bluuebunny/crossref_metadata_2025 huggingface dataset:
Religion and National Identity in Central and Eastern European Countries: Persisting and Evolving Links
Authors: Guglielmi Simona , Piacentini Arianna
Published: October 2023

The article contributes a better understanding of the mechanisms underpinning the intertwining of national and religious identity at the individual level in (some) former Communist and socialist European countries. It starts by retracing from a historical perspective the place religion occupied under the regimes, then paying attention to how, once politicized and ethnicized by the hand of a new class of ethnopolitical entrepreneurs, religion became “the hallmark of nationhood.” This excursus allows us to better contextualize both the theoretical argument and findings. The intertwining of national and religious identity is investigated from two main theoretical sources. The first is the debate within sociology and political science on different ideas of nationhood, while the second consists of socio-psychological models of intergroup relations. The empirical investigation is based on survey data from the European values study (EVS, 2017). A comparative approach is used that includes four countries having Catholic large majorities (Poland, Slovenia, Croatia, and Hungary) and, as a benchmark, Romania, having an Orthodox majority. To test the hypotheses, a structural equation model is specified. The causal model seeks to unravel to what extent different conceptions of nationhood (ethno-religious vs. civil), together with national attachment, influence the intergenerational transmission of religious values and distrust of people of another religion/nationality. The research results are in line with the current European trends pointing in the direction of a stronger overlap between the religious and the national in tailoring collective identities.
Perception of favoritism in Brazilian small private colleges
Authors: Martins Rosiane Dutra , Pauli Jandir , Guadagnin Alana
Published: October 2023

This study aims to analyze the perception of professors about the practices of favoritism in Brazilian small private colleges. For this, qualitative exploratory research was carried out, in which 20 professors were interviewed. For data collection, a semistructured interview script was used and for data analysis, it was carried out through the technique of content analysis. Evidence of cronyism and nepotism were found in hiring processes, in the distribution of hours and disciplines, in the appointment of positions, in dismissal processes, in the distribution of resources, in access to information, and in the protection of some professors who have a closer relationship of friendship with the pedagogical coordinator. On the other hand, professors recognize that greater proximity between professors and managers is associated with a greater commitment to goals, providing evidence of legitimization of the practice of favoritism. This study allowed us to identify some situations in which favoritism occurs even if implicitly within private higher education institutions. The findings help managers to develop tools to increase transparency, equity of processes, and support to achieve organizational goals.
A theoretical and experimental study of surface micro/nanostructure formation in ultraprecision diamond milling
Authors: Chen Ruihua , Guo Pan , Liu Tongke , Zhang Li , Xiong Zhiwen , Zhang Shaojian
Published: October 2023

Ultraprecision diamond milling (UPDM) is a very promising machining method, producing high-quality surface structures with nanometric surface roughness Sa and sub-micrometric form accuracy PV. Due to its high flexibility, it has been widely employed to fabricate complex freeform/structured surfaces. However, there exists little comprehensive understanding of its surface structure formation. Therefore, this study focuses on discussing surface structure formation in the UPDM process. Firstly, a geometric model was proposed for the relationship among the diamond tool with eccentricity, machining motion with tool tilt, and surface formation in the UPDM process. Secondly, the simulation for surface structure formation of UPDM was carried out for the proposed geometric model, considering different tool tilt angles. Finally, a series of UPDM experiments were conducted at the different tool tilt angles. By comparing with the simulation results, it was found that the simulation results were in good consistence with the experimental results. The simulation and experimental results indicated that in the UPDM process the diamond tool eccentricity would prominently induce the droplet-like microstructures on the machined surface, and the tilt angle would dramatically produce the hexagon-like nanostructures. Further, with the increase of the tool tilt angle, the micro/nanostructures’ PV first increased, then decreased, and finally remained stable. Interestingly, UPDM could be directly modulated for the fabrication of micro/nanostructures. Significantly, the study gives a deep insight into surface micro/nanostructure formation of UPDM.
Analytical modelling of a multifunctional heterogeneous beam-bending analysis
Authors: Geetha Narayanan Kannaiyan , Bridjesh Pappula , Yelamasetti Balram , Saxena Kuldeep K , Gupta Nakul
Published: October 2023

