bluuebunny/crossref_metadata_2025 huggingface dataset:
Reflexión metodológica para la investigación de la estructura y lógica de producción de noticias en la industria periodística regional
Authors: Rodríguez Leuro Jairo Antonio , Medina Andrés
Published: May 2024

En este artículo se presenta el modelo metodológico con el que se desarrollaron dos proyectos de investigación en la Facultad de Comunicación y Lenguaje de la Pontificia Universidad Javeriana entre los años 2012 y 2015. Ambos proyectos se inscriben en el campo de estudios de la economía política de la comunicación y la información que el Grupo de Investigación Comunicación, Medios y Cultura, de la misma universidad, viene fomentando en su función de producción de conocimiento.
Indígenas, campesinos, afrodescendientes y economía del suroccidente
Authors: Caviedes Mauricio
Published: May 2024

En una caracterización así, se escaparán sectores de la sociedad caucana. Este capítulo enfatizará en el papel político e histórico de los pueblos indígenas en la región del suroccidente colombiano.
Belalcázar, propiedad de la tierra y movimiento indígena del suroccidente
Authors: Caviedes Mauricio
Published: May 2024

Este capítulo expone elementos para entender la historia del suroccidente colombiano a partir de las luchas indígenas, campesinas y afrodescendientes por redistribuir la tierra fértil que grandes terratenientes han acumulado. Finalmente, este capítulo sugiere que quienes se interesan en la historia de la región deberían escuchar más la versión de la historia de los pueblos indígenas, las comunidades afrocolombianas y las campesinas. Con suerte, este texto puede orientar a lectores y lectoras sobre dónde indagar más sobre esa versión. Para abordar el tema, este capítulo explora por qué las élites atribuyen a Belalcázar la fundación de la ciudad de Popayán y por qué esa idea es falsa. A continuación, explica cómo el reconocimiento de Belalcázar por parte de la colonia española como ‘conquistador’ y ‘fundador’ de Popayán les permitió a varias generaciones de sus descendientes administrar la producción económica indígena, especialmente del pueblo misak. La relación entre la encomienda y las actuales formas de propiedad de la tierra puede ser una pista que explique la pobreza de la región y, por ello, la tercera parte de este capítulo explora esa relación. En una cuarta parte, se analiza cómo intelectuales y organizaciones indígenas han denunciado como falsa la historia narrada por las élites regionales. Como resultado de esa lucha por la tierra, ligada a la lucha por la historia de la región, los pueblos indígenas se han organizado. Finalmente, este texto busca explicar por qué los pueblos indígenas han luchado junto a campesinos y afrocolombianos por cambiar la historia de la región. Este capítulo no busca sustituir las voces de indígenas y campesinos. Y entre esas voces, también hay divergencias y desacuerdos. Pero, dado que este breve texto no puede explorar todas las voces, intentará ofrecer al público pistas para encontrarlas. Será responsabilidad del público aprovechar esas pistas para profundizar en la historia del suroccidente contada por sus protagonistas.
Sistemas patrimoniales en la región del Pacífico colombiano
Authors: Cano Molina Paola Andrea , Sevilla Manuel
Published: May 2024

Como inicio de este capítulo precisamos lo que entenderemos como patrimonio cultural y como región Pacífico. En cuanto al patrimonio, son formas culturales de distinto orden (objetos, espacios naturales y construidos, prácticas y sistemas de ideas) que son reconocidas por grupos comunitarios e instituciones como elementos centrales para su historia y su identidad colectiva. Este enfoque ofrece varias ventajas. La categorización desagregada permite proponer categorizaciones más comprehensivas (patrimonio arquitectónico, documental, arqueológico, lingüístico, musical, etc.) y posibilita el diálogo con clasificaciones de uso común en ámbitos de la administración cultural (patrimonio material e inmaterial, mueble e inmueble, etc.), que dicho sea de paso han empezado a ser revaluadas. También, el énfasis en diferentes instancias de reconocimiento pone distancia de la idea cuestionable de que el patrimonio cultural es solo el que está consignado en listas oficiales. Nos centraremos en formas culturales que se mantienen vigentes en distintas comunidades de la región y haremos mención de otras que desempeñaron un papel importante y están siendo revaloradas. Aun así, indicaremos cuáles figuran en listados oficiales nacionales o mundiales, en atención a los lectores que quieran profundizar al respecto.
Taking care of nurses is a boost for patients and the wider economy
Authors: McMahon Alex , McIlgorm Maria , Tranka Sue , May Dame Ruth
Published: May 2024

Investment in nursing is key to having a healthy workforce and a healthy population. NHS Chief Nursing Officers for Scotland, Northern Ireland, Wales and England Alex McMahon, Maria McIlgorm, Sue Tranka and Ruth May reflect on policies adopted over the past year aimed at developing the healthcare workforce
Getting to grips with generative AI
Authors: Foster Sam
Published: May 2024

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the issues raised for regulators and assessors by the availability of tools such as ChatGPT
Optimization of PMSM for EV based on Vibration and Noise Suppression
Authors: Zhao Mingwei , Wang Xiangyu , Liu Lijun , Tu Xiaowei , Yang Qinghua
Published: May 2024

