bluuebunny/crossref_metadata_2025 huggingface dataset:
estrategias de sobrevivencia de las microempresas en México durante la pandemia
Authors: Guerrero Sánchez Pablo , Hernández Jaimes Belem Gabriela , Bonilla Sánchez Felipe de Jesús , Sánchez Guevara Irene , Guerrero Grajeda José
Published: January 2024

La sobrevivencia organizacional depende de factores dinámicos y complejos como una pandemia. En momentos de contingencia se usa la teoría ecológica. Objetivo: explorar e identificar aquellas estrategias organizacionales de las mipymes de tres sectores (manufactura, comercio y servicios) en condiciones de incertidumbre para analizar y explicar su capacidad de sobrevivencia en México. Metodología: contrastación de tres modelos estadísticos. Primero se hizo la presentación descriptiva de la variable dependiente y posteriormente se aplicó el primer método (análisis correlacional), utilizando dos modelos: (1) de regresión lineal múltiple entre la variable dependiente y las independientes: sin instrucción, capacitación, uso de computadora, ventas por internet, financiamiento, ventas a domicilio, ajuste de precios, reducción de producción y uso de redes sociales, y (2) de regresión lineal automática para abordar las variables de entidad federativa y sector. Resultados: todos los casos coincidieron en que la variable significativa fue el financiamiento y las entidades federativas más castigadas fueron Quintana Roo y Colima; el sector más afectado fue el de servicios. Conclusiones: los modelos mostraron debilidad en términos de muerte y sobrevivencia de empresas; sin embargo, hubo cambio y aprendizaje organizacional.
“Zero Cost” Majority Attacks on Permissionless Proof of Work Blockchains
Authors: Gans Joshua S. , Halaburda Hanna
Published: January 2024

The core premise of permissionless blockchains is their reliable and secure operation without the need to trust any individual agent. At the heart of blockchain consensus mechanisms is an explicit cost (e.g., mining cost) for participation in the network and the opportunity to add blocks to the blockchain. A key rationale for that cost is to make attacks on the network, which could be theoretically carried out if a majority of nodes were controlled by a single entity, too expensive to be worthwhile. We demonstrate that a majority attacker can successfully attack with a negative net cost when accounting for the mining rewards the attacker collects during the attack. This shows that the protocol mechanisms are insufficient to create a secure network, emphasizing the importance of socially driven mechanisms external to the protocol. At the same time, negative cost enables a new type of majority attack that is more likely to elude external scrutiny.

This paper was accepted by David Simchi-Levi, finance.
Insatisfação Corporal em Mulheres: Correlação com o Uso de TICs e Exercício Físico
Authors: Lise Perin Isabella , Limberger Jéssica
Published: January 2024

O corpo magro é o ideal de beleza disseminado pelas mídias e a pressão estética sobre as mulheres se torna constante. Entretanto, ainda é um tema que carece de estudos na população brasileira jovem. O presente estudo objetiva investigar se há relação entre a insatisfação corporal em mulheres na adultez emergente, o uso de Tecnologia da Informação e Comunicação; o acompanhamento de redes sociais de famosas e o exercício físico e comparar a satisfação corporal de mulheres que se inspiram e não se inspiram em famosas. Trata-se de um estudo quantitativo e correlacional. Participaram do estudo 543 mulheres da região sul do Brasil, com idades entre 18 e 24 anos. A maioria das participantes (88,9%) está insatisfeita com o seu corpo. Houve correlação positiva significativa entre a insatisfação corporal e dependência de internet. A insatisfação corporal esteve mais presente em mulheres que se inspiram em famosas, como também nas que fazem checagem de peso na balança frequentemente. Além disso, mulheres que não praticavam exercício físico obtiveram maiores médias em relação a insatisfação corporal e dependência de internet. Conclui-se que é necessária uma cautela quanto ao conteúdo acessado pelas jovens mulheres na internet.
Entrega Voluntária à Adoção: Os Alcances da Escuta Psicanalítica a uma Gestante Vítima de Estupro
Authors: Pedruzzi Daniela Torres Gonçalves Santos , Neves Anamaria Silva
Published: January 2024

O atendimento psicológico na Justiça tem sido uma prática nos processos de entrega voluntária à adoção, determinado no Estatuto da Criança e do Adolescente e especificado em publicações normativas e orientações técnicas no Conselho Nacional de Justiça. A partir do atendimento a uma mulher gestante, vítima de estupro, realizou-se a análise do caso com base na abordagem dos registros dos atendimentos e diário clínico, seguindo o referencial psicanalítico. O objetivo deste trabalho foi promover a reflexão sobre as possibilidades da escuta psicanalítica junto a uma gestante inserida no Programa Entrega Voluntária no contexto judiciário. A análise possibilitou compreender que a escuta deve ser fundamentada em uma leitura sociopolítica que considere a posição do sujeito no laço social. É fundamental apreender as questões políticas que envolvem a entrega voluntária à adoção, além das condições de exclusão, desamparo e impotência que operam no silenciamento das gestantes, mantendo-se o processo opressor que incide sobre elas. Por fim, o debate dessa temática no contexto judiciário abre possibilidades para a discussão mais ampla de questões afeitas à mulher e seus direitos, como a ampliação de políticas públicas e prevenção da violência e a garantia ao aborto legal para todas as mulheres.
A–Z of prescribing for children
Authors: Davies Kate
Published: January 2024

