bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evidence of a Decreased Binary Fraction for Massive Stars within 20 milliparsecs of the Supermassive Black Hole at the Galactic Center
Authors: Chu Devin S. , Do Tuan , Ghez Andrea , Gautam Abhimat K. , Ciurlo Anna , O’neil Kelly Kosmo , Hosek Matthew W. , Hees Aurélien , Naoz Smadar , Sakai Shoko , Lu Jessica R. , Chen 陈 Zhuo 卓 , Bentley Rory O. , Becklin Eric E. , Matthews Keith 
Published: May 2023

Abstract
We present the results of the first systematic search for spectroscopic binaries within the central 2 × 3 arcsec2 around the supermassive black hole at the center of the Milky Way galaxy. This survey is based primarily on over a decade of adaptive optics-fed integral-field spectroscopy (R ∼ 4000), obtained as part of the Galactic Center Orbits Initiative at Keck Observatory, and it has a limiting K’-band magnitude of 15.8, which is at least 4 mag deeper than previous spectroscopic searches for binaries at larger radii within the central nuclear star cluster. From this primary data set, over 600 new radial velocities are extracted and reported, increasing by a factor of 3 the number of such measurements. We find no significant periodic signals in our sample of 28 stars, of which 16 are massive, young (main-sequence B) stars and 12 are low-mass, old (M and K giant) stars. Using Monte Carlo simulations, we derive upper limits on the intrinsic binary star fraction for the young star population at 47% (at 95% confidence) located ∼20 mpc from the black hole. The young star binary fraction is significantly lower than that observed in the field (70%). This result is consistent with a scenario in which the central supermassive black hole drives nearby stellar binaries to merge or be disrupted, and it may have important implications for the production of gravitational waves and hypervelocity stars.
Vies d’esclaves. Une autre perspective sur l’« esclavage atlantique » ?
Authors: Zuñiga Jean-Paul 
Published: May 2023

Cet article a l’ambition de mettre en exergue les apports de l’histoire sociale à une histoire de l’expérience esclave, domaine largement occupé de nos jours par l’histoire culturelle et des concepts. Peut-on aborder les valeurs des temps révolus autrement qu’au travers de regards surplombants ? Les théories scientifiques ou la production de prescriptions juridiques contiennent-elles l’ensemble des normes sociales ? La parole explicite de quelques-uns annule-t-elle les conceptions tacites de la majorité nécessairement silencieuse ? Peut-on écarter sans plus cette immense terra incognita sous prétexte qu’elle n’a jamais été exprimée de manière explicite et directement perceptible ? L’objectif de cet article est de répondre à une partie de ces questions en tentant de saisir l’expérience esclave tout en envisageant les possibles non advenus ou effectivement réalisés qui constituaient son cadre référentiel. Ce procédé doit permettre la mise en perspective de ces expériences et des savoirs vernaculaires qu’elles révèlent avec les appareils et conceptualisations savantes mobilisés par une partie de l’historiographie sur l’esclavage atlantique. Au cœur de cette démarche se trouve par conséquent la question du poids qu’il convient d’accorder à l’exemple individuel ainsi que les conditions de son utilisation comme matériau pour l’histoire.Une première partie s’ouvre par un contrepoint critique entre des interprétations issues de l’historiographie récente sur la race et l’esclavage et ce que l’exemple isolé de la pensée d’un clerc jésuite du xviie siècle peut nous révéler sur ces questions.La deuxième partie pose le problème de l’exemple individuel dès lors que les traces des personnes du passé, en raison de leur statut de subordination, sont minimes. Trois bribes de vie de femmes esclaves sont alors mobilisées afin de les soumettre à un protocole permettant de mettre en travail cet anonymat. Il s’agit de traces écrites retrouvées dans les archives notariales et judiciaires de trois lieux éloignés dans l’espace et dans le temps mais faisant tous partie de la monarchie hispanique : une lettre de vente à Santiago du Chili en 1624 ; une allégation juridique commencée à Tenerife (Canaries) en 1676 et un dossier d’action en justice à la Pointe Coupée (Louisiane espagnole) en 1795.La troisième partie de l’article s’interroge sur les critères permettant d’aboutir à un discours historique à partir d’exemples si épars. Ceux-ci expriment la multiplicité des expériences du social selon les acteurs, les lieux et les périodes : leur confrontation réciproque autorise à porter un regard critique sur la pertinence d’un récit faisant de la race le moteur de la domination esclavagiste coloniale à l’échelle hémisphérique depuis la fin du Moyen Âge, et de la plantation son archétype. Cette explication apparaît dès lors comme un raisonnement téléologique plus que comme une catégorie analytique permettant de comprendre l’agir des acteurs en situation et ses contraintes.
Modelling CD4 reagent usage across a national hierarchal network of laboratories in South Africa
Authors: Cassim Naseem , Coetzee Lindi-Marie , Glencross Deborah K. 
Published: May 2023

