, and other information in the electronic medical record system. Based on our built dataset, we exploit six different ML models, including logistic regression, linear regression, gradient boosting, XGBoost, multilayer perceptron, and random forest, to automatically predict the amount of bleeding during cesarean section. Eighty percent of the dataset was used as model training, and 20$$\%$$
%
was used for verification. Those ML models are constantly verified and improved by root mean squared error(RMSE) and mean absolute error(MAE). Moreover, we also leverage the importance of permutation and partial dependence plot (PDP) to discuss their feasibility.

Result

The experiment results show that random forest obtains the highest accuracy for PPH amount prediction compared to other ML methods. Random forest reaches the mean absolute error of 21.7, less than 5.4$$\%$$
%
prediction error. It also gains the root mean squared error of 33.75, less than 9.3$$\%$$
%
prediction error. On the other hand, the experimental results also disclose indicators that contributed most to PPH prediction, including Ca, hemoglobin, white blood cells, platelets, Na, and K.

Conclusion

It effectively predicts the amount of PPH during a cesarean section by ML methods, especially random forest. With the above insight, ML predicting PPH amounts provides early warning for clinicians, thus reducing complications and improving cesarean sections’ safety. Furthermore, the importance of ML and permutation, complemented by incorporating PDP, promises to provide clinicians with a transparent indication of individual risk prediction.
Exploring the perception of safety culture among nurses in Saudi Arabia
Authors: Al Muharraq Essa H. , Abdali Farida , Alfozan Abeer , Alallah Sultan , Sayed Bashaer , Makakam Abdulrahman
Published: June 2024

Background

Medical errors and adverse events pose a serious challenge to the global healthcare industry. Nurses are at the frontline in implementing safety measures and protecting patients. This study aimed to investigate nurses’ perceptions of the patient safety culture in Saudi Arabia.

Methods

This cross-sectional descriptive study used convenience sampling to survey 402 nurses from various hospitals in Jazan, Saudi Arabia. The Hospital Survey on Patient Safety Culture was used for the data collection.

Results

Nurses reported a moderate perception of safety culture, with 60% positive responses. Teamwork had the highest safety culture rating at 77.8%, while responses to error and staffing were the lowest at 39.75% and 46.17%, respectively. Qualifications significantly predicts nurses’ safety culture rating (B = -0442, t = -4.279, p < 0.01). Positive correlations were found between event reporting frequency and communication openness (r = 0.142, p < 0.01), and patient safety grades with communication about errors (r = 0.424, p < 0.01) and hospital management support (r = 0.231, p < 0.01).

Conclusions

Nurses in Saudi Arabia demonstrated a strong sense of teamwork and commitment to organizational learning. However, critical areas such as staffing and error response require attention to improve patient safety.
Early parent-child intervention with Dialogic Book-Sharing: effects on child communicative and socio-emotional development and on parenting. Study protocol for a multicentre randomised controlled trial in Italy
Authors: Loredana Cena , Alice Trainini , Lynne Murray , Peter Cooper , Stefano Calza , Mauro Belluardo
Published: June 2024

Background

Research in the neurosciences has highlighted the importance of intersubjective relationships in promoting neuromental development of the child. Children’s learning in early childhood occurs mainly in a dyadic context of an interaction with their parents: from this perspective, good dialogic parent–child communication is required to be promoted also through good educational practices. Dialogic Book-Sharing (DBS), a dialogic form of parent–child communication through the use of wordless picture books, provides a privileged ‘intersubjective’ space and is highly effective in promoting communication, language, attention, behavioural development and the parent–child relationship. DBS programme, successfully previously trialled in South Africa and the UK, will be applied for the first time in Italy for research purposes in Italian health, educational and maternal-child centres.

Methods

A multicentre randomised controlled trial is being conducted to evaluate DBS parenting intervention for children aged between 14 and 20 months. Parent–child dyads are randomly allocated to a book-sharing intervention group or to a wait-list control group. In the intervention, parents are trained in supportive book-sharing with their children by local staff of the centres. DBS intervention is carried out in small groups over a period of 4 weeks. Data are collected at baseline, post-intervention and at 6 months post-intervention with a questionnaire and video recording of parent–child interaction.

