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This review essay explores the complex subject of peace in Africa by reviewing six volumes. While the African Union and the United Nations identify peace as providing the foundation for development, the quest for sustainable peace in regions of postcolonial Africa has remained elusive. Several works have sought to examine the contemporary pathways to peace currently being explored on the continent. The works under review must be located in this search for sustainable peace in Africa.
This article highlights the challenges of external reactions to authoritarian higher education governance in certain Central and Eastern European countries, especially Hungary and Poland. It interprets the political change in these countries as an authoritarian cultural backlash, which is not just a legal or political problem, but a kind of post-fascist cultural revolution contesting the liberal script. First, the article explains the framework of authoritarian policing in academia based on the more general works of Bob Altemeyer and Zeev Sternhell. Second, it tries to answer the question: What tools could counter these tendencies from the perspective of the European Union? As the article interprets the rise of authoritarianism as a phenomenon rooted in the cultural deficit of the countries concerned, it argues that a programme for a democratic and pluralist cultural counter-revolution should be implemented. However, no nation can be democratized solely by external actors, and the basics of democratic thinking should be developed from the grassroots level. If the crisis in academia is rooted in a value-crisis within the societies concerned, then measures countering this phenomenon should also include promoting Enlightened pluralism at all levels of these societies.
We aimed to determine whether automated identification of antibiotic targeting suspected urinary tract infection (UTI) shortened the time to antimicrobial stewardship (AS) intervention.
Design:
Retrospective before-and-after study.
Setting:
Tertiary and quaternary care academic medical center.
Patients:
Emergency department (ED) or admitted adult patients meeting best practice alert (BPA) criteria during pre- and post-BPA periods.
Methods:
We developed a BPA to alert AS pharmacists of potential ASB triggered by the following criteria: ED or admitted status, antibiotic order with genitourinary indication, and a preceding urinalysis with ≤ 10 WBC/hpf. We evaluated the median time from antibiotic order to AS intervention and overall percent of UTI-related interventions among patients in pre-BPA (01/2020–12/2020) and post-BPA (04/15/2021–04/30/2022) periods.
Results:
774 antibiotic orders met inclusion criteria: 355 in the pre- and 419 in the post-BPA group. 43 (35 UTI-related) pre-BPA and 117 (94 UTI-related) post-BPA interventions were documented. The median time to intervention was 28 hours (IQR 18–65) in the pre-BPA group compared to 16 hours (IQR 2–34) in the post-BPA group (P < 0.01). Despite absent pyuria, there were six cases with gram-negative bacteremia presumably from a urinary source.
Conclusions:
Automated identification of antibiotics targeting UTI without pyuria on urinalysis reduced the time to stewardship intervention and increased the rate of UTI-specific interventions. Clinical decision support aided in the efficiency of AS review and syndrome-targeted impact, but cases still required AS clinical review.
Since its inception in England and Wales, the partial defence to murder of loss of control has generated a steady stream of appeals. Individually, those appeals have illuminated key aspects of the plea's operation. This paper, though, is the first to explore that operation via a systematic analysis of every loss of control appeal to date (110 cases). Using that data, the paper frames more effectively, and thus improves understanding of, a neglected phenomenon in the plea: specifically, the decision-making roles of criminal justice ‘gatekeepers’ – principally trial judges, juries and prosecutors – in governing access to loss of control. In doing so, the paper assesses how far these gatekeepers interpret the plea's requirements in a ‘civilising’ way – one which prioritises meritorious loss of control claims above those which are unmeritorious. It contends that each gatekeeper struggles to regulate loss of control in such a way. Ultimately, this diminishes the symbolic value these reforms may have had and frustrates any civilising potential of homicide law reform.
This Introduction provides an overview of the topics covered in this special issue on ‘Academic freedom: Global variations in norm conceptualization, diffusion and contestation’, which explores what academic freedom means, how this may vary on a global level, how the norm spread around the world and what current contestations look like. The Introduction defines some terms essential to this debate, such as the freedom of science, academic freedom, freedom of scientific research and the right to science, and offers an analytical framework for the various contributions of the special issue. This includes, in particular, a distinction between illiberal and liberal science scripts and their relationship with academic freedom, as well as between different forms of contestations and limitations of academic freedom. Authors from varying disciplinary and regional backgrounds address different aspects of this theme in their respective contributions, of which the introduction gives a brief summary.