This series focuses on aspects of prescribing for neonates, children and young people, from A–Z. Aspects of pharmacokinetics will be considered, alongside legal considerations, consent and medications in schools
The Quebec Act and Its Alternatives
Authors: Burset Christian R.
Published: January 2024

This chapter explains why Britain restored French civil law to Quebec and Illinois while administering English law in other former French and Spanish colonies. It explains this divergence as the product of party politics. For most of Britain’s new acquisitions, there was a broad consensus in favor of anglicization. As a result, Britain introduced English law to Senegambia, the Floridas, and the West Indies with little debate. But when it came to Illinois and Quebec, politicians disagreed about what kind of colonies they wanted. Accordingly, they disagreed about introducing English law. “Paternalist” politicians emphasized the need to keep Quebec and Illinois dependent on Britain, and they thought legal pluralism would advance that goal by encouraging obedience, isolating Canada from common-law jurisdictions, and slowing economic growth. In contrast, “moderate” and “populist” politicians wanted to transplant English law to Quebec and Illinois in order to create an integrated empire in which all subjects enjoyed the same political status and economic opportunities. The Quebec Act of 1774 marked the triumph of paternalists’ vision of authoritarian empire over moderate and populist alternatives.
Latin America's Democratic Crusade
Authors: Wells Allen
Published: January 2024

Scholars persist in framing the Cold War as a battle between left and right, one in which the global South is cast as either witting or unwitting proxies of Washington and Moscow. What if the era is told from the perspective of the many who preferred reform instead of revolution? All too often, scholarship has neglected, dismissed, or caricatured moderate politicians. This book argues that until the Cuban Revolution, the struggle was not between capitalism and communism—that was Washington’s abiding preoccupation—but democracy and dictatorship. Beginning in the 1920s, the fight against authoritarianism was contested on multiple fronts—political, ideological, and cultural—taking on the dimensions of a political crusade. Convinced that despots represented an existential threat, reformers declared that no civilian government was safe until the cancer of dictatorship was excised entirely from the hemisphere. Dictators retaliated, often with deadly effect, exporting strategies that had been honed at home to guarantee their political survival. Grafted onto this war without borders was a belated Cold War, with all its political convulsions, the aftershocks of which are still felt today.
Introduction
Authors: Wells Allen
Published: January 2024

State terror, guerrilla insurgencies dirty wars, mass graves and the plight of the desaparecidos monopolize the literature on the Latin American Cold War. This almost exclusive focus on the political extremes of the right and the left has inhibited a more nuanced understanding of Latin American politics? Written off as sellouts or ineffectual careerist politicians who stymied meaningful change, reformers, when they are discussed at all, are relegated to an ephemeral role. In fact, broad multi-class parties enjoyed widespread support, in contrast to the region’s weak, fractious, leftist parties, which were badly tarnished by opportunistic alliances with dictators. This introduction addresses this puzzling omission, identifies the protagonists, engages the theoretical and conceptual literatures, situates the work in the scholarship, and presents the book’s principal arguments.
The Obligation to Think
Authors: Wells Allen
Published: January 2024

This chapter tracks a university reform movement that spread like wildfire throughout the hemisphere during the 1920s. What began in June 1918 as a spirited call by students in Córdoba, Argentina to bring about modest reforms to their university soon mushroomed into a full-throated critique of the ills besetting Latin American societies. Peru’s student leader Haya de la Torre spearheaded a transnational movement to depose autocrats, employing the vehicle of the popular university to forge ties between workers and students. Standing shoulder to shoulder with artisans and other members of the urban working-class, middle-class student activists experienced partial victories, bitter defeats, repression and exile, marking members of this historical generation in ways that would not become fully apparent until they were much older.
Your Words Inspired
Authors: Wells Allen
Published: January 2024

A democratic wave emerged in the years immediately after World War II, as despots were booted from power in nine countries. Former student activists who had spent years in exile returned home to contribute to the new democracies. Reformist political parties, such as Venezuela’s AD, Cuba’s Auténticos, and Costa Rica’s PLN, began the task of implementing much-needed reforms to their respective societies. An understated feature of the struggle against dictatorial regimes was the willing and able participation of battletested Spanish Civil War veterans. Hardened by the fight against fascism, exiled “Spanish Reds” brought both convictions and military expertise to the circum-Caribbean theater. Despite the postwar trend toward civilian rule, military high commands, either directly or indirectly, continued to play an intrusive role in the political arena in all but four countries in the hemisphere. Moderates were soon disabused of the idea that representative government was here to stay. By the end of the 1940s, a resurgence of authoritarianism had crushed the democratic offensive.
In Defense of Democracy
Authors: Wells Allen
Published: January 2024