Discussion

DBS programme in early childhood could enhance the educational resources offered by Italian health, educational and maternal-child centres, in support of child’s development and parenting. DBS represents a strategic opportunity for bringing about positive effects, also in terms of prevention of socio-emotional and cognitive difficulties. As such it represents a promising response to the new social, health and educational needs of the post-COVID-19 pandemic era caused by the social isolation measures. Furthermore, the application of the DBS methodology is a way to promote the use of books, and thereby counteract the excessive use of technological devices already present in early childhood.

Trial registration

The trial is registered on the International Standard Randomised Controlled Trial Number database, registration number ISRCTN11755019 Registered on 2 November 2023. This is version 1 of the protocol for the trial.
Nutritional interventions in children with acute lymphoblastic leukemia undergoing antineoplastic treatment: a systematic review
Authors: Guzmán-León Alan E. , Avila-Prado Jessica , Bracamontes-Picos Leslie R. , Haby Michelle M. , Stein Katja , Astiazaran-Garcia Humberto , Lopez-Teros Veronica
Published: June 2024

Background

A compromised nutritional status jeopardizes a positive prognosis in acute lymphoblastic leukemia (ALL) patients. In low- and middle-income countries, ~ 50% of children with ALL are malnourished at diagnosis time, and undergoing antineoplastic treatment increases the risk of depleting their nutrient stores. Nutrition interventions are implemented in patients with cancer related malnutrition. We aimed to evaluate the effect of nutrition interventions in children diagnosed with ALL under treatment.

Methods

Using a predefined protocol, we searched for published or unpublished randomized controlled trials in: Cochrane CENTRAL, MEDLINE, EMBASE, LILACS, and SciELO, and conducted complementary searches. Studies where at least 50% of participants had an ALL diagnosis in children ≤ 18 years, active antineoplastic treatment, and a nutrition intervention were included. Study selection and data extraction were conducted independently by three reviewers, and assessment of the risk of bias by two reviewers. Results were synthesized in both tabular format and narratively.

Results

Twenty-five studies (out of 4097 records) satisfied the inclusion requirements. There was a high risk of bias in eighteen studies. Interventions analyzed were classified by compound/food (n = 14), micronutrient (n = 8), and nutritional support (n = 3). Within each group the interventions and components (dose and time) tested were heterogeneous. In relation to our primary outcomes, none of the studies reported fat-free mass as an outcome. Inflammatory and metabolic markers related to nutritional status and anthropometric measurements were reported in many studies but varied greatly across the studies. For our secondary outcomes, fat mass or total body water were not reported as an outcome in any of the studies. However, some different adverse events were reported in some studies.

Conclusions

This review highlights the need to conduct high-quality randomized controlled trials for nutrition interventions in children with ALL, based on their limited number and heterogeneous outcomes.

Registration of the review protocol

Guzmán-León AE, Lopez-Teros V, Avila-Prado J, Bracamontes-Picos L, Haby MM, Stein K. Protocol for a Systematic Review: Nutritional interventions in children with acute lymphoblastic leukemia undergoing an tineoplastic treatment. International prospective register of systematic reviews. 2021; PROSPERO CRD:42,021,266,761 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=266761).
SAÚDE DIGITAL?
Authors: Resende Sérgio André Lopes , Correia Pedro Miguel Alves Ribeiro
Published: June 2024