Background: The National Health Laboratory Service is mandated to deliver cost-effective and efficient diagnostic services across South Africa. Their mandate is achieved by a network of laboratories ranging from centralised national laboratories to distant rural facilities.Objective: This study aimed to establish a model of CD4 reagent utilisation as an independent measure of laboratory efficiency.Methods: The efficiency percentage was defined as finished goods (number of reportable results) over raw materials (number of reagents supplied) for 47 laboratories in nine provinces (both anonymised) for 2019. The efficiency percentage at national and provincial levels was calculated and compared to the optimal efficiency percentage derived using pre-set assumptions. Comparative laboratory analysis was conducted for the provinces with the best and worst efficiency percentages. The possible linear relationship between the efficiency percentage and call-outs, days lost, referrals, and turn-around time was assessed.Results: Data are reported for 2 806 799 CD4 tests, with an overall efficiency percentage of 84.5% (optimal of 84.98%). The efficiency percentage varied between 75.7% and 87.7% between provinces, while within the laboratory it ranged from 66.1% to 111.5%. Four laboratories reported an efficiency percentage ranging from 67.8% to 85.7%. No linear correlation was noted between the efficiency percentage, call-outs, days lost, and turn-around time performance.Conclusion: Reagent efficiency percentage distinguished laboratories into different utilisation levels irrespective of their CD4 service level. This parameter is an additional independent indicator of laboratory performance, with no relationship with any contributing factors tested, that can be implemented across pathology disciplines for monitoring reagent utilisation.What this study adds: This study provides an objective methodology to assess reagent utilisation as an independent measure of laboratory efficiency. This model could be applied to all routine pathology services.
Deuteronomistic theology in Psalms 44, 74, 80 and 89: Examined through the lens of trauma
Authors: Li Xi 
Published: May 2023

Biblical scholars are divided regarding the presence of Deuteronomistic theology in Psalms 44, 74, 80 and 89. This article re-examines this issue through the lens of trauma and argues for two points. Firstly, Psalms 44, 74, 80 and 89 do not reject Deuteronomistic theology because the accusations of God in these psalms do not indicate attribution of responsibility but demonstrate trauma victims’ negative cognition and emotion associated with the traumatic event. Secondly, the concept of post-traumatic growth (PTG) helps to clarify two crucial elements of Deuteronomistic theology concerning divine retribution and divine promise. Psalms 44 and 74 assume the first element; Psalms 80 and 89 presuppose the second.Contribution: This article provides a fresh angle from trauma studies to approach biblical texts in the Hebrew Bible, clarifying the connection between Deuteronomistic theology and communal laments.
Facilitators and barriers to voluntary medical male circumcision as an HIV prevention strategy in Kavango East, Namibia
Authors: Ashipala Daniel O. , Nhokwara Trymore B. , Joel Medusalem H. 
Published: May 2023