We provide a general recursive method for constructing transfer systems on finite lattices. Using this, we calculate the number of homotopically distinct $N_{\infty} $ operads for dihedral groups $D_{p^n}$, $p \gt 2$ prime, and cyclic groups $C_{qp^n}$, $p \neq q$ prime. We then further display some of the beautiful combinatorics obtained by restricting to certain homotopically meaningful $N_\infty$ operads for these groups.
In Republican China, the Factory Act was first promulgated in 1929, after almost thirty years of unregulated industrialization. Little academic effort has been made to comprehend its actual implementation. Some academics have dismissed it as completely useless, while others have credited it with various enhancements in working conditions. This article focuses on workplace health and safety issues and critically evaluates the implementation of the law to scrutinize its effectiveness (or ineffectiveness) in addressing workers’ life and death matters. This article aims to reassert the Factory Act in China's modern history of industrial development. It points out that despite its inadequate enforcement, the law was significant in laying the foundation for the national institutionalization of state responsibility to systematically monitor and regulate workplace health and safety and paving the way for further safety legislation. Nevertheless, the law fell short of safeguarding workers’ rights during industrial accidents.
If the consumer is insured under the group insurance contract and becomes a party to that contract, the consumer shall enjoy the protection envisaged under the Unfair Terms Directive. As a result, the consumer shall be allowed to get acquainted with the terms of the contract, otherwise the consumer is entitled to rely on protection against unfair terms even if they relate to the insurance cover (author’s summary).
Although clozapine is the most effective antipsychotic for people with treatment-resistant schizophrenia (TRS), only 40% of people with TRS respond, and there is limited evidence for augmentation agents. Cannabidiol (CBD) reduces positive symptoms in individuals with schizophrenia, but no trials have specifically examined its efficacy in those with clozapine-resistant schizophrenia.
Aims
To examine the clinical efficacy of CBD augmentation in people with clozapine-resistant schizophrenia.
Method
This is a 12-week randomised, placebo-controlled, double-blind, parallel-group trial (registration number: ACTRN12622001112752). We will recruit 88 individuals with clozapine-resistant schizophrenia, randomised (1:1) to 1000 mg daily CBD versus placebo. Eligible individuals will be aged between 18 and 64 years, fulfil DSM-IV criteria for schizophrenia or schizoaffective disorder, have a total PANSS (Positive and Negative Syndrome Scale) score ≥60, have received oral clozapine for at least 18 weeks and have a clozapine level of >350 ng/mL. Interim analyses will be conducted at 25, 50 and 75% recruitment; these will also provide an opportunity to reallocate participants dependent on conditional power. The primary endpoint will be the difference in PANSS positive scores at the end of week 12. Secondary endpoints include depression, anxiety, sleep, quality of life, alcohol consumption, change in weight and metabolic syndrome components, and neurocognitive measures, as well as safety and tolerability.
Discussion
Novel treatments for clozapine-resistant schizophrenia are urgently needed. If found to be effective, CBD may have a role as a novel and safe adjunct to clozapine.
We conducted a retrospective cohort study in Ontario, Canada between December 1, 2020 and June 31, 2021 to compare the incidence of neurological events (hospitalization or emergency room visit) within six weeks of COVID-19 vaccination in Chinese, South Asian and Other ethnic groups. Compared to Others, the crude rates after the first dose for Bell’s palsy, ischemic stroke and intracerebral hemorrhage were lower in Chinese (34, 159 and 48 per 1,000,000 doses) and in South Asians (44, 148 and 32), but similar after adjusting for age, sex and vaccine type. Our findings should help encourage vaccination for all, irrespective of ethnicity.
