bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of COVID-19 and recovery of routine diabetic retinopathy digital screening across different regions in England: an analysis of publicly available data
Authors: Pardhan Shahina , Wijewickrama Rumalie Chanika Alwis , Gilbert Clare E , Piyasena Mapa Prabhath , Sapkota Raju 
Published: December 2024

ObjectiveThis study aims to examine the reduction and subsequent recovery of routine digital screening (RDS) uptake in England from 2018 to 2022, exploring national, regional and individual Diabetic Eye Screening Programme (DESP) levels. The COVID-19 lockdown in most areas of England was from 26 March 2020 to 23 June 2020 (first national lockdown), 5 November 2020 to 2 December 2020 (second national lockdown) and 6 January 2021 to 8 March 2021 (third national lockdown).DesignRetrospective data analysis.SettingDESPs of England.ParticipantsIndividuals with diabetes who were invited to take part in the DESP programmes.MethodsPublicly available data from Public Health England (2018–2019) and National Health Service England (2019–2022) were examined to identify the rate of uptake (proportion of those who attended the DESPs to those who were invited) of RDS at national and regional levels and by each DESP in England.Primary outcome measuresRate of uptake of RDS.ResultsThe national uptake of RDS decreased from 82% (2019–2020) to 68% (2020–2021) and then increased to 78% (2021–2022). At the regional level, the sharpest drop was in the Midlands which decreased from 79% (2019–2020) to 53% (2020–2021), increasing to 73% (2021–2022) but did not reach pre-COVID-19 levels. At individual DESP levels across England, the greatest drop in attendance (2020–2021) was recorded in Derbyshire (79% to 45%), Barnsley and Rotherham (78% to 45%) and Arden, Herefordshire and Worcestershire (78% to 46%). Although these DESPs showed an increase in 2021–2022 of 33%, 21% and 31%, they did not reach prepandemic (2018–2019) rates of 81%, 85% and 82%, respectively. Data suggest that West Sussex, East Sussex and East and North Hertfordshire DESPs maintained relatively higher uptake rates (86%–89%) in 2020–2021.ConclusionCOVID-19 had an impact on England’s diabetic eye screening attendance, with notable variations across regions and DESPs. Different regions and DESPs showed variable post-COVID-19 recovery. More importantly, what was not evident is the increased uptake that should have occurred after the COVID-19 lockdown to compensate for the low uptake during the lockdown. In some areas, addressing some of the barriers that affect retinal screening uptake may improve future attendance.
Care delivery in the context of district mental healthcare plans in Ghana: a qualitative study exploring experiences of primary healthcare workers and service users
Authors: Sakyi Lionel , Ae-Ngibise Kenneth , Adwan-Kamara Lyla , Weobong Benedict , Lund Crick 
Published: December 2024

ObjectiveTo explore the perceptions and experiences of mental health service users and healthcare workers regarding the implementation of district mental healthcare plans (DMHPs) in three district demonstration sites in Ghana.DesignThe study employed a qualitative design using reflexive thematic analysis. Interview data were analysed by combining inductive and deductive approaches.SettingThe study was conducted in three DMHP districts in Ghana: Anloga (Volta), Asunafo North (Ahafo) and Bongo (Upper East). The districts were selected via national stakeholder consultations, using a DMHP framework. Data were collected between January 2023 and June 2023.ParticipantsIn-depth interviews were conducted with 28 primary healthcare workers who played key roles in the delivery of care in the demonstration districts. Thirty-two service users who are 18 years and above and have been receiving healthcare for the past year in the demonstration districts were also interviewed. Participants were purposively sampled.FindingsThree main themes were identified: (1) factors supporting DMHP implementation, including capacity building, collaboration, awareness creation and acceptability; (2) challenges affecting DMHP implementation, such as inadequate resources and medication shortages and (3) perceived outcomes of the DMHPs, including improved well-being and daily functioning as well as changing attitudes towards mental health. Some district-level variations were noted in the intensity of challenges and outcomes.ConclusionThe DMHPs have shown promise in improving mental healthcare in primary care settings in Ghana. However, addressing resource constraints and medication shortages and sustaining capacity building and awareness creation efforts will be crucial for successful scale-up. The perspectives of service users and healthcare providers offer valuable insights for policymakers and practitioners aiming to enhance integrated mental healthcare.
Changing the culture: increasing captured intraoperative anaesthesia-related safety events through targeted interventions
Authors: McSoley Joseph William , Buck David Winthrop , Winterberg Abby V 
Published: December 2024