The key to the suppression of vibration and noise for PMSM is the optimization of electromagnetic excitation force. The method of motor body optimization can effectively reduce the radial excitation force of the motor, so as to suppress the vibration and noise of the motor. Firstly, the stator structure of the motor is optimized with V-shape skew slot based on the analytical modeling of the radial electromagnetic excitation force of the motor. Then, the structural parameters of the motor that affect the electromagnetic excitation force of the motor are determined, and the average torque, torque ripple and radial electromagnetic excitation force generated by tangential electromagnetic excitation force are taken as the optimization objectives. The sensitivity analysis and classification of the structural parameters of the motor are carried out. The multi-objective genetic algorithm and response surface method are combined to optimize the structural parameters of the motor. Finally, the finite element analysis, modal analysis, multi-speed vibration and noise analysis of the optimized motor are done. The performance comparisons before and after optimization have proved that the peak of equivalent sound power level have decreased by 8.65% after the optimization of V-shaped skewed slot structure. After the optimization of structural parameters, the power level of permanent magnet synchronous motor has been reduced by 9.22%. For the vibration noise caused by resonance and the main frequency of vibration noise harmonics, the suppression effects are also better than those of V-shape skewed slots optimization, and the ERPL values are reduced by 9.22% and 10.12%, respectively, in two cases. The results show that the vibration and noise of permanent magnet synchronous motor are effectively suppressed.
Formal Metacomics: Practice as Theory
Authors: Gavaler Chris
Published: May 2024

ABSTRACT: A “formal metacomic,” as defined by Roy T. Cook, “is a comic whose plot involves formal manipulations of the conventions of the comic medium.” Such manipulations draw attention to Charles Hatfield’s understanding of comics as an “art of tensions,” specifically “between codes of signification; between the single image and the image-in-series ; between narrative sequence and page surface ; and, more broadly, between reading-as- experience and the text as material object .” These tensions are related to, and possibly unified by, one overarching tension: between the imagined diegetic qualities of an evoked world and the discursive qualities of physical marks on paper that co-produce that world through viewer perception. Such discursive-diegetic tension embodies a range of theoretical concerns, including: the simultaneous discursive presence of multiple images representing a single diegetic subject (recurrence); the ambiguous natures of artistic style and medium materiality as definitively neither diegetic qualities reducible to a depicted subject nor discursive qualities traceable to an artist or to a comic as a physical object (transparency); the connotative influence of image layout on the perception of image content when the two are understood to be unrelated (primary and secondary diegeses); the evoked presence of non-diegetic elements through discursive allusions (intertextual braiding); and the temporal contradictions between a representative image’s implied diegesis and its discursive presence and viewing. While comics generally embody such tensions, formal metacomics directly and literally illustrate them. The following eight comics, developed from my personal artistic practice, are both an application and an analysis of comics theory.
Pontius' Conscience: Pilate's Afterlives and Apology for Empire in John Chrysostom's Antioch
Authors: Kolbeck Ben
Published: May 2024

Abstract: This article explores apologetic early Christian approaches to Pontius Pilate, demonstrating the popularity of the idea that Pilate was innocent of Jesus's death, regarded Christ as innocent and just, and even became a Christian himself. Focusing on the exceptionally detailed image of the man who condemned Jesus to the cross found in the New Testament homilies of John Chrysostom, this article connects Chrysostom's treatment of Pilate to his interaction with a real-life (and pagan) governor of Syria. It suggests that apologetic interpretations of Pilate were used not merely to denigrate Jews but also to allow Christians who were themselves both Christian and Roman to believe that Rome had witnessed their Messiah—a historical example which proved the congruence of Romanness and Christianity.
Defeat on Display: The Public Abuse of Usurpers and Rebels in Late Antiquity
Authors: Mawdsley Harry
Published: May 2024

Abstract: This paper examines the treatment of deposed emperors, defeated usurpers, and other political malcontents in Late Antiquity. During the period, such individuals, or their corpses, were occasionally displayed before the public in some of the major cities of the Roman Empire. While this phenomenon has attracted comparatively little attention in the historiography, this paper demonstrates that it can tell us much about late antique society. By studying these displays in detail, it explores the traditions and practices from which they emerged, how their nature and functions evolved over time, and the extent to which they affected the empire's inhabitants. Ultimately, the paper argues that their development during the period reflects a more autocratic political culture but one which still valued and solicited popular participation in the legitimization of power.
The "Column of the Goths" and Its Place in Constantine's New Capital
Authors: Speidel Michael A.
Published: May 2024

Abstract: The column monument in Istanbul's Gülhane Park, commonly known by its colloquial name "column of the Goths," bears a well-known inscription on its pedestal which states that this monument was dedicated to Fortuna Redux on the occasion of a Roman victory over the Goths. The monument, however, has not attracted much scholarly attention, probably because no consensus has yet been reached regarding its date. An inspection of the inscription in Gülhane Park and a fresh analysis of its text suggest that the emperor Constantine erected the "column of the Goths" in the context of the formal dedication of his new capital in 330 as a memorial for his victory over the Goths in 328 or 329. The monument highlights Constantinople's extraordinary political nature as more than just another imperial residence in the style of the tetrarchy. It bears witness to the emperor's efforts to give Constantinople the status of a second Rome as well as his determination, above all else, to establish his city as the home of triumphant victories. Moreover, the monument's dedication to Fortuna Redux, is another token of Constantine's at least partially ambiguous religious policy, which allowed traditional symbols to be visible in his new capital of Constantinople.
Legal Knowledge among Late Roman Elites: The Evidence of Jerome
Authors: Wiemer Hans-Ulrich
Published: May 2024

