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This article investigates why moments of semiotic silence, or minimal engagement, occur in Facebook practices among Filipino migrant workers engaged in grassroots organizations working for migrants’ rights. We investigate how members and leaders of these organizations subjectively and intersubjectively assess moments of semiotic silence through their discourses. Taking a sociolinguistically grounded chronotopic approach, we show how they make sense of these moments by invoking a multiplicity of space-times related to sociopolitical constraints, their working situation, communication with family, and the organizing of migrants. This study provides empirical data, highlighting the importance of identity, materiality, and media ideology in understanding grassroots social media practices and political engagement. On this basis, we come to understand a broader range of ways in which migrant workers use or do not use social media in relation to community involvement and public discourse. (Social media engagement, grassroots organizing, chronotope, identity construction, media ideology, materiality, migrants’ rights)
Exercise interventions through cardiac fitness programmes improve aerobic capacity and quality of life in paediatric patients with heart disease. The aim of this study was to characterise the landscape of paediatric cardiac fitness programmes via the Global Coalition for Fitness and Congenital Heart Disease (GloCo), an international network of experts providing exercise-based interventions for children and young adults with congenital and acquired heart disease. A survey was developed and distributed electronically to GloCo members and was completed by 40/53 individuals (response rate 75%), including 23 centres in 6 countries, predominantly US based. Programmes were similar with regard to duration, session frequency, and eligible patient populations but varied with regard to mode of delivery, equipment, incentives, funding sources, and cost. At the time of completion, 14 (61%) centres had enrolled at least 1 patient, and 4 (17%) centres were developing programmes. Respondents felt that cardiac fitness programmes are effective at improving quality of life/wellness (87%), cardiovascular fitness parameters (67%), and neuromuscular strength (47%) and that the most important outcomes were quality of life/wellness, exercise testing parameters, and strength/flexibility assessments. Paediatric cardiac fitness programmes focusing on exercise interventions represent a growing international field with diverse applications. Significant variability in their structure and implementation creates barriers to developing consensus guidelines and achieving standardised care. This study underscores this variability and the need for increased collaboration across centres. Multicentre research is essential to determining the optimal design of these programmes, which in turn will allow for the development of comprehensive, evidence-based guidelines.
Sabotage is ubiquitous but little understood in international relations. Sabotage, especially in terms of attacks on infrastructure and property, has increased in recent years and has taken a more central role in national security discourse across Europe. Unfortunately, scholarship is underdeveloped and fragmented across disciplinary silos, leading to conceptual confusion about the nature and scope of sabotage as a form of statecraft. This article seeks to provide conceptual clarity, and in doing so, lay the foundations to better understand and respond to such activity. It does so first by synthesizing ideas from disjointed literatures on conflict, intelligence, terrorism, public administration, and cybersecurity, before distilling key characteristics of sabotage and offering a novel definition. The article finds that sabotage is the weaponization of friction to degrade the performance of systems from within. Sabotage has a strategic logic distinct from related concepts of covert action and subversion: corrosively turning friction into advantage. This logic limits its impact as stand-alone tool but makes it particularly well-placed to enhance and enable other policy instruments. By placing sabotage on the research agenda and theoretically advancing scholarship on ‘secret statecraft’ more widely, this article has significant implications for understanding and responding to contemporary security challenges.
Located on the eastern coast of Lesbos island in the north-east Aegean, Thermi emerges as one of the most emblematic sites in the Early Bronze Age. Since its excavation by Winifred Lamb in the early 1930s, it has been recognised as an early urban settlement, similarly to its equivalent insular sites on Lemnos, Chios and Samos. Although often linked to Anatolian influences due to similarities in pottery assemblages and material culture, especially in terms of morphology, Thermi’s ceramics have largely been confined to significant typological classifications without further analytical investigation. This paper presents the results of a comprehensive study encompassing morpho-stylistic, macroscopic and petrographic analysis of this ceramic assemblage across all settlement phases during the third millennium BC. Through petrographic analysis of pottery and raw material samples, this study has determined the provenance and allowed the characterisation of local and intra-island pottery production and consumption strategies. Additionally, it has identified evidence of Thermi’s extra-insular connectivity with various sources across the Aegean region. While certain ceramic manufacturing choices exhibit diachronic continuities, there is evidence of chronological patterning in the appearance of clay recipes. These changes correlate well with contemporaneous shifts in architectural developments, patterns of consumption of valued goods and the broader outreach of the settlement.
The reimbursement of, and subsequent patient access to, high-risk medical devices (MD) and in vitro diagnostics (IVD) across Europe often vary. The Health Technology Assessment Regulation (HTAR) aims to standardize clinical evaluations through Joint Clinical Assessments. Still, national differences in reimbursement frameworks and evidence integration for MD/IVD may impede the realization of HTAR’s expected benefits. This review aims to map existing reimbursement frameworks for high-risk MD/IVD, identify key oversight structures, and evaluate the use of comparative effectiveness and safety evidence in reimbursement decisions across the EU/EEA/UK.