BackgroundThere is an under-reporting of anaesthesia-related safety events.10Incident-capturing systems (ICSs) are essential for patient safety monitoring, identifying risks and ongoing opportunities for improvement. After a literature review and assessment of our current ICSs, we concluded that our institution lacked a reliable anaesthesia-specific ICS system, leading to under-reporting of anaesthesia-related safety events.MethodsWe conducted a quality improvement initiative to help increase perioperative safety event reporting by anaesthesiologists, fellows and certified registered nurse anaesthetists. We analysed all anaesthesia-related perioperative safety events from July 2019 to December 2020 to determine a baseline rate of safety events captured. We conducted a simplified failure-mode effects analysis and designed a key driver diagram to guide our initiative. Based on these, we designed and implemented seven interventions aimed at increasing anaesthesia-related perioperative safety event reporting. We then reviewed perioperative safety events captured from January 2021 to February 2023 and compared the safety event capture rate to baseline.ResultsOver 10 months, we trialled and implemented multiple interventions aimed at increasing perioperative anaesthesia-related safety event capture, including re-education, strategic placement of report forms, education of anaesthesia and non-anaesthesia personnel, celebration of events captured, promotion of a safe-capture culture where reporting was not seen as punitive and the transition to an online anaesthesia ICS. Over 25 months, we demonstrated a sustained increase in event reporting from a baseline of 1.9 incidents captured per week (average of 1000 cases performed weekly) to 19 events captured per week postinterventions.ConclusionsIncreasing event reporting required a multifaceted approach—ongoing attention to reporting barriers and developing targeted interventions promoting sustained reporting. Education on the importance of reporting, creating a reliable electronic ICS, creating a non-punitive culture and continuing to promote a safety culture contributed to system improvement.
Development and evaluation of a quality improvement educational video on joint contractures for care home staff
Authors: Tariq Hina , Dunn Joel , Forrester Samantha , Collins Kathryn , Porter Sam 
Published: December 2024

BackgroundContractures are a debilitating problem for individuals living in long-term care settings. However, there is a lack of education and training among the care staff regarding the identification of risk factors related to contractures and the preventive strategies that can decrease their development or progression. Addressing this knowledge gap has the potential to improve the quality of care provided to residents in care homes.The objective of this quality improvement (QI) project was to investigate the impact of a newly developed educational video on the awareness, knowledge and understanding of contractures among the care staff.MethodsThis QI project involved two sequential Plan-Do-Study-Act cycles and employed a pre and post-test design to evaluate the impact of the contracture educational video. Primary outcomes were assessed using paper surveys to capture prevideo and postvideo levels of knowledge and understanding of contractures. Furthermore, both verbal and written feedback from participants were gathered to identify areas of strengths and improvement.ResultsBaseline data revealed that about 56% of the care staff lacked knowledge and understanding of contractures with another 33% reporting possessing only basic knowledge. Following the video intervention, percentage of care staff who reported good knowledge and understanding increased to 67% while 22% reported basic knowledge and understanding of contractures. The care staff suggested changes to the video to improve accessibility of the information, this was incorporated in the refilming of the video.ConclusionThis QI project demonstrated that the introduction of a contracture educational video is a feasible and positively received method of enhancing awareness, knowledge and understanding of contractures among care staff. Educating care staff about the risk factors and prevention strategies for contractures will potentially improve their ability to identify the risk of contractures and help prevent their occurrence, ultimately enhancing the quality of care of the residents.
Neutrophil‐to‐Lymphocyte and Platelet Ratio (N/LP Ratio), a Reliable Criterion for Predicting In‐Hospital Mortality in Both Genders Infected With SARS‐CoV‐2
Authors: Mohammadshahi Jafar , Ghobadi Hassan , Shargi Afshan , Moradkhani Hossein , Rezaei Hamed , Kazemy Mahur , Aslani Mohammad Reza 
Published: December 2024