O setor da saúde, inserido na Administração Pública, encontra-se em profundas mudanças no que diz respeito à temática do digital. Por isso mesmo, o presente estudo será relevante na medida em que estará a estudar uma temática nova, um processo/acontecimento que está a decorrer a olhos vistos no presente da Administração da Saúde. Nesse sentido, o presente estudo irá incidir sobre a análise do processo de transição digital na área da saúde, nomeadamente os planos de Portugal, Reino Unido e Itália. A análise será, numa primeira fase, expositiva, e, numa segunda fase qualitativa, isto é, de análise comparada entre os vários países, sem recurso a dados mensuráveis. Com este estudo, poderá dar-se um importante contributo à prática da transição digital, na medida em que as análises comparadas funcionam como uma espécie de benchmarking, capaz de pegar em bons exemplos que se encontrem noutros projetos para aplicar ao seu; neste caso, o plano de transição digital de saúde português.
Η πολιτική της αυτονομίας στην εκπαίδευση
Authors: Περπερίδου Αικατερίνη
Published: June 2024

Η αυτονομία στον τομέα της εκπαίδευσης αναδύεται ως ουσιαστική διάσταση του εκπαιδευτικού συστήματος τις τελευταίες δεκαετίες σε παγκόσμιο επίπεδο και παρουσιάζεται ως λύση στα προβλήματα της δημόσιας εκπαίδευσης. Στο πλαίσιο αυτό, η παρούσα μελέτη έχει ως στόχο να εξετάσει την εξέλιξη της αυτονομίας στον τομέα της εκπαίδευσης σε βάθος σαράντα ετών (1980-2020) στη Μεγάλη Βρετανία, ως σημαντικό παράδειγμα της υπό μελέτης πολιτικής. Η έρευνα αναλύει τις κύριες πολιτικές κατευθύνσεις, τα προγράμματα και τις πρακτικές που έχουν σχηματίσει το εκπαιδευτικό πεδίο στη χώρα αυτή. Με βάση την πρόοδο που έχει επιτευχθεί στη Μεγάλη Βρετανία, αυτή αποτελεί υποκείμενο για την παρακολούθηση και τη σύγκριση με την εκπαιδευτική πορεία της Ελλάδας. Με τη χρήση της μεθόδου της συγκριτικής μελέτης περίπτωσης, εξετάζεται η νεοφιλελεύθερη στροφή στην εκπαιδευτική πολιτική της Ελλάδας και η εξέλιξη προς την αυτονομία σε όλες τις διαστάσεις του εκπαιδευτικού συστήματος. Η μελέτη παρουσιάζει, επιπλέον, τις στάσεις και τις αντιλήψεις της εκπαιδευτικής κοινότητας μέσω σαράντα ημιδομημένων συνεντεύξεων με εκπαιδευτικούς και διευθυντές από δημόσια και ιδιωτικά σχολεία της Θεσσαλονίκης. Τα πρώτα αποτελέσματα που προκύπτουν από την ανάλυση της εκπαιδευτικής κοινότητας αναδεικνύουν μια σειρά ενδιαφέρουσων πτυχών, προσφέροντας μια πολυδιάστατη κατανόηση της πολιτικής προώθησης της αυτονομίας στον εκπαιδευτικό τομέα, αναδεικνύοντας τα θετικά σημεία, τις ενστάσεις αλλά και τα τρωτά σημεία της προωθούμενης πολιτικής και συνολικά τις προκλήσεις που αντιμετωπίζει η εκπαίδευση.
Podcasts jornalísticos de mulheres como experiência estética de reconhecimento em contexto de narrativas transmídia e algoritmos
Authors: Mendes de Barros Laan , Borges de Oliveira Daniela , Fontaniello Bernardo
Published: June 2024