Background: Voluntary medical male circumcision (VMMC) is a strategy used to try to limit new human immunodeficiency virus (HIV) infections, as it has the potential to reduce HIV and/or AIDS transmission from women to men by up to 60%. However, in spite of efforts by the Ministry of Health and Social Services, only a few men in Namibia have been circumcised. The objective of this study was to explore and describe the facilitators of, and barriers to, medical male circumcision for HIV prevention in Kavango East, Namibia.Methods: A qualitative, explorative, descriptive and contextual design was employed. The accessible population in this study comprised 18 health professionals who were selected for the study using a purposive sampling technique.Results: Participants reported numerous barriers to VMMC in Namibia. Barriers to VMMC included ‘myths’ and misconceptions attached to VMMC, age limitations, fear of pain and stigma associated with HIV, small VMMC team and long distances from health facilities. Facilitators to VMMC included family support, having experienced genital sores and genital warts or phimosis and paraphimosis.Conclusion: The study revealed that a number of barriers must be overcome before VMMC before the desired number of men take advantage of VMMC. Multiple factors act as constraints to VMMC, including fear, myths and misconceptions, small VMMC teams and the long distance between clients’ homes and VMMC services.Contribution: The study’s findings can be used to develop targeted interventions and strategies that can be used by VMMC providers to address the identified barriers.
Siphefumula Ngenxeba in our own homes: Gender-based violence during COVID-19 pandemic
Authors: Khosa-Nkatini Hundzukani P. , Mofokeng Jacob T. 
Published: May 2023

Gender-based violence (GBV) has become a major problem in South Africa, making headlines on a regular basis. When the president of the Republic of South Africa, Mr. Cyril Ramaphosa, declared the lockdown in reaction to the worldwide pandemic: COVID-19 one of the expectations was that families would spend more time together in harmony. However, the number of recorded domestic violence instances increased as a result of the lockdown. Women have historically been subjected to GBV in their communities, businesses, streets, marketplaces and even churches; recently, their homes have proven to be unsafe as well. There have been a number of marches of women around the country to call for justice for women who are victims of GBV. The lives of women were endangered, what was supposed to be a place of solace became a dungeon to them. They were essentially breathing through the wound in their own homes: Baphefumula ngenxiba. This article, through a literature review, will highlight how the lives of women were endangered during the lockdown in response to the global pandemic in South Africa. This article aims to call missionary churches to practice the theology of missio Dei within this context.Contribution: In the light of the above challenges of GBV, the missionary churches are called to practice the theology of missio Del within the context of gender-based violence that took place in private homes during COVID-19. ‘Siphefumula Ngenxeba’ is a Zulu phrase that means [we are breathing through the wound]. The church is therefore called to play a significant role in response to GBV in South Africa.
Mobilising towards environmental sustainability – challenges and chances for churches in Germany
Authors: Kroeck Thomas 
Published: May 2023

The current ecological crisis is considered a major challenge for humanity. Various scholars suggest that Christian congregations may contribute to the changes of mind-set and behaviour necessary to meet this challenge. The article presents the results of an empirical study on how Protestant congregations in Germany deal with this issue. Data were collected in an online survey and group discussions with members of the Evangelical Church of Germany (EKD), the Free Evangelical Church (FeG) and the Gnadau movement. The study showed that the environmental awareness of church members is similar to the population in general. Major pragmatic obstacles to mobilise congregations for environmental sustainability were the (1) views that it may compete with other tasks of the congregation, (2) that church members may feel excluded and (3) the lack of knowledge and competence regarding this topic. However, creation care was seen as a bridge to the community which allows the congregation to engage with people outside the church. The study shows which issues need to be addressed for Christian congregations to play a more active role in creation care.Intradisciplinary and/or interdisciplinary implications: The research is concerned with church management fostering ecologically sustainable practices and is situated in the discipline of practical theology. As church management is based on the understanding of the mission of the church it is linked to ecclesiology. The practice of local congregations may have effects on the general public and can therefore be studied from a sociological perspective as well as in development studies.
The Study of Serum C-reactive Protein/Albumin Ratio as a Prognostic Marker in Patients with Sepsis and Septic Shock in a Tertiary Care Hospital
Authors: Krishnamurthy H A , Kishor U 
Published: May 2023

Introduction:
Sepsis is a common and deadly disease. The acute-phase reactants such as high-sensitive C-reactive protein (CRP), lactate dehydrogenase (LDH), ferritin, procalcitonin, interleukin (IL)-6, tumor necrosis factor-alpha, and IL-1 are elevated in all most all cases of sepsis Their early elevation is associated with high mortality. They are widely used for early diagnosis, management, and risk stratification of patients with septic shock. However, in resource-poor setup and financial constraints, getting above investigations is not always possible. This study would like to examine, is there any role of ratio between serum CRP and albumin level as a potential prognostic marker of outcome in sepsis and septic shock in a resource-poor and constrained setup.