Pores have a crucial role in shaping the features of functionally graded materials. If the distribution of pores is permitted to gradually rise from the outside inwards towards the center, many more features can be incorporated. A shear shape function is used to analyze the bending response of a two-directional functionally graded porous beam (FGPB), which can be considered a multifunctional heterogeneous material while accounting for both even as well as uneven porosity distributions. The power law is adapted to modify the material properties of FGPB through out the length and thickness dimensions. The notion of virtual displacements is applied when establishing equilibrium equations in FGPB. The Navier method is applied to clamped-clamped, clamped-free boundary conditions and simply supported boundary conditions to offer solutions to FGPB. The proposed methodology is supported by the numerical results of functionally graded beams from earlier studies. The dimensionless deflections and stresses under study are affected by gradient exponents, porosities, and aspect ratios.
Numerical investigation of aero-optical effects around the turret based on delayed detached eddy simulation and unsteady Reynolds averaged Navier-Stokes
Authors: Tan Xiao-Tong , Xu He-Yong
Published: October 2023

Delayed Detached Eddy Simulation (DDES) and Unsteady Reynolds Averaged Navier-Stokes (URANS), based on the two-equation Shear Stress Transport (SST) model, are implemented to investigate the flow features and the aero-optical distortions around the turret. The Mach number is Ma = 0.4 and the Reynolds number is Re = 1.43 × 106. Instantaneous and time-averaged flow fields are presented to compare the ability of DDES and URANS in predicting the flow features. The instantaneous results show that DDES can resolve the abundant flow structures and more disordered density distributions than URANS. The time-averaged pressure coefficient and the density distribution of both methods are generally similar, but the time-averaged turbulent kinetic energy of URANS is far higher than that of DDES. The time-averaged pressure coefficient of DDES is closer to experimental data. In the windward view, typical surface flow features of DDES and URANS are similar. In the leeward view, there are remarkable differences of typical flow features between DDES and URANS. At the six angles of elevation, 60°, 76°, 90°, 103°, 120°, and 132°, the spatial-temporal wavefront distortions are calculated and discussed with the geometric ray-tracing method and the Zernike polynomial fitting, respectively. In spatial distribution, the wavefront distortions of DDES and URANS are slightly different from the experimental data. At the angles of 60°, 76°, 90°, and 103°, the tendencies of wavefront distortion of DDES at different tracing distances are the same with that of URANS, which is due to the same ability of two methods to resolve the density distributions in the attached flow region. However, the results of DDES agree well with the experimental results at the angles of 120° and 132°, which is bigger than the results of URANS. For temporal characteristics, the frequencies of wavefront distortions of DDES are obviously higher than that of URANS. The amplitudes of wavefront distortions by DDES are about 3 to 5 times higher than that by URANS. At the cases of two different FLHs at Ma = 0.4, the flow structures are totally similar, and the tendencies of wavefront distortion with θ are also similar. At the cases of three Mach number, the compression has a big influence on the wavefront distortion.
Assessing information literacy training of postgraduate students from input-process-output perspectives: A case of the University of Dodoma
Authors: Msoffe Grace E. P. , Mongi Hector J. , Buhomoli Obadia S.
Published: October 2023

The advancement of Information and Communication Technology (ICT) has changed the way information resources are accessed, evaluated, and used. The changes have necessitated new capabilities to utilise information resources effectively. Information Literacy (IL) programmes facilitate the acquisition of the necessary skills for accessing, evaluating, and using information resources in the digital era. Most of the studies on IL in Tanzania have focused on traditional practices with little or no consideration of contributing factors to the IL training outcomes in the digital era. This study assessed the IL training of postgraduate students at the University of Dodoma (UDOM) from an input-process-output perspective to ascertain the factors contributing to IL training outcomes. The study employed quantitative and qualitative approaches within input-process-output perspectives. Primary data (Qualitative) were collected using key informants’ interviews with postgraduate IL training organisers and facilitators working at UDOM. Secondary data (Quantitative) were collected from IL training reports from 2018 to 2022. The study findings show that most of the aspects of IL training from an input-process-output perspective were considered. The participants viewed the training input and processes as effective enough to transform their IL practices. However, the findings indicated that there were aspects that needed improvement. These included the training schedule and time allocation. The study recommends continuous review of the IL training programmes to ensure the necessary components of IL are considered for successful training outcomes. It is essential to consider the stakeholders’ needs in planning, organising, and conducting the IL training programmes for effective learning.
Profitability–Stability Nexus in Commercial Banks: Evidence from BRICS
Authors: Sain Anjali , Kashiramka Smita
Published: October 2023