Neste artigo, propomos articulações entre comunicação, ecologia dos meios e experiência estética, bem como, problematizamos tensionamentos relacionados aos mecanismos de controle dos sistemas de streaming e às possibilidades de interação sensível, reconhecimento e engajamento político e social no âmbito dos podcasts. Confrontamos, assim, a existência de monitoramento de dados dos usuários na era da plataformização aos formatos de podcasts que dão voz a pautas minoritárias, femininas, como experiências insurgentes de (re)existência. Discutimos a questão do reconhecimento e emancipação das espectadoras/es no contexto da sociedade em rede, que se configura em um tecido complexo de interações e recriações, consensos e dissensos, compartilhamentos e pertencimentos. Analisamos produções feitas por mulheres, como “partilha do sensível” e experiência estética, que constroem um “sensus communalis” mesmo em ambientes regidos por algoritmos. Utilizamos, para tanto, critérios da hermenêutica, da interpretação, e os processos de apropriação por parte de espectadoras/es, para problematizar o fenômeno do podcasting a partir de estudo de caso dos podcasts Mamilos e Conversa de Portão. Dessa forma, combinamos a abordagem teórica com discussões empíricas sobre o fenômeno dos podcasts.
A mimetização da narrativa jornalística em conteúdos desinformativos checados pelo Coletivo Bereia
Authors: De Santana Palmeira Victor Vinícius , Piccinin Fabiana
Published: June 2024

Este artigo propõe uma análise da estrutura narrativa dos conteúdos desinformativos que circularam em portais religiosos entre os meses de agosto e outubro de 2022, período que compreende desde o início da campanha eleitoral até a realização das eleições presidenciais no Brasil. Busca-se compreender como se dá a mimetização do ato jornalístico feita nos conteúdos desinformativos, mobilizando conceitos de desinformação, de narrativa jornalística e do fenômeno da religião cristã no Brasil. Para tanto, a partir de uma metodologia que consorcia técnicas qualitativas e quantitativas de análise de conteúdo, analisa-se estas publicações, que são obtidas a partir de checagens do Coletivo Bereia, uma agência de verificação de conteúdos que circulam em mídias que publicam informações com viés religioso. Como resultados, encontramos evidências de que portais cujo posicionamento editorial está voltado para o tema da religião se utilizam de estratégias da narrativa jornalística para veicular conteúdos que nem sempre encontram referência nos fatos, de modo a conferir sentido de veracidade a estas notícias.
¿Manual, livre de poche o coursebook? Repensando la construcción de un libro de curso elaborado desde y para el salón de derecho internacional público en el ámbito latinoamericano
Authors: Arévalo-Ramírez Walter
Published: June 2024

El presente capítulo pretende compartir la experiencia colaborativa entre el autor, estudiantes, investigadores y miembros de la Red Latinoamericana de Revistas de Derecho Internacional (relaredi.org) al construir el libro Manual de derecho internacional público: fundamentos. Tribunales internacionales y casos de estudio (Walter Arévalo-Ramírez, Tirant lo Blanch, 2019), un reciente instrumento de clase que buscó atender la necesidad de involucrar de manera activa y reconocida a los estudiantes latinoamericanos en la elaboración de sus propios materiales de estudio y abordar limitaciones en la literatura disponible como la de manuales en español, construir el contenido del manual no desde la imitación de antiguos temarios extranjeros, sino desde los casos y temas de mayor interés para la clase y el escenario geográfico, construir el instrumento desde la perspectiva e intereses locales de los estudiantes manifestadas a lo largo de varios años de enseñanza, potenciar la citación y relacionamiento con la literatura vigente y latinoamericana en la materia y darle una mirada desde nuestro hemisferio a temas clásicos a través de problemas locales que reflejaran el contenido y los vacíos de doctrinas que se presentan como universales pero que al llegar al ámbito latinoamericano se evidencian distantes y desconectadas de nuestra realidad.
Vaccine Progress, Stock Prices, and the Value of Ending the Pandemic
Authors: Acharya Viral V. , Johnson Timothy , Sundaresan Suresh , Zheng Steven
Published: June 2024

One measure of the ex ante cost of disasters is the welfare gain from shortening their expected duration. We introduce a stochastic clock into a standard disaster model that summarizes information about progress (positive or negative) toward disaster resolution. We show that the stock market response to duration news is essentially a sufficient statistic to identify the welfare gain to interventions that alter the state. Using information on clinical trial progress during 2020, we build contemporaneous forecasts of the time to vaccine deployment, which provide a measure of the anticipated length of the COVID-19 pandemic. The model can thus be calibrated from market reactions to vaccine news, which we estimate. The estimates imply that ending the pandemic would have been worth from 5% to 15% of total wealth as the expected duration varied in this period.