Abstract: Hans-Dieter Spengler sodali et iuris consulto Jerome's oeuvre is huge; it comprises translations and commentaries of many books of the Christian Bible, a universal history, a history of Christian literature, biographies of monks, many treatises, and more than 130 letters addressed to people from the educated upper classes of the late Roman West. This article investigates what role Roman law played in Jerome's writings, what he knew about it, and how he evaluated it. It also looks at his views on late Roman jurisdiction and collects the evidence he provides for petitions to the emperor and for imperial rescripts. The main section analyzes Jerome's ideas about imperial legislation, his knowledge of individual laws, and the way he presented them. On this basis, it is argued that Jerome's writings bear impressive witness to the importance of Roman law for both the social practice and the mindset of the provincial and local elites in the late Roman empire.
Eastern Mediterranean Fineware Imports to the Iberian Peninsula, 300–700 ce , and the Economic Impact of the Justinianic Pandemic
Authors: Gruber Henry
Published: May 2024

Abstract: Recent excavations in Spain and Portugal have recovered abundant fineware ceramics imported from the eastern Mediterranean and dating to the period after the fall of the western Roman Empire. The date of the latest sherds has been interpreted as showing the survival of trans-Mediterranean trade into the seventh century. However, archaeologists have tended to minimize a collapse in the volume of these imports around 550 ce. This article seeks to adjudicate between a survivalist interpretation (based on the continuity of some trade) and a catastrophist interpretation (based on decreased volume of trade). It analyzes the import volume and geographic distribution of ceramics at over 4,000 Iberian sites, 202 of which contain late Roman fineware imported from the eastern Mediterranean. The data suggest a steady increase in imports beginning by 450 ce, followed by a rapid drop in both import volume and network participation around 550 ce, with no observed recovery. This drop's magnitude has not yet been fully analyzed, and recent excavations in the eastern Mediterranean have allowed it to be fixed with greater chronological precision. Four causes are considered, three (warfare, shifting fiscal obligations, and changing tastes) that have been already proposed, and a fourth (pandemic disease) that has not.
Language and Postsecondary Trajectories: How “Ever-English Learner” Status Predicts College Student Pathways and Outcomes
Authors: Schudde Lauren , Callahan Rebecca , Kwon Yujin
Published: May 2024

Although students who have ever been identified as English learners (ever-ELs) during K-12 comprise a significant and growing share of the population, the transient nature of K-12 EL status and services makes it difficult for researchers to follow ever-ELs throughout their educational pipeline and into college. We use longitudinal state administrative data with repeated measures of EL status to examine the college entrance, college type, and early, intermediate, and long-term college outcomes of ever- and never-EL students who attended public colleges and universities in Texas. Our results offer new insights into the postsecondary trajectories of ever- and never-EL high-school seniors.
Engineering History in Latin America: A Review of Spanish-Language Books
Authors: Castro J. Justin
Published: May 2024

abstract: This review essay examines five Spanish-language books published in Latin America on the emergence of engineering in the region. Focusing on a period from roughly 1850 to 1970, these works share themes of foreigners and foreign education, nation-state construction, and social conceptions of prestige. This research suggests that throughout Latin America foreign educators and models were prominent in early engineering programs and enterprises. However, many historians associate the growth of engineering, especially civil engineering, with increasing state consolidation and economic intervention. As social perceptions of the value of professional engineering changed, domestic engineers increasingly became important planners and mediators. Some engineers became state leaders. By contextualizing these works with other scholarship on the history of engineering, this review essay highlights new insights while suggesting the need for greater attention to gender, race, and labor; comparisons between developments in Latin America, Africa, and Asia; and more research on private-sector engineers.
Spectral continuum in the Rabi–Stark model [Invited]
Authors: Braak Daniel , Cong Lei , Eckle Hans-Peter , Johannesson Henrik , Twyeffort Elinor K.
Published: May 2024

The Rabi–Stark model is a nonlinear generalization of the quantum Rabi model including the dynamical Stark shift as a tunable term, which can be realized via quantum simulation on a cavity QED platform. When the Stark coupling becomes equal to the mode frequency, the spectrum changes drastically, a transition usually termed “spectral collapse” because numerical studies indicate an infinitely degenerate ground state. We show that the spectrum extends continuously from a threshold value up to infinity. A set of normalizable states is embedded in the continuum, which furnishes an unexpected analogy to the atomic Stark effect. Bound states and continuum can be obtained analytically through two equally justified but different confluence processes of the associated differential equation in Bargmann space. Moreover, these results are obtained independently using a method based on adiabatic elimination of the spin degree of freedom and corroborated through large-scale numerical checks.
Relative strengths of sum and difference frequency generation in perturbative high harmonic wave mixing
Authors: Wei Zijuan , Yan Mingdong , Xia Fan , Men Ting , Tang Weiqi , Yan Weiwei , Liu Shiyuan , Li Zhengyan
Published: May 2024