The financial stability of the banking sector is a prerequisite for a thriving and stable economy. Against this backdrop, this article investigates the relationship between bank profitability and the financial stability of the banks by explicitly capturing the role of bank size, institutional quality and market concentration. A sample of 776 banks operating in Brazil, Russia, India, China and South Africa over the period 2005–2020 are examined using panel regression and System GMM. Our findings support this axiom, and we conclude that bank profitability plays a critical role in determining the stability of the financial system. Our results are consistent across alternate measures of stability (VaR and ∇CoVaR), albeit insignificant. Furthermore, the results support the existence of the concentration–stability hypothesis in the banking industry of BRICS nations. The findings also indicate that non-interest income and NPA have a negative impact on stability, whereas institutional quality plays a significant role in maintaining the stability of the banking industry in these emerging economies. This article tries to provide empirical research investigating the association of the financial stability of banks with profitability, non-interest income ratio, market concentration and institutional quality.
Empowering Health care Systems and Communities for Snakebite Envenoming Control in India
Authors: Munshi Hrishikesh , Gajbhiye Rahul K.
Published: October 2023

Snakebite envenoming (SBE) is a global health challenge, predominantly affecting economically disadvantaged regions. India contributes significantly to global snakebite mortality. Since 2013, the Indian Council of Medical Research (ICMR) has spearheaded efforts to combat SBE. A multi-sectoral engagement in the snakebite research projects and inputs from communities, traditional healers, and the health system have led to the creation of an Information Education and Communication (IEC) material suite, including management flowchart, information booklets, posters, and brochures, all available in local languages. These resources were broadly disseminated in high-burden regions in Maharashtra and Odisha, resulting in an approximately 10% increase in case reporting within a year. This holistic approach, engaging diverse stakeholders and addressing multiple facets of SBE, offers promise for alleviating the snakebite burden, not only in India but also in other low- and middle-income countries across South Asia, Africa, and South America, holding potential for broader positive global impact.
Patient Admission and Mechanical Ventilator Allocation Decision-Making Processes by Frontline Medical Professionals in a Japanese ICU During the COVID-19 Pandemic: A Qualitative Study
Authors: Ishizaki Sakura , Jindai Kazuaki , Saito Hiroki , Oshitani Hitoshi , Kulstad Gonzalez Tess
Published: October 2023

During the COVID-19 pandemic, the need to triage COVID-19 patients in ICUs emerged globally. Triage guidelines were established in many countries; however, the actual triage decision-making processes and decisions themselves made by frontline medical providers may not have exactly reflected those guidelines. Despite the need to understand decisions and processes in practice regarding patient ICU admission and mechanical ventilator usage to identify areas of improvement for medical care provision, such research is limited. This qualitative study was conducted to identify the decision-making processes regarding COVID-19 patient ICU admissions and mechanical ventilator allocation by frontline medical providers and issues associated with those processes in an ICU during the COVID-19 pandemic. Semi-structured, in-depth interviews were conducted with ICU physicians and nurses working at an urban tertiary referral hospital in Japan between February and April 2022. Patient characteristics that influenced triage decisions made by physicians and the interaction between physicians, nurses, and senior management staff upon making such decisions are discussed in this article. An implicated issue was the lack of legal support for Japanese physicians to practice withdrawal of life-sustaining treatments even during emergencies. Another issue was the impact of non-clinical forces—likely specific to health emergencies—on physicians’ decisions regarding mechanical ventilator allocation, where such forces imposed a significant mental burden on the medical providers. We consider public policy and legal implications for future pandemics.
The Ethics of Conscientious Objection to Teaching Physician-Assisted Death
Authors: Berens Noah , Mahon Margaret M. , Roth Katalin , Berger Ann , Wendler David
Published: October 2023