This paper was accepted by Lukas Schmid, finance.

Supplemental Material: The online appendix and data files are available at https://doi.org/10.1287/mnsc.2023.00863 .
Risk factors of the depressive and anxiety disorders development among patients with Adolescent Idiopathic Scoliosis and possible therapeutic interventions
Authors: Tomczak Tomasz , Rogalski Jakub
Published: June 2024

Introduction: Adolescent idiopathic scoliosis is a common type of scoliosis among adolescents. A significant problem is the coexistence of depressive and anxiety disorders. However, the causes of this condition are not fully recognized. Thus, it seems reasonable to search for possible risk factors that may trigger mental disorder occurrence.
Material and methods: This is a literature narrative review concentrating on the influence of the adolescent idiopathic scoliosis on the development of depression and anxiety disorders among adolescents, as well as possible therapeutic interventions. Google Scholar, Medline, PubMed and Science Direct databases were searched throughout January 2024 for relevant original and review
articles from 2000 to 2024, using the following keywords: “adolescent idiopathic scoliosis”, “anxiety”, “body image”, “bracing”, “chronic disease”, “depression”, “mental disorders”, “pain”, “peer relationship”, “physical activity”, “pulmonary function”, “sleep disorders”, “surgery”, “treatment”. Manuscripts in other language than Polish or English were excluded from the search. To ensure the appropriate quality of this review, the Scale for the Assessment of Narrative Review Articles was used.
Results: Chronic pain, sleep disorders, pulmonary function impairment, perception of the disease as a chronic somatic disease, disturbed body image, lack of social interactions, physical activity limitation and applied methods of treatment may lead to the depressive and anxiety disorders development in the adolescent idiopathic scoliosis course.
Conclusions: Biological and psychosocial factors contribute to the pathogenesis of depressive and anxiety disorders among patients with adolescent idiopathic scoliosis. Their identification should help create a comprehensive plan of treatment, which may effectively maximize therapeutic outcomes in the context of both scoliosis and mental disorders.

Keywords: depression, risk factors, anxiety, adolescent idiopathic scoliosis, mental health
ÍNDICE DE DESENVOLVIMENTO HUMANO SUSTENTÁVEL: uma abordagem para blocos econômicos a partir de países selecionados
Authors: Benício de Oliveira Renata , Sousa Eliane Pinheiro de , Da Silva Rodrigues Anderson , Khan Ahmad Saeed
Published: June 2024

Este trabalho propõe mensurar o nível de desenvolvimento humano sustentável para 57 países, distribuídos em oito blocos econômicos, considerando o ano de 2014. Especificamente, almeja-se avaliar quais países e blocos econômicos se desenvolvem de forma sustentável. Para tal, construiu-se o Índice Ambiental (IA), conforme proposto por Blancard & Hoarau (2013) e Chansarn (2014), utilizando-se a Análise Envoltória de Dados. Em seguida, mensurou-se o Índice de Desenvolvimento Humano Sustentável (IDHS) considerando a média geométrica das três dimensões do IDH e do IA, de acordo com a formulação sugerida por Blancard & Hoarau (2013) e Bravo (2014). Os resultados indicaram que, em geral, as nações obtiveram elevado IA e experimentaram melhorias em seu bem-estar. Portanto, conclui-se que estão empregando seus recursos naturais de forma eficiente.
REGIONALIDADE EM ADMINISTRAÇÃO: Como O Construto Está Difundido No Ensino Superior Brasileiro?
Authors: Alves Santos Murilo , Schiavinati Nathália Cristine , Machado Valadão Júnior Valdir , Silva Pereira Vinícius
Published: June 2024