High harmonic generation (HHG) modulated by a weak laser field allows the perturbative wave mixing process which involves sum and difference frequency generations (SFG and DFG). The relative strengths of SFG and DFG have been extensively discussed in the literature but are still ambiguous. Here we experimentally study the relative strengths between SFG and DFG channels by applying a frequency-offset second-harmonic perturbing laser field collinearly in a thin gaseous nonlinear medium. It shows that SFG is favored for low harmonic orders, but DFG dominates for high-energy photons, when only short trajectories of high harmonics are considered. A semi-classical model incorporating both modulations to the tunneling ionization and the electron propagation steps by the perturbing laser field for a train of attosecond pulses explains the experimental results.
Inverse optical scatterometry using sketch-guided deep learning
Authors: Liu Shuo , Chen Xiuguo , Yang Tianjuan , Zhang Jiahao , Liu Shiyuan
Published: May 2024

Optical scatterometry, also referred to as optical critical dimension (OCD) metrology, is a widely used technique for characterizing nanostructures in semiconductor industry. As a model-based optical metrology, the measurement in optical scatterometry is not straightforward but involves solving a complicated inverse problem. So far, the methods for solving the inverse scattering problem, whether traditional or deep-learning-based, necessitate a predefined geometric model, but they are also constrained by this model with poor applicability. Here, we demonstrate a sketch-guided neural network (SGNN) for nanostructure reconstruction in optical scatterometry. By learning from training data based on the designed generic profile model, the neural network acquires not only scattering knowledge but also sketching techniques, that allows it to draw the profiles corresponding to the input optical signature, regardless of whether the sample structure is the same as the generic profile model or not. The accuracy and strong generalizability of proposed approach is validated by using a series of one-dimensional gratings. Experiments have also demonstrated that it is comparable to nonlinear regression methods and outperforms traditional deep learning methods. To our best knowledge, this is the first time that the concept of sketching has been introduced into deep learning for solving the inverse scattering problem. We believe that our method will provide a novel solution for semiconductor metrology, enabling fast and accurate reconstruction of nanostructures.
Establishment of dry-chemistry-based reference intervals of routine liver function tests for the adult population of Gandaki Province, Nepal
Authors: Sharma Asmita , Pokharel Daya Ram , Dhakal Ganesh
Published: May 2024

Every clinical laboratory should ideally establish its own population-specific reference intervals (RIs) to promote precision and evidence-based medicine. However, clinical laboratories in Nepal find it easier to follow external RIs than establish their own, leading to a lack of RIs specific to the local population. This study thus aimed to establish RIs of routine LFTs for the adult population of Gandaki Province, Nepal, and compare them with the current RIs used by our laboratory. We established the dry-chemistry-based reference intervals of 11 common LFT parameters for the adult population of Gandaki Province, Nepal using the direct priori-based method. The combined and sex-specific 95% double-sided RIs of total protein, albumin, globulin, A/G ratio, bilirubin, aspartate aminotransaminase (AST), alanine aminotransaminase (ALT), AST/ALT ratio, and alkaline phosphatase (ALP) were established using non-parametric percentile method. The new RIs were also compared with the currently used RIs that were adopted from the reagent kit inserts. The newly established RIs for each LFT were: Total proteins: 68.0–69.0g/L, albumin: 39.0–52.0g/L; globulin: 27.0–42.0g/L; A/G ratio: 1.1–1.8; total bilirubin: 5.13–25.65μmol/L (0.30–1.50mg/dl); unconjugated bilirubin: 1.71–17.10μmol/L (0.10–1.00mg/dl); conjugated bilirubin: 0.00–10.26 μmol/L (0.00–0.60mg/dl); AST: 20.0–43.2U/L; ALT: 11.0–53.0 U/L; AST/ALT ratio: 0.7–2.1; ALP: 42.0–135.4U/L. The RIs of albumin, globulin, A/G ratio, AST, ALT, and AST/ALT ratio differed significantly (p < 0.05) between males and females. Moreover, calculated out-of-range values showed that up to 4–40% of apparently healthy adults were classified as having abnormal test results based on current RIs. The newly established RIs fulfil the need for population and platform-specific RIs for the adult population of Gandaki Province of Nepal and bring more conformity and accuracy in interpreting the LFT results, diagnosis of hepatobiliary diseases, clinical decision-making, monitoring the success of therapy and future liver specific biomedical researches within the Gandaki Province of Nepal.
Factors associated with pregnancy termination in six sub-Saharan African countries
Authors: Kassa Rahel Nega , Kaburu Emily Wanja , Andrew-Bassey Uduak , Abdiwali Saad Ahmed , Nahayo Bonfils , Samuel Ndayishimye , Akinyemi Joshua Odunayo
Published: May 2024