Background: The neutrophil‐to‐lymphocyte ratio (NLR), monocyte‐to‐lymphocyte ratio (MLR), platelet‐to‐lymphocyte ratio (PLR), derived neutrophil‐to‐lymphocyte ratio (dNLR), neutrophil‐to‐lymphocyte and platelet ratio (N/LP ratio), aggregate index of systemic inflammation (AISI), systemic inflammation response index (SIRI), and systemic inflammation index (SII) have emerged as noteworthy determinants in evaluating the severity and mortality prognosis of inflammatory diseases. In order to predict mortality rate, this study aimed to assess the impact of systemic inflammatory markers on both men and women who were admitted to the hospital due to SARS‐CoV‐2 infection.Methods: The laboratory parameters of the 2007 COVID‐19 patients were analyzed in a retrospective study (men = 1145 and women = 862). Receiver operating characteristic (ROC) analysis was used to determine the capability of inflammatory markers to differentiate the severity of COVID‐19, while survival probability was determined using Kaplan–Meier curves, with the endpoint being death. To prevent any linear bias, the inflammatory indices were assessed separately using univariate analysis for Charlson comorbidity index (CCI), and adjustments were made for confounding factors if p < 0.2.Results: Adjusted‐NLR, adjusted‐MLR, N/LP ratio, adjusted‐dNLR, adjusted‐AISI, adjusted‐SII, and adjusted‐SIRI exhibited remarkably higher values in patients who did not survive as compared to those who did. The multivariate Cox regression models demonstrated significant association between survival and N/LP ratio (HR = 1.564, 95% CI = 1.161 to 2.107, p < 0.01) in men and N/LP ratio (HR = 1.745, 95% CI = 1.230 to 2.477, p < 0.01) and adjusted‐SII (HR = 6.855, 95% CI = 1.454 to 32.321, p < 0.05) in women.Conclusion: A reliable predictor in the current study of men and women with COVID‐19 was N/LP ratio.
Enhancing Decision-Making and Supply Chain Agility through Artificial Intelligence
Authors: Mahama Umar Farouk Aliu , Boison David King , Doumbia Musah Osumanu , Antwi-Boampong Ahmed 
Published: December 2024

Abstract
This study evaluates AI’s effectiveness in boosting real-time decision-making and supply chain agility in West African ports. Utilizing Structural Equation Modeling (SEM), data from 250 supply chain experts across several countries, including Ghana and Nigeria, were analyzed. Results indicate significant enhancements in supply chain agility, particularly through improved data processing speed, system integration, prediction accuracy, and user interface quality, with the latter having the most substantial impact. The study underscores the importance of user-friendly AI systems, supported by Dynamic Capabilities Theory, which facilitates organizational adaptability to market changes. Recommendations focus on developing AI systems with robust user interfaces and ensuring seamless integration with existing IT infrastructures. This research contributes to the literature by empirically demonstrating AI’s role in improving operational adaptability and filling theoretical gaps, with a unique regional focus and methodological approach.
Salvation and the Roman empire: Eusebius of Caesarea on pastoral peace and the martial shepherd
Authors: Rotiroti Francesco 
Published: December 2024