The ruling of countries by autocrats in the 1950s, galvanized reformers into voicing objections and a three-day conference was held in Havana, which established the Inter-American Association for Democracy and Freedom. Betancourt warned that international organizations must pressure dictators to respect human rights. Figueres declared that Latin America’s democracies had a moral obligation to assist those living under the thumb of the region’s dictatorships. The chapter delineates the reformers’ brief, their aspirations, and the daunting challenges they faced during the early 1950s. Especially problematic was Washington’s cozying up to dictatorships. Regional democrats insisted that Washington withhold recognition from dictators or military regimes that seized power extralegally. Reformers were frustrated by Washington’s reluctance to criticize or cut off military aid to authoritarian regimes. What especially concerned reformers was that U.S. arms and planes were, in some cases, employed against neighboring democracies. The argument was that the dictators would simply acquire arms from another country if the U.S. did not make them available. Push came to shove when the Eisenhower administration assessed how reformist or revolutionary certain governments were. In the Bolivian case, Washington sided with the reformers. In Guatemala, it concluded that President Árbenz was beholden to the Guatemalan Communist Party.
The Hour of the Sword No Longer Tolls
Authors: Wells Allen
Published: January 2024

The democratic surge at the end of the 1950s dovetailed with Richard Nixon’s and Charles Porter’s visits to the region in 1958. This chapters teases out the implications for reformers of these trips as they sought to navigate a moment that was at once promising and perilous. Columnist Walter Lippmann fittingly referred to the vice president’s goodwill mission as a “diplomatic Pearl Harbor,” as voices that had been silenced by years of repression now seized the opportunity afforded by democratic openings to express their dissatisfaction with Washington’s policies. Latin Americans were savvy enough to realize that North American politicians were not all cut from the same cloth, however. In fact, “Charley” Porter’s triumphal reception in Caracas, coming as it did so soon after the Nixon debacle, proved to be a balm for the many who aspired to a democratic future. The jarringly dissimilar responses to the two visits prompted a long-overdue reckoning in U.S. policy.
COMPARATIVE EVALUATION OF NATIVE JOINT INFECTIONS DURING COVID AND PRE-COVID PERIOD AT A TERTIARY CENTRE
Authors: Raghavendra Ram Mohan , Panwalkar Parag , Veravalli Karunakar , Tofighi Mehdi , Mofidi Ali
Published: January 2024

Introduction

The short and long-term effects of covid infection are still being explored. Following a series of joint infections noted in patients presenting to a tertiary care hospital during the COVID-19 pandemic, we explored if there was any difference in the incidence of these joint infections when compared to pre-COVID era.

Aim

The aim of this study was to determine the incidence of native joint infections during COVID and pre-COVID period and compare the two groups for any differences.

Methodology

Patients diagnosed with septic arthritis over the 15th months of lockdown were studied and were compared with the same period prior to Covid-19 infection. The patient characteristics, the rate of septic arthritis, the presence of recent Covid-19 infection, delay in diagnosis and the difference in the microbiology between the two groups was studied.

Results

There were 36 joint infections during the COVID period in comparison to 46 joint infections during pre-COVID period. Both groups had similar mean age. Knee was the most common joint involved in both groups. About 50% (n = 18) of the joint infections during the COVID period did not grow any micro-organisms even after extended culture, which was higher in comparison to the pre-COVID group (35%, n = 16).

Conclusion

The culture negative group have significantly reduced markers of infection. The was no increase in the rate of septic arthritis however there was an increase in culture negative arthritis denoting a possible outbreak of reactive arthritis in the Covid-19 period.
A Foot in the Right Direction: Metatarsal Osteoblastoma-A Rare Case and its Management
Authors:   Department of Orthopaedics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India., Siddharth Raghul , Balasubramanian Raghavendran ,   Department of Orthopaedics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India., Umasankar Thiyagarajan ,   Department of Orthopaedics, Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India.
Published: January 2024

Introduction: Osteoblastoma is a rare, benign, bone-forming tumor accounting for <1% of all primary bone tumors. It has a predilection for the posterior elements of the spine and metaphysis and diaphysis of long bones. The occurrence of this tumor in the metatarsal region is rare. We report such the case of a metatarsal osteoblastoma which was treated with wide excision and non-vascularized fibular autograft: a reliable method of reconstruction. Case Report: A 25-year-old woman presented with progressive pain and swelling over the right foot for 4 years. On examination, there was a gross swelling over the fourth metatarsal region over the dorsum of the foot. Radiographs revealed a osteoblastic lesion of the fourth metatarsal bone expanding into the intermetatarsal region. Magnetic resonance imaging (MRI) revealed an expansile altered signal intensity lesion which was hypointense on both T1 and T2 – weighted images with no soft-tissue component. With a working diagnosis of locally aggressive bone-forming tumor, she underwent wide excision of the tumor with reconstruction using a non-vascularized fibular autograft. Intraoperative samples sent for histopathological examination confirmed the diagnosis of osteoblastoma. After 2 years of follow-up, the patient is able to weight bear with no pain and imaging shows graft incorporation with no signs of recurrence. Conclusion: Osteoblastoma of the metatarsal region can present a diagnostic conundrum to the treating clinician due to its rare nature. Proper evaluation and reconstruction at an early stage with wide excision and reconstruction with non-vascularized fibular autograft are a reliable treatment option. Keywords: Osteoblastoma, metatarsal, fibular autograft.
An Uncommon Presentation of Osteosarcoma in a Child: A Case Report
Authors:   Department of Pediatric Orthopedic, Mother and Child Unit, University Hospital Mohamed VI of Marrakech, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco., El  Khassoui Amine , Attibbi Maha ,   Department of Pediatric Orthopedic, Mother and Child Unit, University Hospital Mohamed VI of Marrakech, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco., TOURAIF Mariem ,   Department of Pediatric Orthopedic, Mother and Child Unit, University Hospital Mohamed VI of Marrakech, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco., Aghoutane , El Mouhtadi ,   Department of Pediatric Orthopedic, Mother and Child Unit, University Hospital Mohamed VI of Marrakech, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco., Salama Tarik ,   Department of Pediatric Orthopedic, Mother and Child Unit, University Hospital Mohamed VI of Marrakech, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco., El Fezzazi Redouane ,   Department of Pediatric Orthopedic, Mother and Child Unit, University Hospital Mohamed VI of Marrakech, Faculty of Medicine and Pharmacy, Cadi Ayyad University, Marrakech, Morocco.
Published: January 2024