Materials and Methods:
This was a prospective cross-sectional study conducted on 100 subjects, who were admitted in intensive care unit, emergency ward, and various other wards with sepsis and septic shock. The purpose of the study was explained to subjects and their attenders; informed consent was taken from the study subjects. The following biochemical parameters were done on day 1 and day 3 of admission. They were complete blood count, liver function test, renal function test, serum electrolytes, random blood sugar, electrocardiogram, arterial blood gas, lactate level, CRP, LDH, serum ferritin, erythrocyte sedimentation rate, blood culture, urine culture, sputum culture, and sensitivity. The quick Sequential Organ Failure Assessment (qSOFA) score was used to assess the severity of sepsis and septic shock. All the parameters were correlated with inhospital outcome of subjects. Data obtained from the subjects were systematically recorded and analyzed using SPSS (Statistical Package for the Social Sciences) software version 23.

Results:
The male cases constituted about 63%. One-fourth of the patients belonged to the age group of 61–70 years. The mortality in the present study was 27%. The serum CRP/albumin ratio was 73.58 mg/dl: 3.14 g/dl on day 1 and 65.66 mg/dl: 3.03 g/dl on day 3 of admission (P < 0.001). The serum CRP/albumin ratio, serum LDH level, and serum ferritin level on day 1 (P = 0.019) and day 3 (P < 0.001) of admission were positively correlated with the outcome of sepsis and septic shock.

Conclusion:
The serum CRP/albumin ratio is a highly sensitive marker, which is noninferior to the other high-cost biomarkers (serum ferritin and LDH) in assessing the daily prognosis in patients with sepsis in a resource-poor and constrained setup. Hence, this study endorses and reiterates that serum CRP/albumin ratio is a cost-effective, novel, easily feasible, and one of the most relevant investigations available in assessing the severity and mortality of sepsis and septic shock in a rural resource-limited and financially poor health-care setting.
Neurological Manifestations of Scrub Typhus in Children: Clinical Profile and Outcome
Authors: Gupta Medha , Tapaswini A. P. , Panda Subhasmita , Sarangi Rachita 
Published: May 2023

Abstract

Background:
Re-emerging scrub typhus is gaining recognition as an important cause of focal or disseminated vasculitis or perivasculitis which is responsible for its various clinical manifestations and complications. Neurological manifestations with varied presentations have been reported in rickettsial diseases with variable prevalence (28%–80%).

Methods:
A cross-sectional study among admitted children was conducted for 1½ years in a tertiary care hospital with the objective to study the clinical profile and outcome of the patients with neurological manifestations of scrub typhus.

Results:
Out of 105 scrub typhus cases (immunoglobulin M enzyme-linked immunosorbent assay positive), 32 patients (30.4%) had neurological manifestations with a male: female ratio of 19:13. These children presented with fever (100%), headache (71.8%), vomiting (62.5%), convulsion (53.1%), and altered sensorium (43.7%). Neurological manifestations included meningeal signs (75%), ataxia (6.2%), lateral rectus palsy (9.3%), papilledema (18.7%), stroke (6.2%), and retinal hemorrhage (3.1%). Lumbar puncture was done in 31 cases and the mean cerebrospinal fluid (CSF) white blood cell count, lymphocyte, and neutrophil proportion was 66 cells/cu.mm, 60%, and 27%, respectively, with the mean CSF protein and glucose is 67 mg/dl and 55 mg/dl. Neuroimaging was done in 24 patients and the abnormalities found were cerebral edema (n = 5), basal ganglia infarct (n = 2), and features of cerebellitis (n = 2).

Conclusion:
Rickettsial disease should be considered an etiological agent in all febrile illnesses with neurological manifestations, especially in endemic areas. Early recognition and treatment of rickettsial infections with neurological manifestations are important to prevent morbidity and mortality of the disease.
The Study of Lactate/Albumin Ratio as a Predictor of In-Hospital Mortality in Patients with Sepsis and Septic Shock in a Tertiary Care Hospital
Authors: Krishnamurthy H. A. , Kishor U. 
Published: May 2023

Abstract

Background:
Sepsis is a common and deadly disease that is characterized by elevated levels of acute phase reactants such as high-sensitivity C-reactive protein, lactate dehydrogenase, ferritin, procalcitonin, interleukin (IL-6), tumor necrosis factor, and IL-1. These markers are often used for early diagnosis, management, and risk stratification in patients with septic shock, but they may not be accessible in resource-poor settings with financial constraints. This study aimed to investigate the potential use of the ratio between serum lactate and negative acute phase reactant serum albumin level as a prognostic marker for the outcome of sepsis in resource-poor and -constrained settings.