Summary
The present article is the first in a diptych looking at the pastoral characterisation of Constantine in the works of Eusebius of Caesarea through the lens of institutional theory. Through pastoral discourse, I argue, Eusebius systematises key elements of the policy and functions of the first Christian emperor, thus contributing to the institutional construction of the early Christian basileiā. Central to this construction are pastoral narratives of peace and warfare, drawn from earlier traditions but revisited and remodelled. By identifying the so-called pax Constantiniana with the pastoral peace preannounced by the prophets, Eusebius’ panegyric at Tyre, in particular, repositions the Roman empire within the conceptual framework of Christian soteriology. The perceived peace of the empire becomes a juncture of salvation history, brought about by the divine shepherd through the agency of the pious emperors. Eusebius’ later works reiterate the association of the pastoral metaphor with warfare already articulated in the panegyric at Tyre, but also innovate it significantly, as the soteriological underpinning of the shepherd’s military engagement becomes increasingly blurred.
A Biscayan jurist in the Renaissance
Authors: Mancisidor Mikel 
Published: December 2024

Summary
Fortún García de Ercilla (Fortunius) was a quite known jurist in his century, quoted and discussed by some significative authors of his time. He was also a politician with relevant mandates in the service of Emperor Charles v. However, his name faded away in the following centuries. It is only very recently that his contributions to different areas of law, as well as to Castilian and Navarrese politics, have been vindicated. This article a) begins with a brief outline of his hitherto insufficiently well-known biography; b) proposes an updated list of his written works, including news of two recent findings, and places him as an actor in the communicative process that sixteenth century law was; and c) defends the hypothesis that the political and legal culture of his homeland, and the specific position of his lineage, allows a better understanding of some of the implications the topic of his first work, De Pactis (1514), had for him.
Struggling for legal primacy in the Zwin: Bruges and Sluys, 1492–1520
Authors: Gordijn Femke 
Published: December 2024

Summary
This article examines a series of conflicts between the city of Bruges and its main outport Sluys brought before the Council of Flanders and the Great Council of Malines around the turn of the sixteenth century. Although Bruges’ commercial successes declined during this period, the previously consolidated hierarchical relationships with Sluys persisted as the courts continuously judged in Bruges’ favour. This contribution attempts to expose the underlying legal dynamics that determined Bruges’ continued primacy over its outport.
Droit au coeur de la science politique
Authors: Decock Wim 
Published: December 2024

Summary
This article serves as a prolegomenon to further studies on the political and legal thought of Jean de Chokier (1571–1656). Trained in Roman law and canon law at the University of Orléans, he became one of the most prominent canon lawyers, political thinkers and humanist scholar of the Principality of Liège, an Imperial State situated in the Western part of the Holy Roman Empire. Author of major works in canon law, history and political science, he became vicar general of the Diocese of Liège under Prince-Bishops Ferdinand and Maximilian-Henri of Bavaria, successively. He belonged to the Neo-Stoic network around Justus Lipsius (1547–1606), the humanist jurist from Overijse. Inspired by this intellectual movement, Chokier published legal, political, historical and literary treatises next to performing his duties as an ecclesiastical administrator. His life and writings reflect the osmosis between humanist erudition, political commitment and legal knowledge that characterized the careers of many of the great jurists of the sixteenth and seventeenth centuries. Considering that Chokier was foremostly trained as a canon lawyer and also professionally active in this domain, this article invites readers to take a fresh look at Chokier’s political and juridical oeuvre from a canon law perspective.
Not Feuerbach: the origin of the adage Nulla poena sine lege in the Ancien Régime
Authors: Pierrard François 
Published: December 2024

Summary
The expression Nulla poena sine lege is one of the most widely used Latin legal adages in the world. It is one of the formulas of the principle of the legality of offences and penalties. Lawyers and legal historians unanimously date its invention from 1801 and attribute it to Paul Johann Anselm von Feuerbach (1775–1833), the promoter of the Bavarian Criminal Code of 1813, which served to disseminate it. However, a consultation of the archives held at the Haus-, Hof- und Staatsarchiv in Vienna has forced us to revise this conclusion. The first occurrence found dates back to 1777, but the adage appears to be even older, as it was already considered a maxim in the Austrian Netherlands. Originally, the adage Nulla poena sine lege does not seem to have had the positivist and legicentrist connotation that it has had since the 19th century.
Revisiting possessio naturalis and possessio civilis in Roman law: a new perspective emerges?
Authors: Costa-Neto João 
Published: December 2024