Introduction: Osteosarcoma is the most common primary malignant bone tumor in childhood distinguished by its clinical aspects, epidemiological features, and radiological and histological findings. Around 10% of patients present with distant metastasis at the most frequent sites, which are lungs and bone. Furthermore, death rates for osteosarcoma have been declining by about 1.3% per year. Case Report: We report the case of a 12-year-old child who presented to the emergency department with a large thigh hematoma, and after running all the necessary clinical investigations, it turned out to be secondary to femoral osteosarcoma. Conclusion: In this case, our aim is to highlight the unusual clinical manifestations observed in a child with osteosarcoma, which can lead to a diagnosis delay and the subsequent impact on prognosis. Keywords: Osteosarcoma, hematoma, swelling, diagnostic delay, fracture.
Optimizing optical pulse breakup for efficient supercontinuum generation in an all-fiber system
Authors: Chang Kuan-Yuan , Gong Chen-Jia , Liu Jia-Ming
Published: January 2024

Ultra-broadband supercontinuum (SC) is generated by an all-fiber system with well-defined pulses (WDPs) as a seed laser. Through properly adjusting the lengths of the fiber segments in the system, sub-pulses with high peak powers are generated through the process of optical pulse breakup. Then, the broken optical pulses are launched into a hybrid nonlinear, which consists of a highly nonlinear optical fiber and a photonic crystal fiber, generating a SC of 1.8 W covering a spectral range from 554 nm to 2.17 µm. In this study, it is demonstrated through experimental observation that optical pulse breakup is an essential process for WDPs before the pulses are launched into a nonlinear optical fiber to generate SC. However, pulse breakup must not happen before the amplification of the WDPs; otherwise, the amplification efficiency is decreased, leading to a subsequent low efficiency of SC generation. The proper breakup of the WDPs after they are efficiently amplified is accomplished by sending these pulses through an optimum length of regular optical fiber, which depends on the peak power of the amplified WDPs. An optical fiber of an insufficient length leads to insufficient pulse breakup, which does not significantly increase the peak power of the pulses, resulting in little enhancement of SC generation. An excessively long fiber leads to excessive pulse breakup, which stretches the pulsewidth and splits the pulse energy, resulting in decreasing the efficiency of SC generation.
Mask Defect Detection by Combining Wiener Deconvolution and Illumination Optimization
Authors: Kunyang Li , Deng Shuying , Zhang Aiqin , Fu Jinjiang , Luo Junyao , Chen Xuehao , Zhou Jianying , Zhou Zhou
Published: January 2024

In the extreme ultraviolet (EUV) lithography process, mask defect is inevitably replicated on chips hence the yield and quality of the product are directly related to the mask quality. Mask microscopy resolution is then an essential specification. In this work, a high-efficiency method for enhancing the resolution of mask defect is proposed based on illumination optimization and Wiener deconvolution. To validate this approach, we established a verification apparatus designed to achieve a theoretical resolution of 3.0 μm with visible light. Remarkably, the empirical results demonstrated that the actual resolution attained is as low as 2.5 μm, which can be extrapolated to 53 nm resolution based on the wavelength ratio to an EUV source. The verification demonstrates a significant improvement for various periodic fringes. Moreover, the augmented capability of the apparatus facilitates the identification of mask defects.
Genetically programmable optical random neural networks
Authors: Tegin Ugur , Carpinlioglu Bora
Published: January 2024

Today, machine learning tools, particularly artificial neural networks, have become crucial for diverse applications. However, current digital computing tools to train and deploy artificial neural networks often struggle with massive data sizes and high power consumptions. Optical computing provides inherent parallelism and perform fundamental operations with passive optical components. However, most of the optical computing platforms suffer from relatively low accuracies for machine learning tasks due to fixed connections while avoiding complex and sensitive techniques. Here, we demonstrate a genetically programmable yet simple optical neural network to achieve high performances with optical random projection. By genetically programming the orientation of the scattering medium which acts as a random projection kernel and only using 1% of the search space, our novel technique finds an optimum kernel and improves its initial test accuracies 7-22% for various machine learning tasks. Our optical computing method presents a promising approach to achieve high performance in optical neural networks with a simple and scalable design.
Genetically programmable optical random neural networks
Authors: Tegin Ugur , Danis Bahrem Serhat , Carpinlioglu Bora
Published: January 2024