Methods
A scoping review was conducted according to the registered protocol (osf.io/65bdk) and was reported following the PRISMA-ScR guidelines. Results were validated through direct engagement with national organizations.
Results
Reimbursement frameworks across the EU/EEA/UK for MD/IVD vary significantly. Of the thirty-four countries reviewed, twenty-three incorporate HTA for MD/IVD reimbursement decisions; of these, only eleven countries have a formal HTA process as part of reimbursement pathways. Eight countries have structured mechanisms to address safety and effectiveness evidence uncertainty. Furthermore, twelve countries have primarily centralized processes, while six rely on regional or local decision-making.
Conclusions
This review highlights the variations in how countries integrate HTA into reimbursement frameworks for MD/IVD, how the national decisions are implemented, and how the evidence uncertainty is assessed. Some countries have a well-established reimbursement framework with formal HTA components, whereas others rely on ad hoc HTA processes. Understanding these differences can help optimize the use of HTAR-generated evidence. Further research is needed to capture ongoing reforms in response to the HTAR.
We examined how BMI, BMI trajectories, and BMI fluctuation around these trajectories in adolescence were correlated with BMI trajectories and BMI fluctuation in early adulthood, as well as the genetic basis of these associations. BMI data from Finnish twins (N = 1379, 48% males) were collected at ages 11.5, 14, 17.5, 24, and 37 years. BMI trajectories in adolescence (11.5–17.5 years) and early adulthood (17.5–37 years) were estimated using linear mixed-effect models. BMI fluctuation was calculated as the average squared differences between observed and expected BMI around these trajectories. Genetic twin models and a polygenic risk score for BMI (PRSBMI) were used to assess genetic contributions to BMI fluctuation and its associations with BMI and BMI trajectories. Adolescent BMI fluctuation was positively correlated with early adulthood BMI trajectories in females, while in males, adolescent BMI trajectories were positively associated with BMI fluctuation in early adulthood. Genetic factors affected BMI fluctuation in both adolescence and early adulthood when estimated using twin modelling and PRSBMI. Adolescent BMI was positively associated with early adulthood fluctuation in both sexes, with genetic factors playing a role (genetic correlations .08–.29). It was concluded that genetic factors play a significant role in BMI fluctuations in adolescence and early adulthood, with some overlap with the genetics of BMI.
Timely selection of appropriate empirical treatment for carbapenem-resistant Enterobacterales (CRE) bacteremia remains challenging, especially when prior antibiotic exposure data is unavailable. We found that intensive care unit stay duration predicts CRE bacteremia—with ≥8 days showing 81% sensitivity and 96% PPV—providing a practical clue for empirical therapy decisions.
Systematized information on the background of policymakers across long time-periods and all geographical regions of the world remains limited. In this article, we introduce Paths to Power (PtP), a new dataset on the educational, occupational, and social background of cabinet members. PtP contains detailed individual-level data – whenever identifiable – on 44,789 cabinet members across 141 countries in the period 1966-2021. This comprehensive dataset will be of relevance to numerous scholars (and others) interested in understanding politics and recent political history, and it enables a wide variety of new, empirically founded insights. We first present how the data is created and then discuss data quality and limitations. Next, we show how PtP is useful for researchers in diverse fields, including comparative politics, political sociology, gender studies, public administration, and international relations.
Henry Sidgwick and G. E. Moore’s claims about the irreducibility of ethical concepts to non-ethical ideas began analytical metaethics and the search for fundamental ethical concepts. Moore famously held that the basic ethical notion was that of intrinsic goodness. Subsequent research has revealed, however, that William Frankena was right when he pointed out that what drove Moore’s ‘open question argument’ was the idea of normativity and that this vindicated Sidgwick’s claim that ought rather than good is the fundamental ethical notion. This essay discusses the history of this and related debates between reasons, ought, and fittingness fundamentalists and how these figure in accounting for the difference between deontic moral concepts of right and wrong, on the one hand, and various ethical notions of goodness, on the other.
We characterize a general traveling periodic wave of the defocusing mKdV (modified Korteweg–de Vries) equation by using a quotient of products of Jacobi’s elliptic theta functions. Compared to the standing periodic wave of the defocusing NLS (nonlinear Schrödinger) equation, these solutions are special cases of Riemann’s theta function of genus two. Based on our characterization, we derive a new two-parameter solution form which defines a general three-parameter solution form with the scaling transformation. Eigenfunctions of the Lax system for the general traveling periodic wave are also characterized as quotients of products of Jacobi’s theta functions. As the main outcome of our analytical computations, we derive a new solution of the defocusing mKdV equation which describes the kink breather propagating on a general traveling wave background.