Pregnancy termination continues to be a leading cause of maternal morbidity and mortality among young women in Africa. The sub-Saharan Africa region has the highest rate of abortion-related deaths in the world, at 185 maternal deaths per 100,000 abortions. The aim of this study is to investigate the factors associated with pregnancy termination among women aged 15 to 29 years in six sub-Saharan African countries. We used secondary data from the most recent Demographic and Health Survey of six sub-Saharan African countries: Kenya, Tanzania, Ethiopia, Burundi, Nigeria, and Rwanda. A total weighted sample of 74,652 women aged 15–29 were analyzed. A multivariable logistic regression model was used to identify the factors associated with pregnancy termination at a p-value < 0.05. Results were presented using adjusted odds ratios (AOR) with 95% confidence interval. The study showed that 6.3% of women aged 15–29 reported pregnancy termination with a higher prevalence rate in Tanzania (8.8%) and lowest in Ethiopia (4%). Highest odds of pregnancy termination occurred among women aged 20–24 as compared to women aged 15–19 in Rwanda (AOR: 4.04, 95%CI 2.05, 7.97) followed by Nigeria (AOR: 2.62, 95% CI 1.99, 3.43), Kenya (AOR: 2.33, 95%CI 1.48, 3.66), Burundi (AOR: 1.99 95%CI 1.48, 2.85), Tanzania (AOR: 1.71 95%CI 1.29, 2.27), and Ethiopia (AOR: 1.69, 95% CI 1.19, 2.42). Women with no education had 4 times higher odds of pregnancy termination compared to women with higher education in Tanzania (AOR: 4.03 95%CI 1.00, 16.13) while women with no education and primary level education were 1.58 times (AOR: 1.58 95% CI 1.17, 2.13) and 1.78 times (AOR: 1.78 95% CI 1.34, 2.37) as likely to terminate pregnancy in Ethiopia. In Tanzania, the likelihood of a pregnancy termination was associated with a relationship to the household head; head (AOR: 3.66, 95% CI (2.32, 5.78), wife (AOR: 3.68, 95% CI 2.60, 5.12), and in-law (AOR:2.62, 1.71, 4.03). This study revealed that a significant number of women had pregnancy termination. Being in the age group of 20–24 & 25–29, having a lower level of education, being a domestic employee and professional, being single/never-in-union, being in the poorest and richer wealth quantile category, and being head, wife, daughter, and in-law to the household head were the significantly associated with pregnancy termination. Taking these socio-economic factors into consideration by stakeholders and specific sexual education targeted to women aged 15 to 29 would help tackle the problem.
Persistent high mortality rates for Diabetes Mellitus and Hypertension after excluding deaths associated with COVID-19 in Brazil, 2020–2022
Authors: Moreira Rodrigo , Bastos Leonardo S. , Carvalho Luiz Max , Freitas Laís Picinini , Pacheco Antonio G.
Published: May 2024

Introduction

The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) posed a significant public health challenge globally, with Brazil being no exception. Excess mortality during this period reached alarming levels. Cardiovascular diseases (CVD), Systemic Hypertension (HTN), and Diabetes Mellitus (DM) were associated with increased mortality. However, the specific impact of DM and HTN on mortality during the pandemic remains poorly understood.

Methods

This study analyzed mortality data from Brazil’s mortality system, covering the period from 2015 to 2022. Data included all causes of death as listed on death certificates, categorized by International Classification of Diseases 10th edition (ICD-10) codes. Population data were obtained from the Brazilian Census. Mortality ratios (MRs) were calculated by comparing death rates in 2020, 2021, and 2022 to the average rates from 2015 to 2019. Adjusted MRs were calculated using Poisson models.

Results

Between 2015 and 2022, Brazil recorded a total of 11,423,288 deaths. Death rates remained relatively stable until 2019 but experienced a sharp increase in 2020 and 2021. In 2022, although a decrease was observed, it did not return to pre-pandemic levels. This trend persisted even when analyzing records mentioning DM, HTN, or CVD. Excluding death certificates mentioning COVID-19 codes, the trends still showed increases from 2020 through 2022, though less pronounced.

Conclusion

This study highlights the persistent high mortality rates for DM and HTN in Brazil during the years 2020–2022, even after excluding deaths associated with COVID-19. These findings emphasize the need for continued attention to managing and preventing DM and HTN as part of public health strategies, both during and beyond the COVID-19 pandemic. There are complex interactions between these conditions and the pandemic’s impact on mortality rates.
Mortality risk score for patients with Chagas cardiomyopathy and pacemaker
Authors: de Lima Peixoto Giselle , de Siqueira Sérgio Freitas , Nishioka Silvana Angelina D’Orio , Pedrosa Anísio Alexandre Andrade , Teixeira Ricardo Alkmim , Costa Roberto , Martinelli Filho Martino
Published: May 2024

Background

Prognosis of Chronic Chagasic Cardiomyopathy (CCC) patients depends on functional and clinical factors. Bradyarrhythmia requiring pacemaker is a common complication. Prognosis of these patients is poorly studied, and mortality risk factors are unknown. We aimed to identify predictors of death and to define a risk score for mortality in a large cohort of CCC patients with pacemaker.

Methods

It was an observational, unicentric and prospective study. The endpoint was all-cause mortality. Cox regression was used to identify predictors of death and to define a risk score. Bootstrapping method was used to internal score validation.

Results

We included 555 patients and after a mean follow-up of 3.7±1.5 years, 100 (18%) deaths occurred. Predictors of death were: right ventricular dysfunction (HR [hazard ratio] 2.24; 95%CI 1.41–3.53; P = 0.001); heart failure class III or IV (HR 2.16; 95% confidence interval [95%CI] 1.16–4.00; P = 0.014); renal disease (HR 2.14; 95%CI 1.24–3.68; P = 0.006); left ventricular end-systolic diameter > 44mm (HR 1.97; 95%CI 1.26–3.05; P = 0.003); atrial fibrillation (HR 1.94; 95%CI 1.25–2.99; P = 0.003) and cardiomegaly on X-ray (HR 1.87; 95%CI 1.10–3.17; P = 0.020). The score identified patients with: low (0–20 points), intermediate (21–30 points) and high risk (>31points).