Today, machine learning tools, particularly artificial neural networks, have become crucial for diverse applications. However, current digital computing tools to train and deploy artificial neural networks often struggle with massive data sizes and high power consumptions. Optical computing provides inherent parallelism and perform fundamental operations with passive optical components. However, most of the optical computing platforms suffer from relatively low accuracies for machine learning tasks due to fixed connections while avoiding complex and sensitive techniques. Here, we demonstrate a genetically programmable yet simple optical neural network to achieve high performances with optical random projection. By genetically programming the orientation of the scattering medium which acts as a random projection kernel and only using 1% of the search space, our novel technique finds an optimum kernel and improves its initial test accuracies 7-22% for various machine learning tasks. Our optical computing method presents a promising approach to achieve high performance in optical neural networks with a simple and scalable design.
Assessing COVID-19 pandemic’s impact on essential diabetes care in Manila, the Philippines: A mixed methods study
Authors: Malijan Greco Mark B. , Besa John Jefferson V. , Mendoza Jhaki , Uy Elenore Judy B. , Yan Lijing L. , Østbye Truls , Palileo-Villanueva Lia
Published: January 2024

The COVID-19 pandemic directly increased mortality and morbidity globally. In addition, it has had extensive indirect ill effects on healthcare service delivery across health systems worldwide. We aimed to describe how patient access to diabetes care was affected by the pandemic in Manila, the Philippines. We used an explanatory, sequential mixed method approach including a cross-sectional survey (n = 150) and in-depth interviews of patients (n = 19), focus group discussions of healthcare workers (n = 22), and key informant interviews of health facility administrators (n = 3) from October 2021 to January 2022. Larger proportions of patients reported absence of livelihood (67.3%), being in the lowest average monthly household income group (17.3%), and disruptions in diabetes care (54.0%) during the pandemic. They identified the imposition of lockdowns, covidization of the healthcare system, and financial instability as contributors to the reduced availability, accessibility, and affordability of diabetes-related consultations, medications, and diagnostics. At least a quarter of the patients experienced catastrophic health expenditures across all areas of diabetes care during the pandemic. Most healthcare workers and administrators identified telemedicine as a potential but incomplete tool for reaching more patients, especially those deemed lost to follow-up. In the Philippines, the pandemic negatively impacted access to essential diabetes care.
Prevalence of chronic conditions and multimorbidity among healthcare workers in Zimbabwe: Results from a screening intervention
Authors: Calderwood Claire Jacqueline , Marambire Edson , Nzvere Farirai Peter , Larsson Leyla Sophie , Chingono Rudo M. S. , Kavenga Fungai , Redzo Nicole , Bandason Tsitsi , Rusakaniko Simbarashe , Mujuru Hilda A. , Simms Victoria , Khan Palwasha , Gregson Celia Louise , Ndhlovu Chiratidzo E. , Ferrand Rashida Abbas , Fielding Katherine , Kranzer Katharina
Published: January 2024

The burden of non-communicable diseases (NCDs) in southern Africa is expanding and is superimposed on high HIV prevalence. Healthcare workers are a scarce resource; yet are vital to health systems. There are very limited studies on the burden of chronic conditions among healthcare workers in Africa, and none exploring multimorbidity (≥2 chronic conditions). We describe the epidemiology of infectious (HIV) and non-communicable chronic conditions, and multimorbidity, among Zimbabwean healthcare workers. Healthcare workers (≥18 years) in eight Zimbabwean provinces were invited to a voluntary, cross-sectional health-check, including HIV, diabetes, hypertension and mental health screening. Statistical analyses described the prevalence and risk factors for multimorbidity (two or more of HIV, diabetes, hypertension or common mental disorder) and each condition. Missing data were handled using multiple imputation. Among 6598 healthcare workers (July 2020–July 2022) participating in the health-check, median age was 37 years (interquartile range 29–44), 79% were women and 10% knew they were living with HIV. Half had at least one chronic condition: 11% were living with HIV, 36% had elevated blood pressure, 12% had elevated HbA1c and 11% had symptoms of common mental disorder. The overall prevalence of multimorbidity was 15% (95% CI: 13–17%); 39% (95% CI: 36–43%) among people aged 50 and older. Whilst most HIV was diagnosed and treated, other chronic conditions were usually undiagnosed or uncontrolled. Limiting our definition of multimorbidity to two or more screened conditions sought to reduce bias due to access to diagnosis, however, may have led to a lower reported prevalence than that found using a wider definition. Half of healthcare workers screened were living with a chronic condition; one in seven had multimorbidity. Other than HIV, most conditions were undiagnosed or untreated. Multisectoral action to implement contextually relevant, chronic disease services in Africa is urgently needed. Specific attention on health workers is required to protect and retain this critical workforce.
Low complexity smart grid security protocol based on elliptic curve cryptography, biometrics and hamming distance
Authors: Mutlaq Keyan Abdul-Aziz , Nyangaresi Vincent Omollo , Omar Mohd Adib , Abduljabbar Zaid Ameen , Abduljaleel Iman Qays , Ma Junchao , Al Sibahee Mustafa A.
Published: January 2024