Drawing on recent scholarship on international criminalisation, this article demonstrates how this concept is not only critical for explaining why certain global atrocities were recognised as international crimes but also why others failed to be criminalised in world politics. To do so, it focuses on piracy, an act that has been conventionally depicted as the first international crime to have been established within the international legal order but was subsequently excluded from the existing list of current international crimes. Guided by a conceptualisation of international criminalisation as a process that embraces, firstly, the emergence of an international criminal norm and, secondly, the translation of such a norm into an international legal proscription, the article analyses four historical periods across the twentieth century during which piracy was the subject of international debate amongst legal diplomats. Through a close analysis of primary documents from this period, it shows how piracy failed to be recognised as an international crime principally because an international criminal norm against piracy failed to emerge in world politics across this period.
This study aimed to compare appropriateness of restricted antimicrobial prescriptions, as assessed by antimicrobial stewardship program (ASP) prospective audit and feedback (PAF), between those ordered by medical trainees versus staff. Secondary objectives were to determine whether certain timing factors and other independent variables impacted prescription appropriateness.
Design:
Single center, retrospective cohort study.
Setting:
The University of Alberta Hospital a 700-bed tertiary care hospital in Edmonton, Canada.
Participants:
Prescriptions of six health-authority restricted antibiotics subject to ASP PAF between 2018 and 2023. Cases were excluded if prescriber role or prescription dates or times were unavailable.
Methods:
Data from a local ASP quality improvement database was extracted. Multiple logistic regression analysis was completed with adjusted odds ratios (aOR) reported.
Results:
A total of 3,687 restricted antibiotic prescriptions subjected to PAF were included in this study, of which 1,163 (31.5%) were assessed as not appropriately prescribed. Prescriptions written by medical trainees did not have higher odds of appropriateness compared to staff (aOR 1.09 [95% CI 0.94–1.28], P = .25). Weekend prescriptions had a reduced odds of being appropriate (aOR 0.71 [0.60–0.84], P < .0001). Through the course of the Coronavirus Disease 2019 (COVID-19) pandemic, appropriateness improved from 56.2% (prepandemic), 71.5% (peri-pandemic) to 76.9% (postpandemic).
Conclusions:
No differences were noted in restricted antibiotic prescription appropriateness between medical trainees and staff. Weekend prescriptions were less likely to be appropriate. Improved appropriateness over time may be multifactorial, including implementation of ASP preceding the pandemic. Further studies examining timing factors associated with appropriateness are needed.
In this paper I offer a defence of absence causation in response to a central challenge: the problem of profligacy. Focussing on two related cases of absence causation, holes and surface absences, the account of absence causation offered for these cases has the following attractions: it captures the central features of many of our common-sense judgments about absence causation in these cases; it doesn’t appeal to norms; and is grounded in salient features of the metaphysics of the cases. As such, there’s a metaphysically respectable, principled criterion for absence causation that solves the problem of profligacy for these cases.
The analysis of the radiocarbon age of dissolved organic carbon (DOC) is fundamental for understanding the aquatic component of the global carbon cycle, yet the technique is not routinely available at radiocarbon laboratories. This study presents validation experiments for an improved wet oxidation method for 14C-DOC analysis in a freshwater matrix. Emphasis in design protocol for the method was placed on the quantitative removal of inorganic carbon, and a background level consistent with modern accelerator mass spectrometry (AMS) radiocarbon measurements. The method utilizes a pre-oxidized potassium persulfate oxidant in crimp-sealed vials with rigorous multi-stage helium purging to achieve and maintain a sample without atmosphere carbon dioxide and the contamination of modern 14C (14C-free). Method validation of 14C-free samples are demonstrated with procedural blanks, phthalic anhydride (PhA), and an International Atomic Energy Agency Oxalic Acid standard (IAEA-C8).
Design Neurocognition, a field bridging Design Research and Cognitive Neuroscience, offers new insights into the cognitive processes underlying creative ideation. This study adopts a micro-perspective on design ideation by examining convergent and divergent thinking as its core components. Using 32-channel EEG recordings, it investigates how educational background (Industrial Design Engineering vs. Engineering Design) influences designers’neural activity (alpha, beta, and gamma frequency bands), behavioral responses, and perceived stress during ideation tasks. Data from forty participants reveal a consistent and meaningful interaction between brain activity, behavior, and self-reported stress, highlighting that educational background significantly modulates cognitive and neural patterns during ideation. Importantly, perceived stress shows strong negative correlations with neural power across all frequency bands, suggesting a close alignment between subjective experience and physiological measures. By integrating neural, behavioral, and psychological data, this study advances the understanding of the neurocognitive mechanisms driving design ideation and establishes a methodological foundation for bridging Design and Cognitive Neuroscience. These findings contribute to building a unified evidence base for future human-centred and neuro-informed design research.
Atop El Castillo, the largest pyramid within the Maya site of Chichen Itza, in Mexico’s Yucatan Peninsula, stand two ruined columns that once portrayed the feathered serpent deity K’uk’ulkan. 3D-imaging technologies have identified scattered sculptural fragments belonging to these columns, allowing a digital reconstruction that opens new possibilities for their conservation.