The literature on the ethics of conscientious objection focuses on objections to participating in morally contested practices. This literature emphasizes the potential for participation to undermine objecting clinicians’ moral integrity. Significantly less attention has been given to conscientious objection to teaching morally contested practices. Thus, it is unclear whether teaching morally contested practices has the potential to undermine objecting educators’ moral integrity, and to the extent that it does, what steps can be taken to address this concern. We accordingly examine the ethics of conscientious objection to teaching morally contested practices, with a focus on teaching physician-assisted death (PAD) to trainees in US palliative care programs. We focus on three primary components of teaching PAD: (1) teaching the history and context of PAD; (2) teaching trainees how to understand and respond to requests for PAD; and (3) teaching trainees how to provide PAD. We argue that teaching components one and two has little potential to undermine objecting educators’ moral integrity. Moreover, permitting objecting educators to opt out of teaching components one and two might undermine the education of trainees. In contrast, allowing objecting educators to opt out of teaching how to provide PAD may be important to preserving their moral integrity, and is unlikely to undermine trainees’ education. We argue that educators should be permitted to opt out of teaching trainees how to provide PAD and describe policies that training programs can adopt to implement this approach.
Association Between Interleukin 6 and C-Reactive Protein Serum Levels and Body Composition Compartments and Components in Breast Cancer Survivors
Authors: Navarro-Ibarra María Jossé , Saucedo-Tamayo María del Socorro , Alemán-Mateo Heliodoro , Parra-Sánchez Héctor , Othón-Ontiveros Paola , Hernández Jesús , Caire-Juvera Graciela
Published: October 2023

Obesity is highly prevalent in breast cancer (BC) survivors. Adipose tissue promotes inflammation, affecting recurrence, morbidity, and quality of life. This study aimed to determine the relationship of body composition parameters with the levels of C-reactive protein (CRP) and interleukin 6 (IL-6) in female BC survivors. Additionally, we evaluated the association of log-transformed serum concentrations of CRP and IL-6 with the appendicular skeletal lean mass index (ASMI). The results showed that CRP was positively associated with body fat percentage (BFP; β adjusted = .08, 95% CI: .02–.14) in all participants, and with fat mass index (FMI; β = .24, 95% CI: .08–.40) only in premenopausal women. IL-6 was positively associated with FMI (β adjusted = .16, 95% CI: .03–.29), while ASMI decreased as CRP levels increased (β adjusted = −.30, 95% CI: −.53 to −.06). Interventions to improve body composition in BC survivors should also consider the role of inflammatory markers in changes in body composition to avoid sarcopenic obesity (SO) and the risk of BC recurrence.
The Co-Occurrence of Conduct Problems and Depressive Symptoms From Childhood to Adulthood for Men: Stability Over Time and Prediction to Substance Use
Authors: Capaldi Deborah M , Tiberio Stacey S , Kerr David CR , Owen Lee D
Published: October 2023

The dual pathway hypothesis of risk for substance use was tested by examining risk from symptoms of conduct problems and depressive symptoms in adolescence (from ages 10-11 to 17-18 years) to substance use—including tobacco, alcohol, cannabis, and other illicit drugs—in both early adulthood (approximately from ages 20 to 29 years) and middle adulthood (approximately from ages 29 to 38 years). Hypotheses were tested on a sample of boys who were at risk for conduct problems by virtue of the neighborhoods where they lived in childhood (the Oregon Youth Study; N = 206 at Wave 1). Dual-trajectory modeling (Latent Class Analysis) resulted in a 3-group solution of high, moderate, and low co-occurring symptoms. The latent class of boys with co-occurring symptoms in adolescence showed higher levels of substance use in adulthood; namely, higher levels of cannabis and illicit substance use during early adulthood compared to either of the moderate or low symptom classes, and higher use of cannabis in midadulthood than the low symptom class. Those with co-occurring symptoms also showed, overall, higher vulnerability to use of tobacco in these 2 periods, but not to higher use of alcohol. Regression analyses indicated that the higher substance use of the co-occur group of men was related to their adolescent conduct problems, but was not related to their adolescent depressive symptoms; however, these associations were nonsignificant when adolescent use of the respective substances were included in the models. Thus, the dual-trajectory hypothesis was not supported. However, the findings indicated that, as assessed in the present study, the psychopathology symptoms of boys with conduct problems in adolescence who show risk for later substance use may be complex, involving depressive symptoms.
Whatever happened to the girl in #MeToo?
Authors: Werner Ann
Published: October 2023