We study the dynamics of thermal and momentum boundary regions in three-dimensional direct numerical simulations of Rayleigh–Bénard convection for the Rayleigh-number range $10^5\leq Ra \leq 10^{11}$ and $Pr=0.7$. Using a Cartesian slab with horizontal periodic boundary conditions and an aspect ratio of 4, we obtain statistical homogeneity in the horizontal $x$- and $y$-directions, thus approximating best an extended convection layer relevant for most geo- and astrophysical flow applications. We observe upon canonical use of combined long-time and area averages, with averaging periods of at least 100 free-fall times, that a global coherent mean flow is practically absent and that the magnitude of the velocity fluctuations is larger than the mean by up to 2 orders of magnitude. The velocity field close to the wall is a collection of differently oriented local shear-dominated flow patches interspersed by extensive shear-free incoherent regions which can be as large as the whole cross-section, unlike for a closed cylindrical convection cell of aspect ratio of the order 1. The incoherent regions occupy a 60 % area fraction for all Rayleigh numbers investigated here. Rather than resulting in a pronounced mean flow with small fluctuations about such a mean, as found in small-aspect-ratio convection, the velocity field is dominated by strong fluctuations of all three components around a non-existent or weak mean. We discuss the consequences of these observations for convection layers with larger aspect ratios, including boundary layer instabilities and the resulting turbulent heat transport.
The expansion of electronic health record (EHR) data networks over the last two decades has significantly improved the accessibility and processes around data sharing. However, there lies a gap in meeting the needs of Clinical and Translational Science Award (CTSA) hubs, particularly related to real-world data (RWD) and real-world evidence (RWE).
Methods:
We adopted a mixed-methods approach to construct a comprehensive needs assessment that included: (1) A Landscape Context analysis to understand the competitive environment; and (2) Customer Discovery to identify stakeholders and the value proposition related to EHR data networks. Methods included surveys, interviews, and a focus group.
Results:
Thirty-two CTSA institutions contributed data for analysis. Fifty-four interviews and one focus group were conducted. The synthesis of our findings pivots around five emergent themes: (1) CTSA segmentation needs vary according to resources; (2) Team science is key for success; (3) Quality of data generates trust in the network; (4) Capacity building is defined differently by researcher career stage and CTSA existing resources; and (5) Researchers’ unmet needs.
Conclusions:
Based on the results, EHR data networks like ENACT that would like to meet the expectations of academic research centers within the CTSA consortium need to consider filling the gaps identified by our study: foster team science, improve workforce capacity, achieve data governance trust and efficiency of operation, and aid Learning Health Systems with validating, applying, and scaling the evidence to support quality improvement and high-value care. These findings align with the NIH NCATS Strategic Plan for Data Science.
Current recommendations do not separate adult and pediatric palliative care (PC) in terms of the personnel needed, or the distribution of care between community and hospital-based services. We evaluated the differences in the utilization of pediatric and adult hospital PC services for non-oncological patients.
Methods
Retrospective study. Parameters included demographics, underlying diagnoses, number of consultations per patient, duration of PC involvement, and follow-up. All non-oncology patients seen by the adult or pediatric PC teams between June 2021 and July 2023 at a single tertiary hospital.
Results
A total of 445 adults and 48 children were seen by the adult and pediatric palliative teams, respectively. Adults were primarily seen in the terminal stages of common chronic diseases, with a high mortality rate. Children were mainly seen at a very young age with rare and complicated diseases. Children needed longer duration of follow-up (114 vs. 5 days, p < 0.001), more consultations (8.5 vs. 4, p < 0.001), and died less while hospitalized (25% of patients vs. 61.6%, p < 0.001).
Significance of results
Adult patients had relatively common diseases, seen and treated often by primary care practitioners, whereas children had rare life-limiting diseases, which primary care pediatricians may have limited experience with, and which require involvement of multiple specialized hospital-based services. Future healthcare PC planning should consider these factors in planning the primary setting for PC teams, specifically more training of adult general practitioners in PC skills, and earlier referral of pediatric patients to hospital-based PC.