Summary
This is a brief critical assessment of the distinction between possessio naturalis and possessio civilis in Roman law. The text provides a concise historical outline of the distinction. Costa-Neto re-examines conventional perspectives concerning possession, including those proposed by Savigny, Jhering and Riccobono. It also examines the notion of possessio naturalis as proposed by D’Angelo and Klinck in recently published works. Costa-Neto underscores the differences from possessio civilis and mere detention and concludes that, even if a ‘quite dominant’ view basically reduces naturalis possessio to mere detention, a new trend is gradually emerging: naturalis possessio as an independent and separate institution, distinct from detention.
The Libri feudorum
Authors: Chorus Jeroen M.J. 
Published: December 2024

Summary
This article mainly reviews Attilio Stella’s new edition of the Latin text of the Libri feudorum and his new English translation thereof. Additionally, it seemed useful to recall and summarize Peter Weimar’s authoritative and convincing views regarding the notoriously complicated history of the formation of the Libri feudorum and their Glossa ordinaria. Moreover, some remarks are made on the surviving medieval manuscripts and the printed editions (1472–1896) of the Latin text. Previous translations into various languages (1493–2016) are discussed. Stella’s new translation is then addressed. It may be called sound and solid. It is but rarely that some nuance does not return in the translation. If the choice of Lehmann’s Latin text (1896) is debatable, its inconvenience has been compensated by references to Osenbrüggen’s standard edition (1840). Stella’s annotation to the translation is rich and ingenious and gives delightful explanations of many unclear or ambiguous passages.
Similarity within Univocity: The Foundation of World Christianity beyond ‘Differentiation or Uniformity’
Authors: You Grace 
Published: December 2024

Abstract
Recent scholarship suggests the postmodern era, marked by a rejection of universal objectivity and ideas of unity, and by an emphasis on difference and plurality, may be ending. World Christianity scholars are also shifting focus from ‘difference’, ‘locality’ and ‘contextuality’ and seeking to recuperate the ‘universal’ via the concepts of unity, exchange and mutual dependence. They do, though, recognise the risks of claiming universalism, as exemplified by Radical Orthodoxy. This anti-modern theology, which argues for a retrieval of medieval Platonic Christendom as ‘the common vision’, is criticised by post-colonialists as a Eurocentric totalising tendency. Going beyond total difference or total sameness, this article proposes ‘similarity within univocity’ as a theoretical solution to the dilemma facing World Christianity: either a hyper-fragmented contextual model or Radical Orthodoxy’s universalism model. It demonstrates that ‘similarity’ not only avoids totalitarian absolute sameness, but also fragmentary difference, thus providing a novel hermeneutical foundation for the future of World Christianity.
The Role of the Safavids in the Spread and Institutionalization of the Nastaʿliq Script
Authors: Shahidani Shahab , Amiri Mostafa , Lewental D Gershon 
Published: December 2024

Abstract
The development of calligraphy during the Safavid period was tied closely to the emergence of a new religious and national identity. Nastaʿliq, which had emerged in association with Persian literature and culture during the Il-khanid period, became increasingly popular for both artistic and administrative purposes under Safavid patronage, at which time nastaʿliq became the favored script for transcribing not only Persian literary manuscripts, but also Shiʿi literature. Its privileged position in Safavid political historiography, manuscript illumination, and epigraphy, both in an architectural context and elsewhere, attests to the fact that nastaʿliq was institutionalized in Safavid Persia with respect to both Persian and Shiʿi aspects. The present study reveals that the material and spiritual support of the Safavids was instrumental in effectively integrating nastaʿliq into Persian culture and identity. However, nastaʿliq’s influence extended beyond Iran, as it became a distinguishing feature of Persian calligraphy and was widely used in other territories, including Mughal India and the Ottoman Empire, to transcribe inscriptions and manuscripts as a distinctively Persian art.