The incorporation of information and communication technologies in the power grids has greatly enhanced efficiency in the management of demand-responses. In addition, smart grids have seen considerable minimization in energy consumption and enhancement in power supply quality. However, the transmission of control and consumption information over open public communication channels renders the transmitted messages vulnerable to numerous security and privacy violations. Although many authentication and key agreement protocols have been developed to counter these issues, the achievement of ideal security and privacy levels at optimal performance still remains an uphill task. In this paper, we leverage on Hamming distance, elliptic curve cryptography, smart cards and biometrics to develop an authentication protocol. It is formally analyzed using the Burrows-Abadi-Needham (BAN) logic, which shows strong mutual authentication and session key negotiation. Its semantic security analysis demonstrates its robustness under all the assumptions of the Dolev-Yao (DY) and Canetti- Krawczyk (CK) threat models. From the performance perspective, it is shown to incur communication, storage and computation complexities compared with other related state of the art protocols.
“You can because you do and you do, because you can”: Using interpretative description to examine what it means to be a physically literate adult living with multiple chronic conditions
Authors: Petrusevski Celeste , Joy MacDermid , Wilson Michael , Richardson Julie
Published: January 2024

Aims

Physical literacy is an emerging strategy to increase participation in movement activities for children and youth, however little is known about how to frame physical literacy for aging adults. The purpose of this qualitative study was to explore how adults with multiple chronic conditions describe physically literacy for adults and to understand the needs, preferences, barriers, and facilitators to acquiring and maintaining physical literacy despite fluctuations in health status.

Methods

Sixteen semi-structured interviews were conducted with working and retired teachers in Ontario, Canada, with varying self-identified physical activity levels and are living with 2 or more chronic conditions. A semi-structured interview guide was used to conduct the interviews. Thematic analysis was used to analyze the data.

Results

Participants identified 5 themes when describing physical literacy for adults: understanding one’s body, conscious commitment to movement, access to and knowledge of rehabilitation health resources, valuable physical activities, and confident problem solver. Results indicate that when acquiring physical literacy for adults, there are important new constructs, such as self-management and the awareness of rehabilitation strategies to maintain mobility, that differ from the traditional physical literacy model.

Conclusions

To improve function and mobility outcomes for adults living with chronic conditions, programs should be guided by a physical literacy framework that addresses the needs unique to aging adults, such as understanding the changes that occur with aging, self-monitoring mobility changes and participating in rehabilitation strategies.
Validating the Emergency Department Avoidability Classification (EDAC): A cluster randomized single-blinded agreement study
Authors: Strum Ryan P. , Mondoux Shawn , Mowbray Fabrice I. , Griffith Lauren E. , Worster Andrew , Tavares Walter , Miller Paul , Aryal Komal , Sivakumaran Ravi , Costa Andrew P.
Published: January 2024

Introduction

The Emergency Department Avoidability Classification (EDAC) retrospectively classifies emergency department (ED) visits that could have been safely managed in subacute primary care settings, but has not been validated against a criterion standard. A validated EDAC could enable accurate and reliable quantification of avoidable ED visits. We compared agreement between the EDAC and ED physician judgements to specify avoidable ED visits.

Materials and methods

We conducted a cluster randomized, single-blinded agreement study in an academic hospital in Hamilton, Canada. ED visits between January 1, 2019, and December 31, 2019 were clustered based on EDAC classes and randomly sampled evenly. A total of 160 ED visit charts were randomly assigned to ten participating ED physicians at the academic hospital for evaluation. Physicians judged if the ED visit could have been managed appropriately in subacute primary care (an avoidable visit); each ED visit was evaluated by two physicians independently. We measured interrater agreement between physicians with a Cohen’s kappa and 95% confidence intervals (CI). We evaluated the correlation between the EDAC and physician judgements using a Spearman rank correlation and ordinal logistic regression with odds ratios (ORs) and 95% CIs. We examined the EDAC’s precision to identify avoidable ED visits using accuracy, sensitivity and specificity.

Results

ED physicians agreed on 139 visits (86.9%) with a kappa of 0.69 (95% CI 0.59–0.79), indicating substantial agreement. Physicians judged 96.2% of ED visits classified as avoidable by the EDAC as suitable for management in subacute primary care. We found a high correlation between the EDAC and physician judgements (0.64), as well as a very strong association to classify avoidable ED visits (OR 80.0, 95% CI 17.1–374.9). The EDACs avoidable and potentially avoidable classes demonstrated strong accuracy to identify ED visits suitable for management in subacute care (82.8%, 95% CI 78.2–86.8).

Discussion

The EDAC demonstrated strong evidence of criterion validity to classify avoidable ED visits. This classification has important potential for accurately monitoring trends in avoidable ED utilization, measuring proportions of ED volume attributed to avoidable visits and informing interventions intended at reducing ED use by patients who do not require emergency or life-saving healthcare.
Innovative German technology in sub-Saharan Africa: Where is it used?
Authors: Schneider Christian P.
Published: January 2024

Germany is the largest economy in Europe, and currently the fourth largest in the world. It is also the most innovative country as measured by patent registrations. Technology transfers originating in Germany are therefore highly innovative and have a great potential to positively impact the economic situation in other countries as well. As the patents are generally held by businesses, it is commonly assumed that the logic of transferring technologies across borders also follows an economic motive. Here, this motive is questioned in a quantitative analysis, showing what determines the selection of destination country for German businesses looking to transfer their technology. It is shown that, contrary to common perception, the primary motivation is developmental, not economic. This is in line with international political declarations and calls for more (and more effective) international technology transfer. Furthermore, the best way to support international technology transfer is through the presence of German experts providing support in manifold ways to those businesses interested in international transfers.
Appointment Booking and Drug Inventory System in Healthcare Services Using Blockchain Technology
Authors: Sumathi M. , Dhiraj Inti , Mahita Dhavala Sai , Raja S. P.
Published: January 2024