To address the issues of low positioning accuracy and weak robustness of prior visual simultaneous localization and mapping (VSLAM) systems in dynamic environments, a semantic VSLAM (Sem-VSLAM) approach based on deep learning is proposed in this article. The proposed Sem-VSLAM algorithm adds semantic segmentation threads in parallel based on the open-source ORB-SLAM2’s visual odometry. First, while extracting the ORB features from an RGB-D image, the frame image is semantically segmented, and the segmented results are detected and repaired. Then, the feature points of dynamic objects are eliminated by using semantic information and motion consistency detection, and the poses are estimated by using the remaining feature points after the dynamic feature elimination. Finally, a 3D point cloud map is constructed by using tracking information and semantic information. The experiment uses Technical University of Munich public data to show the usefulness of the Sem-VSLAM algorithm. The experimental results show that the Sem-VSLAM algorithm can reduce the absolute trajectory error and relative attitude error of attitude estimation by about 95% compared to the ORB-SLAM2 algorithm and by about 14% compared to the VO-YOLOv5s in a highly dynamic environment and the average time consumption of tracking each frame image reaches 61 ms. It is verified that the Sem-VSLAM algorithm effectively improves the robustness and positioning accuracy in high dynamic environment and owning a satisfying real-time performance. Therefore, the Sem-VSLAM has a better mapping effect in a highly dynamic environment.
Late talkers (LTs) exhibit delayed vocabulary development, which might stem from a lack of a typical word learning strategy to generalise object labels by shape, called the ‘shape bias’. We investigated whether LTs can acquire a shape bias and whether this accelerates vocabulary learning. Fourteen LTs were randomly allocated to either a shape training group (Mage = 2.76 years, 6 males), which was taught that objects similar in shape have the same name, or a control group (Mage = 2.61 years, 4 males), which was taught real words without any focus on object shape. After seven training sessions, children in the shape training group generalised trained labels by shape (d = 1.28), but not unfamiliar labels. Children in the control group extended all labels randomly. Training did not affect expressive vocabulary.
Scholars and policymakers warn that with rising affective polarization, politicians will find support from the public and permission from military professionals to use military force to selectively crack down on political opponents. We test these claims by conducting parallel survey experiments among the US public and mid-career military officers. We ask about two hypothetical scenarios of domestic partisan unrest, randomly assigning the partisan identity of protesters. Surprisingly, we find widespread public support for deploying the military and no significant partisanship effects. Meanwhile, military officers were very resistant to deploying the military, with nearly 75 percent opposed in any scenario. In short, there is little evidence that public polarization threatens to escalate domestic disputes, and strong evidence for military opposition.
This study extends the line of linguistic relativity research by assessing the effect of the French grammatical gender system on French speakers' and learners' perception of objects. Four groups of 140 adults (English monolinguals, French monolinguals, English–French bilinguals and French–English bilinguals; N = 35 each) rated 32 selected objects' gender by assigning them a masculine/feminine voice on a slider. We also assessed the participants' second-language (L2) proficiency. Multilevel modelling results revealed that French monolinguals and English–French bilinguals rated objects' gender in line with the French grammatical gender system. The effect of French on perception was not reduced by acquiring English, as French–English bilinguals performed on par with French monolinguals. Moreover, the effect was independent of L2 proficiency. These findings suggest that learning a gendered L2 affects the perception of objects – thus supporting the linguistic relativity hypothesis.
The tombstone of an Italian woman, Caterina Vilioni, in Yangzhou (1342) is a rare and important testimony to Christianity in Yuan China. By exploring the visual language and the multicultural geopolitical context of Caterina's funerary monument, this article sheds light on the dynamic processes behind how cultural and religious barriers were negotiated in the premodern Eurasian world. Despite the increasing scholarly interest in the European import of Asian luxury merchandise along the Silk Roads, movement of objects, persons, and ideas the other way around from Europe to Asia is much less explored. Moreover, the expansion of European networks towards the east was written from the perspective of men: friars, diplomats and merchants. Yet, the Yangzhou tombstone directs attention to the overlooked presence of non-elite Christian women in the cosmopolitan port cities of south-east China well before the era of modern global maritime exchange. While previous scholars traced the tombstone to Buddhist and Christian art, I argue that the visual language intentionally projected cultural ambiguity. By comparing it to the Mongol paiza (safe conduct pass), this article proposes that Caterina's burial marker functioned as an ‘otherworldly passport’, which invoked spiritual protection and facilitated the passage between two realms.