Materials and Methods:
The study was a prospective observational study that included 122 patients admitted to the intensive care unit and emergency ward with sepsis or septic shock. Ethical clearance was obtained from the Ethics Committee of Mysore Medical College and Research Institute, and informed consent was obtained from the patients and their attendants. Blood samples for analysis of arterial blood gases, albumin, and other biochemical parameters were collected on the 1st and 3rd days of admission. The outcome of the disease was compared to these parameters using statistical methods such as ANOVA and Chi-square tests with multivariate analysis.

Results:
The study population consisted of 54.09% males, with one-third of the patients belonging to the age group of 61–70 years. The mortality rate was 27%. The mean serum lactate level on day 1 was 1.7 ± 0.15 mmol/L and on day 3 was 2.65 ± 0.32 mmol/L. The mean serum albumin level on day 1 was 3.14 ± 0.14 g/dL and on day 3 was 3.03 ± 0.13 g/dL. The lactate/albumin ratio on day 1 was 0.49 ± 0.12 and on day 3 was 0.89 ± 0.1 and was positively correlated with the severity of sepsis and septic shock (P < 0.001) and showed a greater significance than lactate or albumin alone.

Conclusion:
The serum lactate/albumin ratio is a highly sensitive marker that is noninferior to other high-cost biomarkers in assessing the daily prognosis of patients with sepsis in resource-poor and -constrained settings. This study suggests that the lactate/albumin ratio may be a cost-effective, novel, easily feasible, and relevant investigation for assessing the severity and mortality of sepsis and septic shock in rural resource-limited and financially poor hospital settings.
Competency-Based Medical Education for Indian Undergraduates: Where do we Stand?
Authors: Gehlawat Mamta , Thumati Goutham , Samala Priyanka , Alekhya Chaganti Lalitha , Shailaja Are , Sharma Anamika 
Published: May 2023

Abstract
The traditional system of medical education was a structure and process-based system with limited assessment of application of knowledge, skills, and attitudes. Decades after the World Health Organization gave preliminary guidelines on Competency-based medical education (CBME) in 1978, countries around the world are still taking to the newer medical education systems. In India, CBME replaced traditional system of medical education in 2019 while the National Medical Council replaced Medical Council of India in 2020. The annual intake of medical undergraduates has reached an all-time high of one lakh students per year in India and our medical education system is taking baby steps toward CBME. The implementation of CBME poses different hurdles for medical educators as well as medical students. Medical educators are yet to develop confidence in the newer teaching learning methods (e.g., Small Group Teaching, Role-play, Peer group learning etc.), along with the array of newer assessment methods. There in lies an immense and urgent need of training medical educators with continued hand holding along with adapting newer teaching learning methods to the students of generation Z who are tech-savvy but anxious and indulged yet stressed. This review has tried to articulate the current situation of CBME in the world and in India, acceptance of CBME by faculty and students and the way forward for India’s medical education system.
IgA Vasculitis Following ChAdOx1 nCoV-19 Vaccination
Authors: Basu Manabendra , Prathibha P. M. , Mohan B. V. Murali 
Published: May 2023

Abstract
IgA vasculitis (IgAV), a small-vessel vasculitis, is more frequently seen in children than in adults. IgAV is triggered by various bacterial and viral infective agents. Here, we are describing a case of IgAV following ChAdOx1 nCoV-19 vaccination. A 39-year-old male presented with skin rash, joint pain, and pain abdomen. Symptoms started within 3 days of ChAdOx1 nCoV-19 vaccination. His clinical examination and investigations lead to a diagnosis of IgAV. After ruling out other possible etiologies, we concluded it as vaccine-induced IgAV. A few cases of IgAV have been reported worldwide post SARS-CoV-2 vaccination. Although rare and often self-limited, it is important to recognize the possibility of IgAV post-SARS-CoV-2 vaccination because early recognition, initiation of treatment, and timely follow-up can improve the disease outcome.