Blockchain technology has the potential to revolutionize the healthcare industry by improving data security, reducing administrative inefficiencies, and enabling the seamless sharing of medical information. In the healthcare sector, blockchain can be applied to a wide range of use cases, such as medical record-keeping, clinical trials, drug traceability, and telemedicine. By using a secure, decentralized system, healthcare organizations can ensure that sensitive patient data is kept confidential and can be easily accessed by authorized parties. Additionally, the use of smart contracts can contribute to reducing the risk of errors and saving time and resources. In the proposed work, a decentralized application integrates healthcare services with blockchain technology to ensure transparency and security and prevent tampering with electronic medical records. The three main functionalities implemented in this work are to provide a transparent appointment booking system where patients can view the real-time availability status of the doctors and book an appointment with the doctor of their choice, and to store and retrieve data in an efficient and secure manner. To maintain a transparent and tamper-resistant medical inventory to prevent the unauthorized sale of medicines and drugs and also verify the availability of the drug. This helps the patients get the drugs in the quickest manner possible. Compared to existing centralized storage techniques, the proposed decentralized storage technique provides higher data availability, the fastest response time, and immutable storage of existing data. Experimental results show that, compared to existing work, the proposed work provided better results in throughput and latency. The communication cost of the proposed technique is 7% lesser than the existing Telecare Medicine Information system.
¿Emperador por Gracia de Madre? La instrumentalización gibelina de la figura de Beatriz de Suabia
Authors: Collamati Giovanni
Published: January 2024

Se suele creer que una de las principales razones por las que Alfonso X, rey de Castilla y León, se propuso como rex romanorum y emperador, fue su ascendencia materna de la casa de Hohenstaufen. De hecho, gracias a su madre Beatriz de Suabia, el soberano podía presumir de unir en sí mismo tanto la sangre de la familia imperial germánica como la de la dinastía de los Comnenos de Constantinopla. Una lectura más atenta de las fuentes revela, en cambio, cómo Alfonso nunca empleó este argumento en las numerosas negociaciones que caracterizaron el fecho del imperio. Algunos gibelinos italianos, en particular Bandino Lancia de Pisa y el rey Enzo de Cerdeña, último hijo de Federico II, hicieron un uso instrumental de la figura de Beatriz de Suabia. Si Alfonso mencionó su ascendencia alemana, lo hizo solo en el contexto de la disputa sobre sus derechos al ducado de Suabia. Este artículo analiza cómo se presenta la figura de la reina Beatriz en las diferentes fuentes (alfonsinas, italianas gibelinas y papales) en relación con el fecho del imperio y la sucesión al ducado de Suabia.
Kauzális elvárások
Authors: Horváth Márta
Published: January 2024

A kognitív narratológia egyik alaptézise, hogy a történetek
elhagyhatatlan összetevőjének tekintett oksági kapcsolatok többnyire nem
szövegszerűen valósulnak meg, hanem az olvasó következtetései által. Az
olvasó mindazonáltal nem csak az elbeszélt események között feltételez
kauzális kapcsolatot, a történetek megértésének egyik további fontos
komponensét képezik a kauzális elvárások. A kauzális elvárások
meghatározzák az olvasó értelmezésének irányát, és az érzelmi hatás
forrását is képezhetik. Így például az „izgalmasság” szubjektív élményének
egyik alapját képező két hatás, a feszültség és a meglepetés is többek
között a kauzális elvárásokra vezethető vissza. A tanulmány első lépésben
bemutatja, hogyan alapozhatják meg a szöveg által ébresztett kauzális
elvárások a feszültség és a meglepetés befogadói élményét, majd pedig egy
kortárs populáris gyermekirodalmi regény, a Harry-Potter-sorozat első
darabját elemzi abból a szempontból, hogyan épít az olvasói elvárásokra,
illetve azok be nem teljesítésére.
Az időrendi-oksági gondolkodás elidegenített képe
Authors: Némedi Andrea
Published: January 2024

Jelen tanulmányban az időrendi-oksági gondolkodás és az elbeszélés
kapcsolatát vizsgálom Ted Chiang Életed története című sci-fi-novellájában,
amelynek nyelvész elbeszélője elmeséli, hogyan alakul át saját
időrendi-oksági gondolkodása a heptapodnak nevezett idegen lényekkel való
kommunikáció révén. A heptapodok szimultán-teleologikus gondolkodása
hatására a narrátor elkezd „emlékezni” a jövőre. Tanulmányomban arra a
kérdésre keresem a választ, hogyan iktatja ki és mivel helyettesíti a
novella az oksági gondolkodást, mint a koherenciateremtő megértés egyik
alapvető mechanizmusát, és hogyan jelenik meg a két gondolkodásmód ötvözete
az elbeszélésmódban, azon belül is a narratív időkezelésében. A
megtestesült elme kognitív tudománya alapján amellett érvelek, hogy az
olvasó a heptapodok testfelépítése által aktivált képi sémák és kognitív
metaforák révén koherens egységbe szervezheti a heptapodok nyelvi,
matematikai-fizikai és tudati világát, míg a narrátor kreatív metaforái
segítségével a heptapodok jövőlátását is megértheti. A narrátor elbeszélése
hitelesen demonstrálja az időrendi-oksági gondolkodás átalakulását: a
szöveg megjeleníti a heptapodok jellemzőit (ciklikusság, sorrend
nélküliség, egyidejűség), létrehozva az időrendi-oksági elbeszélés
elidegenített képét, amelyben ötvöződik az időrendi és kusza elbeszélés,
illetve az oksági és a képi-metaforikus megértés.
Tragikus cselekmény, kauzalitás, tényellenesség
Authors: Szabó Judit
Published: January 2024