Through #MeToo social media feminist digital grassroot activism, in tweets, threads, and groups, in petitions and in the intermedial debates following the hashtag, a girl took shape. This girl was constructed as vulnerable, ambitious, naïve, or duped and was central for bringing on feminist social change in policy and practice in the 2010’s. The figure faced intra-feminist critical questions about whiteness, heteronormativity, cis femininity, class, ability, and Western-ness. A few years later, this girl has magically disappeared from public debate. This article poses the question; Who was she, and what does her disappearance mean for future feminist activist struggles against sexism, sexual harassment, sexual violence, and rape, other discrimination and bullying in the workplace? The girl is analysed by considering the Swedish #MeToo petition #NärMusikenTystnar (#WhenThe MusicStops), a petition and hashtag that gathered narratives of sexism, sexual harassment, sexual violence, and rape on social media and presented them in the daily press in 2017. The article draws out both strengths and weaknesses of the girl as a figure for feminist digital activism. In the conclusion the case of the missing girl in 2023, and the possible impacts her disappearance may have on feminist digital activism, is discussed.
Reasons for not entering opioid agonist treatment: A survey among high-risk opioid users in Finland
Authors: Prami Tuire , Pölkki Mari , Ruotsalainen Jarno , Nordbeck Elin Banke , Meyner Susanna , Kaski Ari
Published: October 2023

Aims: To characterise and understand the untreated high-risk opioid user population in Finland, and to determine the reasons why these people do not enter treatment. Methods: The study setting was a half-year cross-sectional survey in Finland during 2021–2022. An electronic questionnaire with 24 structured questions was concluded in 16 needle exchange units. Participants were opioid-dependent people without opioid agonist treatment (OAT), and they answered the survey voluntarily and anonymously. Results: Of the 167 respondents, 62% were men, 53% were aged ≤34 years, 66% had used opioids for >6 years, and 78% used drugs intravenously (IV) daily. The most used opioid (95%) was buprenorphine. Most respondents used opioids as self-medication for withdrawal symptoms (75%), or to treat psychological symptoms (59%) or pain (43%). Of them, 70% also used other substances for recreational purposes. The most common named reasons to stay outside OAT were as follows: seeking treatment is too difficult (37%); treatment is too binding (36%); and fear of actions from authorities (23%). Conclusions: For opioid-dependent respondents who would be eligible for OAT in Finland, treatment awareness is limited. These high-risk opioid users also think that the treatment would be too binding. In conclusion, there is a need for increase in general information about, accessibility to, acceptance for and individualisation of OAT.
Police perceptions of defunding and redirecting calls for service: A qualitative analysis
Authors: Dragon Stephanie , Monk-Turner Elizabeth
Published: October 2023

The concept of “defunding the police” calls for municipalities to divert monetary resources away from police departments toward other social services to limit the scope of police response. Although this approach has gained traction, current research fails to gauge how police officers perceive “defunding arguments” and the feasibility of diverting calls to other social service providers. This study utilized 15 semi-structured in-depth interviews to investigate police perceptions of the defund the police movement. Using thematic analysis, we identified three emergent themes across the interviews. These themes included distrust of the police, extended scope of the police, and caution toward redirecting mental health calls away from police departments. This study offers insight into the complexity of diverting mental health calls away from police departments. It also sheds light on the recurring nature of domestic violence responses within their respective communities.
Exploring professionalization in early childhood: Reflections from a veteran Head Start teacher
Authors: Whyte Kristin Lyn , Delaney Katherine K
Published: October 2023

In early childhood education there has long been a focus on “professionalizing the field.” While professionalization initiatives can be well meaning, they can have unintended consequences that exacerbate already existing systemic inequities present in the early childhood workforce, such as restricting opportunities for teachers of color to both progress in their fields and contribute to the knowledge that is often valued in “child-centered” spaces. In this article, the authors explore the consequences of professionalization policies from the perspective of a veteran Head Start teacher, Monae, whose tenure in early childhood started as a child attendee of the Head Start grant that her mother, and several other Black women, implemented in a Midwestern rust-belt city beginning in 1967. Drawing from post-qualitative and narrative methodologies, they foreground Monae's lived experience, as she had a front-row seat to a rising tide of accountability and the ways in which professionalization efforts created structures that limited the participation of many early childhood teachers. The organization that had held the Head Start grant in Monae's community since 1967 failed to meet rising accountability requirements. Monae describes what happened next, when a local district took over the grant. Through these stories, we can learn lessons about how problematic power dynamics and inequitable district policies can weaken the relationships between teachers, families, and Head Start classrooms, as well as between Head Start and the broader community.
AI's empathy gap: The risks of conversational Artificial Intelligence for young children's well-being and key ethical considerations for early childhood education and care
Authors: Kurian Nomisha
Published: October 2023