Os cursos de Administração no Brasil devem, conforme Diretrizes Curriculares Nacionais (DCNs), incluir conteúdos de formação básica e complementar alinhados com as perspectivas históricas e regionais. O objetivo deste estudo foi analisar a regionalidade enquanto construto presente nos cursos de Administração a nível de graduação pelas universidades públicas do país. Através da análise de conteúdo, foram analisadas ementas de cursos de administração que alcançaram conceito máximo no ENADE, mapeando regionalidade a partir das palavras-chave: “região”, “regionalidade”, “regional” e “regionalismo”. Embora o escopo do trabalho não alcance aprofundamentos vivenciados no cotidiano da sala de aula ou formas diversas de se interpretar a regionalidade, com a presença do construto regionalidade em apenas 45% dos projetos pedagógicos pesquisados, 35% das disciplinas obrigatórias e 30% das optativas, infere-se não existir ampla difusão e implementação da regionalidade, evidenciando a distância para adequação, tratamento e valorização ao ambiente de aprendizagem da região.
Palavras-chave: Regionalidade. Ensino. Administração
Infertilidad y duelo perinatal
Authors: Mollá Teresa María Martínez , Martínez-Ruiz Maria Esperanza
Published: June 2024

Introducción. La demora de edad en el deseo concepcional ha supuesto un aumento en la dificultad de reproducción que se está viendo compensada por el desarrollo de las técnicas de reproducción asistida, aunque los sentimientos que acompañan su uso son los mismos que en el duelo perinatal pero no siempre son reconocidos. Objetivo. Explorar los sentimientos de duelo de las mujeres y sus parejas en el proceso de esterilidad, desde que acceden a la primera consulta de esterilidad en los Hospitales de San Juan y de Alcoy hasta la derivación a las técnicas de fecundación in vitro. Metodología. Investigación cualitativa desde su vertiente fenomenológica. Recogida de datos mediante entrevistas en profundidad individuales. La información fue grabada, transcrita, codificada, triangulada e interpretada. Análisis mediante la herramienta validada Atlas-ti 8. Resultados. Se identificaron tres categorías: sentimientos de la esfera psicológica, social y espiritual, que se agrupan en doce subcategorías: ansiedad, frustración, tristeza, miedo, ambivalencia emocional, justificación, soledad, banalización, búsqueda de significado, culpa y aceptación. Conclusión. Las parejas incluidas en programas de reproducción asistida manifestaron sentimientos de duelo que coinciden con el duelo perinatal (ansiedad, miedo, frustración, ambivalencia, aislamiento social, banalización, búsqueda de significado, culpa y aceptación). Siguen existiendo diferencias de género. El apoyo de familiares, amigos y profesionales es imprescindible. Se pone de manifiesto la necesidad de mejorar la calidad de la atención con una continuidad de los profesionales, con la formación de estos para dar una atención integral, y con la existencia de protocolos.
Obligaciones derivadas del principio de respeto a la dignidad en el ámbito de la pérdida perinatal
Authors: Boladeras-Cucurella Margarita
Published: June 2024

Esta investigación presenta un análisis conceptual del término «dignidad», especialmente en su aplicación en el contexto de los problemas derivados de la pérdida perinatal, en el que ha de ser una guía moral de las prácticas necesarias para abordarlos. Estas prácticas pueden ser también reguladas por leyes y por guías de orientación profesional, por lo que se presentan y analizan tres leyes en vigor en Argentina, Chile y Colombia, así como tres guías españolas de actuación profesional para estos casos. En base a todo ello se proponen algunas conclusiones. Objetivos. Determinar las obligaciones morales que se derivan del principio de respeto a la dignidad humana en el ámbito de la práctica profesional de las pérdidas perinatales. Mostrar la relación que existe entre los conceptos de dignidad, autonomía, integridad (física y moral) e inviolabilidad. Analizar y dar a conocer las obligaciones legales establecidas en algunos países. Informar sobre algunas guías de prácticas profesionales existentes en España sobre esta materia. Material y método. Búsqueda bibliográfica, análisis y hermenéutica de textos filosóficos, legales y deontológico- profesionales relativos a los problemas relacionados con la pérdida perinatal. Conclusiones. Orientaciones sobre las mejores formas de actuación profesional en las situaciones de pérdida perinatal.
Metanarration and the Reassessment of Narrative Information in Lemony Snicket's A Series of Unfortunate Events
Authors: Beyad Maryam Soltan , Poursanati Susan , Khorasani Maryam
Published: June 2024