The optimism-corrected C-statistic of the predictive model was 0.751 (95% CI 0.696–0.806). Internal validation with bootstrapping revealed a calibration slope of 0.946 (95% CI 0.920–0.961), reflecting a small degree of over-optimism and C-statistic of 0.746 (95% CI 0.692–0.785).

Conclusions

This study identified predictors of mortality in CCC patients with pacemaker defining a simple, validated and specific risk score.
Expanded Access Programme for the use of tecovirimat for the treatment of monkeypox infection: A study protocol for an Expanded Access Programme
Authors: Bourner Josephine , Redji Mbrenga Festus Devincy , Malaka Christian Noël , Dunning Jake , Rojek Amanda , Fandema Emmanuel , Horby Peter , Boum Yap , Nakouné Emmanuel , Olliaro Piero
Published: May 2024

Background

Monkeypox is a viral zoonotic disease commonly reported in humans in parts of Central and West Africa. This protocol is for an Expanded Access Programme (EAP) to be implemented in the Central African Republic, where Clade I monkeypox virus diseases is primarily responsible for most monkeypox infections. The objective of the programme is to provide patients with confirmed monkeypox with access to tecovirimat, a novel antiviral targeting orthopoxviruses, and collect data on clinical and virological outcomes of patients to inform future research.

Methods

The study will be conducted at participating hospitals in the Central African Republic. All patients who provide informed consent to enrol in the programme will receive tecovirimat. Patients will remain in hospital for the duration of treatment. Data on clinical signs and symptoms will be collected every day while the patient is hospitalised. Blood, throat and lesion samples will be collected at baseline and then on days 4, 8, 14 and 28. Patient outcomes will be assessed on Day 14 –end of treatment–and at Day 28. Adverse event and serious adverse event data will be collected from the point of consent until Day 28.

Discussion

This EAP is the first protocolised treatment programme in Clade I MPXV. The data generated under this protocol aims to describe the use of tecovirimat for Clade I disease in a monkeypox endemic region of Central Africa. It is hoped that this data can inform the definition of outcome measures used in future research and contribute to the academic literature around the use of tecovirimat for the treatment of monkeypox. The EAP also aims to bolster research capacity in the region in order for robust randomised controlled trials to take place for monkeypox and other diseases.

Trial registration

{2a & 2b}: ISRCTN43307947.
Studying the context of psychoses to improve outcomes in Ethiopia (SCOPE): Protocol paper
Authors: Hanlon Charlotte , Roberts Tessa , Misganaw Eleni , Malla Ashok , Cohen Alex , Shibre Teshome , Fekadu Wubalem , Teferra Solomon , Kebede Derege , Mulushoa Adiyam , Girma Zerihun , Tsehay Mekonnen , Kiross Dessalegn , Lund Crick , Fekadu Abebaw , Morgan Craig , Alem Atalay
Published: May 2024

Background

Global evidence on psychosis is dominated by studies conducted in Western, high-income countries. The objectives of the Study of Context Of Psychoses to improve outcomes in Ethiopia (SCOPE) are (1) to generate rigorous evidence of psychosis experience, epidemiology and impacts in Ethiopia that will illuminate aetiological understanding and (2) inform development and testing of interventions for earlier identification and improved first contact care that are scalable, inclusive of difficult-to-reach populations and optimise recovery.

Methods

The setting is sub-cities of Addis Ababa and rural districts in south-central Ethiopia covering 1.1 million people and including rural, urban and homeless populations. SCOPE comprises (1) formative work to understand care pathways and community resources (resource mapping); examine family context and communication (ethnography); develop valid measures of family communication and personal recovery; and establish platforms for community engagement and involvement of people with lived experience; (2a) a population-based incidence study, (2b) a case-control study and (2c) a cohort study with 12 months follow-up involving 440 people with psychosis (390 rural/Addis Ababa; 50 who are homeless), 390 relatives and 390 controls. We will test hypotheses about incidence rates in rural vs. urban populations and men vs. women; potential aetiological role of khat (a commonly chewed plant with amphetamine-like properties) and traumatic exposures in psychosis; determine profiles of needs at first contact and predictors of outcome; (3) participatory workshops to develop programme theory and inform co-development of interventions, and (4) evaluation of the impact of early identification strategies on engagement with care (interrupted time series study). Findings will inform development of (5) a protocol for (5a) a feasibility cluster randomised controlled trial of interventions for people with recent-onset psychosis in rural settings and (5b) two uncontrolled pilot studies to test acceptability, feasibility of co-developed interventions in urban and homeless populations.
Systematic review protocol of aetiology of mechanical bowel obstruction in low-and-middle income countries: Has anything changed in the last two decades?
Authors: Kwarshak Yakubu Kevin , Yisa Mohammed Nakodi , Kigbu Oghenegare Asheaba , John Daniel Akut , Jimwan Nankam David , Ubabuike Karen Chineme , Yawe Peter Mkurtar
Published: May 2024