Jelen tanulmány a tragédia cselekményére vonatkozóan vizsgálja az
oksági elv szerepét. Kiindulópontként azt a tézist képviseli, hogy a
tragédia, mint műfaji idea és a hozzá társított prototipikus cselekmény a
legszigorúbb kauzális logika alapján szerveződik. A tragédia az emberi
cselekvések oksági elv alapján történő elrendezése révén tanulságot
szolgáltat az életutat és a jellemet alakító változásról, illetve morális
döntésekről. Az itt olvasható elméleti fejtegetés egyrészt Arisztotelész
Poétikáján, másrészt pedig az ókori görög tragédia cselekményéről, mint
prototípusról kialakított elképzeléseken alapul. Középpontjában az az
elméleti kérdés áll, hogy a tragédia által színre vitt sikeres életút
drámai megszakítása (azaz a fordulat) tekinthető-e a korábbi élettörténet
folyományának, és ha igen, akkor ezt a történést hogyan lehet korábbi
cselekvésekből levezetni. A tanulmány e megértési kísérlet egyik legjobb
példájaként az Oidipusz király tragédiájának részleteit is feleleveníti. Az
Oidipusz által feltérképezett oksági motiváltság az eleddig boldog királyt
a legszörnyűbb balsorshoz vezeti, egyúttal nem nyújt valódi magyarázatot a
szerencsétlenségre, amelyet Oidipusz kényszerűen végzetként, illetve az
emberi létezést meghatározó sorszerűségként fogad el.
A „tökéletes azonosság” mint szükségszerű fikció
Authors: Lamár Erzsébet
Published: January 2024

A személyes azonosság fogalmát (ti. az ún. ontológiai azonosságtól
megkülönböztetendő) John Locke vezette be a filozófiai diskurzusba
Értekezés az emberi értelemről című, 1689-es művében. Tézise szerint az,
ami az ember mint személy azonosságát megalapozza és fenntartja, nem más,
mint a tudat folytonossága. De vajon valóban szükségszerű előfeltétele-e a
tudatos tapasztalatnak az öntudat valamiféle eleve adott egysége? Ha
viszont ilyen nem létezik, akkor mégis ki vagy mi vagyok „én”?
Gondolatmenetem középpontjában a személyes azonosság hume-i, nyalábelméleti
modellje áll, amelynek értelmében a tudatos szubjektumként értett „én” nem
több, mint észleletek nyalábja. Első lépésben megkülönböztetem egymástól az
ontológiai, illetve a személyes azonosság problémáját, valamint az
azonosság alapvető ontológiai modelljeit. Hume koncepciójának
ismertetésekor az azonosság és a kauzalitás összefüggéseire fókuszálok,
miközben arra a kérdésre próbálok választ találni, hogy vajon lehetséges-e
a hume-i okság-fogalom olyan értelmezése, amely az egységes tudat
tételezésének legalább az episztemikus szükségszerűségét megengedi.
In a Digital World With Generative AI Detection Will Not be Enough
Authors: Davis Jason
Published: January 2024

Recent and dramatic improvements in AI driven large language models (LLMs), image generators, audio and video have fed an exponential growth in Generative AI applications and accessibility. The disruptive ripples of this rapid evolution have already begun to fundamentally impact how we create and consume content on a global scale. While the use of Generative AI has and will continue to enable massive increases in the speed and efficiency of content creation, it has come at the cost of uncomfortable conversations about transparency and the erosion of digital trust. To have any chance at actually diminishing the societal impact of digital disinformation in an age of generative AI, approaches strategically designed to assist human decision making must move past simple detection and provide more robust solutions.
Literary Theory for LLMs
Authors: Gunkel David
Published: January 2024

Recent criticism of large language models (LLM) and generative AI have focused on the way that these applications are little more than Stochostic Parrots' technological devices that generate seemingly intelligible statements but do not know and cannot understand a word of what they say. If the terms of these evaluations sound familiar, they should. They are rooted in foundational concepts regarding language and technology that have been definitive of Western systems of knowing since the time of Plato. The current crop of critical correctives and well-intended LLM hype-reduction efforts reproduceâ€”or one might be tempted to say "parrot" this ancient wisdom. And it works, precisely because it just sounds like good common sense. But that's the problem. This presentation takes aim at this largely unquestioned theoretical framework, identifies its inherent limitations and inabilities to accurately understanding the opportunities and challenges of LLMs, and conclude by providing a more robust method for responding to and taking responsibility for these technological innovations.