Abstract: Notwithstanding that scholarly discussions generally commend the deployment of metafictive techniques in children's literature, metafiction's subversive edge is blunted in those children's books that depict the solace offered by books as the panacea for all the conflicts within a given narrative. That said, as Joe Sutliff Sanders contends, it is possible for a children's book to highlight the salvific power of books while encouraging close reading. In A Series of Unfortunate Events (1999–2006), written by Daniel Handler using the pseudonym Lemony Snicket, the defamiliarized relationship between metanarrative signifiers and their referents induces readers to adopt a critical approach toward Snicket's story. Drawing on Gerald Prince's theory of metanarrative signs, the present study explores the ways in which Handler's exploitation of metanarrative space destabilizes the narrative methods incorporated in his own story, thereby propelling readers to consider forming a more interrogative relationship with books and fictional narratives.
The Interdiocesan Tribunal: Dying Institution or Possible Solution?
Authors: Valentyn Scott D.
Published: June 2024

abstract: An examination of the history and development of interdiocesan tribunals reveals their implementation for more than eighty years as a means by which to ensure the proper administration of justice in the processing of causes. In order for this proper administration to occur, tribunals must be populated with ministers whose expertise in the matters to be adjudicated and availability to devote adequate time and energy to the process truly qualifies them for this grave task. The current scarcity of ministers with adequate knowledge of penal law, especially on the level of the particular church, is an obstacle to justice in the processing of penal causes with expedience and accuracy. By combining the ministers and resources of multiple dioceses, interdiocesan penal tribunals could contribute to the removal of this obstacle in the future.
Is the Internal Forum under Attack? The Status of the Sacramental Seal and the Internal Forum in Church and State in the USA
Authors: Mazza Michael J.
Published: June 2024

abstract: In recent years, the sacramental seal and the internal forum have been subjected to numerous attacks in both the mainstream media and in state legislatures. Arguments are made with increasing frequency that "secrecy" has no place in modern society, at least when respecting "confidential communications" means certain heinous crimes may go unreported. Nevertheless, respect for the contents of the internal forum is a long-established principle of morality and canon law, and its importance in the life of the Church cannot be ignored. This article begins with an examination of the current civil laws of the United States respecting confidential communications made to clergy. It then considers the relevant moral and legal principles, including recent and important relevant guidance from the Holy See. Finally, the article concludes with a review of three specific areas in which the balance between sharing necessary information and protecting the internal forum are especially imperative: abuse reporting systems, seminary formation programs, and document retention policies and practices.
The Discretionary Authority of the Diocesan Bishop in the Penal Law of the CIC : A Legal Historical Perspective (1917–2021)
Authors: Mauer Quintijn
Published: June 2024

abstract: The discretionary authority granted to the diocesan bishop in the Church's penal law has undergone historical and legal development during the timeframe 1917–2021. This can be demonstrated through legal historical analyses of canon 2214 §2 of the 1917 CIC and its "replacements": canon 1341 of the 1983 CIC and canon 1341 of the new penal law of 2021. In these canons, the universal legislator grants the diocesan bishop discretionary authority in canonically irregular situations in his own particular church. In general, it can be said that the most substantial discretionary authority of the diocesan bishop can be found in the penal law of the 1983 CIC . In both theory and practice, this discretionary authority led to an impediment in the application of the Church's penal law. A similar impediment did not exist in the Church's penal law in the 1917 code. The alterations made in the reform of 2021 have, in theory, taken away most obstacles with regard to the functionality of the Church's penal law.