The aetiology of mechanical bowel obstruction exhibits significant variability based on geographical location and age. In high-income countries, postoperative adhesions and hernias are frequently cited as the primary causes, whereas in low- and middle-income countries (LMCIs), hernias take precedence. Speculation exists within the surgical community regarding whether this trend has evolved in LMCIs. To address this knowledge gap, our study aims to conduct a systematic review of existing literature, focusing on understanding the most prevalent causes of mechanical bowel obstruction in both pediatric and adult populations within LMCIs, providing valuable insights for surgical practice. This protocol was designed and written according to the guidelines of the Preferred Reporting Items for Systematic Review and Meta-analysis Protocol 2015 (PRISMA-P 2015) statement. However, the results of the systematic review will be reported following the Preferred Reporting Items for Systematic Review and Meta-analysis (PRISMA) statement. We will consider studies published in English and French between 2002 and 2022 that reported on the aetiology of mechanical bowel obstruction in any age group in low- and middle-income countries. We will conduct a literature search using Ovid MEDLINE, Ovid Embase, CINAHL on EBSCO and Web of Science databases employing relevant subject headings, keywords and synonyms, which will be combined using Boolean operators to refine the search results. A hand search of references of retrieved literature will be conducted. The retrieved articles will be imported into Zotero for de-duplication. The resulting set of titles and abstracts will be uploaded to Rayyan (an AI-assisted online systematic review tool), where they will be double-checked to identify articles eligible for inclusion. Two independent reviewers will screen articles to be included and disagreement will be resolved by discussion or by a third reviewer as a tie-breaker. Also, data extraction will be done by one reviewer and confirmed by another. Critical appraisal to assess the quality of the included studies will be carried out by two independent reviewers using the Joanna Briggs Institute (JBI) tools. We anticipate that the eligible studies will be quite heterogeneous in terms of their design, outcomes of interest, populations and comorbidities. Therefore, resmay be synthesised descriptively without meta-analysis using charts, graphs and tables. Where possible, we will conduct a sub-analysis using conceptual frameworks based on age, WHO regions and continents.
The magnitude of stunting and its determinants among late adolescent girls in East Africa: Multilevel binary logistics regression analysis
Authors: Asebe Hiwot Altaye , Seifu Beminate Lemma , Mare Kusse Urmale , Kase Bizunesh Fantahun , Tebeje Tsion Mulat , Asgedom Yordanose Sisay , Shibeshi Abdu Hailu , Lombebo Afewerk Alemu , Sabo Kebede Gemeda , Fente Bezawit Melak , Asmare Zufan Alamrie
Published: May 2024

Background

Stunting poses a significant health risk to adolescent girls aged 15–19 in low- and middle-income countries, leading to lower education levels, reduced productivity, increased disease vulnerability, and intergenerational malnutrition. Despite the inclusion of adolescent nutrition services in the Sustainable Development Goals, little progress has been made in addressing malnutrition among adolescent girls in several African nations. Limited evidence exists in East Africa due to small sample sizes and methodological limitations. To overcome these constraints, this study utilizes the latest Demographic and Health Survey data to estimate the prevalence and factors influencing stunting among late adolescent girls in ten East African countries.

Methods

This study utilized the most recent Demographic and Health Survey (DHS) data from 10 East African countries, including a total sample weight of 22,504 late-adolescent girls. A multilevel mixed-effect binary logistic regression model with cluster-level random effects was employed to identify factors associated with stunting among these girls. The odds ratio, along with the 95% confidence interval, was calculated to determine individual and community-level factors related to stunting. A p-value less than 0.05 was considered statistically significant in determining the factors influencing stunting among late-adolescent girls.

Results

The prevalence of stunting among late adolescent girls in East Africa was found to be 13.90% (95% CI: 0.13–0.14). Religion, relationship to the head, presence of under-five children in the household, lactating adolescent, marital status, Time to get water source, and country of residence were significantly associated with Stunting.

Conclusion

This study highlights the complexity of stunting in East Africa and identifies key factors that need attention to reduce its prevalence. Interventions should focus on improving water access, supporting lactating girls, addressing socioeconomic disparities, promoting optimal care practices, and implementing country-specific interventions to combat stunting and improve adolescent girls’ nutrition.
Factors influencing uptake of protective behaviours by healthcare workers in England during the COVID-19 pandemic: A theory-based mixed-methods study
Authors: Meyer Carly , Crayton Elise , Wright Abigail , Spyer Moira , Vora Nina , Houlihan Catherine , Walker Naomi F. , Nastouli Eleni , Michie Susan , Lorencatto Fabiana ,   on behalf of the SAFER investigators
Published: May 2024

Background

Hospital infection control policies protect patients and healthcare workers (HCWs) and limit the spread of pathogens, but adherence to COVID-19 guidance varies. We examined hospital HCWs’ enactment of social distancing and use of personal protective equipment (PPE) during the COVID-19 pandemic, factors influencing these behaviours, and acceptability and feasibility of strategies to increase social distancing.

Methods

An online, cross-sectional survey (n = 86) and semi-structured interviews (n = 22) with HCWs in two English hospitals during the first wave of the COVID-19 pandemic (May-December 2020). The Capability, Opportunity, Motivation (COM-B) model of behaviour change underpinned survey and topic guide questions. Spearman Rho correlations examined associations between COM-B domains and behaviours. Interviews were analysed using inductive and deductive thematic analysis. Potential strategies to improve social distancing were selected using the Behaviour Change Wheel and discussed in a stakeholder workshop (n = 8 participants).

Results

Social distancing enactment was low, with 85% of participants reporting very frequently or always being in close contact with others in communal areas. PPE use was high (88% very frequently or always using PPE in typical working day). Social distancing was associated with Physical Opportunity (e.g., size of physical space), Psychological Capability (e.g., clarity of guidance), and Social Opportunity (e.g., support from managers). Use of PPE was associated with Psychological Capability (e.g., training), Physical Opportunity (e.g., availability), Social Opportunity (e.g., impact on interactions with patients), and Reflective Motivation (e.g., beliefs that PPE is effective). Local champions and team competition were viewed as feasible strategies to improve social distancing.

Conclusions

It is valuable to understand and compare the drivers of individual protective behaviours; when faced with the same level of perceived threat, PPE use was high whereas social distancing was rarely enacted. Identified influences represent targets for intervention strategies in response to future infectious disease outbreaks.
E-CLEAP: An ensemble learning model for efficient and accurate identification of antimicrobial peptides
Authors: Wang Si-Cheng
Published: May 2024

With the increasing problem of antimicrobial drug resistance, the search for new antimicrobial agents has become a crucial task in the field of medicine. Antimicrobial peptides, as a class of naturally occurring antimicrobial agents, possess broad-spectrum antimicrobial activity and lower risk of resistance development. However, traditional screening methods for antimicrobial peptides are inefficient, necessitating the development of an efficient screening model. In this study, we aimed to develop an ensemble learning model for the identification of antimicrobial peptides, named E-CLEAP, based on the Multilayer Perceptron Classifier (MLP Classifier). By considering multiple features, including amino acid composition (AAC) and pseudo amino acid composition (PseAAC) of antimicrobial peptides, we aimed to improve the accuracy and generalization ability of the identification process. To validate the superiority of our model, we employed five-fold cross-validation and compared it with other commonly used methods for antimicrobial peptide identification. In the experimental results on an independent test set, E-CLEAP achieved accuracies of 97.33% and 84% for the AAC and PseAAC features, respectively. The results demonstrated that our model outperformed other methods in all evaluation metrics. The findings of this study highlight the potential of the E-CLEAP model in enhancing the efficiency and accuracy of antimicrobial peptide screening, which holds significant implications for drug development, disease treatment, and biotechnology advancement. Future research can further optimize the model by incorporating additional features and information, as well as validating its reliability on larger datasets and in real-world environments. The source code and all datasets are publicly available at https://github.com/Wangsicheng52/E-CLEAP.
Efficient attribute-based strong designated verifier signature scheme based on elliptic curve cryptography
Authors: Ma Rui , Du Linyue
Published: May 2024

In an attribute-based strong designated verifier signature, a signer who satisfies the access structure signs the message and assigns it to a verifier who satisfies the access structure to verify it, which enables fine-grained access control for signers and verifiers. Such signatures are used in scenarios where the identity of the signer needs to be protected, or where the public verifiability of the signature is avoided and only the designated recipient can verify the validity of the signature. To address the problem that the overall overhead of the traditional attribute-based strong designated verifier signature scheme is relatively large, an efficient attribute-based strong designated verifier signature scheme based on elliptic curve cryptography is proposed, as well as a security analysis of the new scheme given in the standard model under the difficulty of the elliptic curve discrete logarithm problem (ECDLP). On the one hand, the proposed scheme is based on elliptic curve cryptography and uses scalar multiplication on elliptic curves, which is computationally lighter, instead of bilinear pairing, which has a higher computational overhead in traditional attribute-based signature schemes. This reduces the computational overhead of signing and verification in the system, improves the efficiency of the system, and makes the scheme more suitable for resource-constrained cloud end-user scenarios. On the other hand, the proposed scheme uses LSSS (Linear Secret Sharing Schemes) access structure with stronger access policy expression, which is more efficient than the "And" gate or access tree access structure, making the computational efficiency of the proposed scheme meet the needs of resource-constrained cloud end-users.
Equivalent user experience and improved community augmented meta-analyses knowledge for a new version of a Plain Language Summary guideline
Authors: Jonas Mark , Kerwer Martin , Stoll Marlene , Benz Gesa , Chasiotis Anita
Published: May 2024

Plain Language Summaries (PLS) offer a promising solution to make meta-analytic psychological research more accessible for non-experts and laypeople. However, existing writing guidelines for this type of publication are seldom grounded in empirical studies. To address this and to test two versions of a new PLS guideline, we investigated the impact of PLSs of psychological meta-analyses on laypeoples’ PLS-related knowledge and their user experience (accessibility, understanding, empowerment). In a preregistered online-study, N = 2,041 German-speaking participants read two PLSs. We varied the inclusion of a disclaimer on PLS authorship, a statement on the causality of effects, additional information on community augmented meta-analyses (CAMA) and the PLS guideline version. Results partially confirmed our preregistered hypotheses: Participants answered knowledge items on CAMA more correctly when a PLS contained additional information on CAMA, and there were no user experience differences between the old and the new guideline versions. Unexpectedly, a priori hypotheses regarding improved knowledge via the use of a disclaimer and a causality statement were not confirmed. Reasons for this, as well as general aspects related to science communication via PLSs aimed at educating laypeople, are discussed.