Rapid technological advancements make it easier than ever for young children to ‘talk to’ artificial intelligence (AI). Conversational AI models spanning education and entertainment include those specifically designed for early childhood education and care, as well as those not designed for young children but easily accessible by them. It is therefore crucial to critically analyse the ethical implications for children's well-being when a conversation with AI is just a click away. This colloquium flags the ‘empathy gap’ that characterises AI systems that are designed to mimic empathy, explaining the risks of erratic or inadequate responses for child well-being. It discusses key social and technical concerns, tracing how conversational AI may be unable to adequately respond to young children's emotional needs and the limits of natural language processing due to AI's operation within predefined contexts determined by training data. While proficient at recognising patterns and data associations, conversational AI can falter when confronted with unconventional speech patterns, imaginative scenarios or the playful, non-literal language that is typical of children's communication. In addition, societal prejudices can infiltrate AI training data or influence the output of conversational AI, potentially undermining young children's rights to safe, non-discriminatory environments. This colloquium therefore underscores the ethical imperative of safeguarding children and responsible child-centred design. It offers a set of practical considerations for policies, practices and critical ethical reflection on conversational AI for the field of early childhood education and care, emphasising the need for transparent communication, continual evaluation and robust guard rails to prioritise children's well-being.
Parables of resilience: Promising pessimism, Octavia Butler's ‘purpose’, and the making of worlds
Authors: Olson Alix
Published: October 2023

Resilience is the trailblazing saviour of contemporary social and political life. Politicians, scientists, self-help experts, public school administrators, military officials, and psychologists increasingly tout resilience-building as the only rational solution to a twenty-first-century world of unprecedented uncertainty. The underlying (pessimistic) promise of resilience is that people, and by extension global systems, can not only survive but flourish through crisis. In order to underscore the material, ideological and political danger that this logic poses, I examine NASA/SpaceX's plans for interplanetary colonisation – a project explicitly intended to promote a resilient human species – as promising pessimism's devastating finale. Despite this dire trajectory, I conclude by considering the cost for left feminist thinkers and activists of reducing the concept of resilience to a neoliberal technology of power. To this end, I contend that Octavia Butler's prophetic diptych Parable of the Sower (1993) and Parable of the Talents (1998) counters the colonising project of promising pessimism and recovers a liberatory account of resilience: one which refuses to exchange utopian surety for acquiescence to power, but which recuperates the present as a practice ground for transformation. Ultimately, this article insists that to engage in political struggle over how to govern ourselves and our world, in a shared context of escalating crises, requires sustained critical investment in the ethical and political implications of valorising certain kinds of resilient life.
Reflecting on nation image and perceptions of nation brand: Scottish-themed pubs, bars and restaurants outside of Scotland
Authors: Clarke Amy
Published: October 2023

Nation-themed retail, hospitality and entertainment spaces are a valuable yet underutilised resource for the analysis of national stereotypes and dominant brand narratives. When such spaces operate outside the borders of the nation upon which they are themed, they can be interpreted as presenting a ‘stage’ national identity: one that is understood as being unreal, and yet simultaneously hyperreal. This article explores the visual signifiers (e.g. décor, displayed products and promotional materials) and consumption opportunities (e.g. food, drink and cultural events) at 110 Scottish-themed pubs, bars and restaurants located outside of Scotland’s borders. In doing so, it highlights how national historical narratives, symbols and motifs are commercialised by and for people outside that nation, often to the extent that outdated views are perpetuated, stereotypes are exacerbated, and the signifiers of other nations are absorbed and/or hybridised. This has potential impacts inside said nation, too: on the tourism industry, food and drink sector, and on the nation’s ability to attract and retain the interest of outside investment and skilled migrants, among other things. This research thus draws attention to the complex role(s) of nation-themed spaces in overseas settings, particularly in mediating and – in some instances, contradicting – the collective and commercial identities and/or official (government-endorsed) brands of the nation being displayed for consumption.
Carriage of multidrug-resistant carbapenemase-producing gram-negative bacteria in patients admitted to NHS Greater Glasgow and Clyde hospitals: Implications for treatment
Authors: Espie Megan , Marek Aleksandra , Farrugia Leonard , MacLeod Mairi , Bal Abhijit M
Published: October 2023

Background:

Infections caused by gram-negative carbapenemase-producing organisms (CPO) have become a global phenomenon. Screening of patients for CPO that was carried out at 48-h intervals enables early detection of carriers for infection control purposes and planning therapy.

Methods:

We investigated the bacterial flora detected on screening, the enzymes that conferred resistance and the proportion of patients who developed bacteraemia with CPO and their therapy.

Results:

In all, 27 patients had a positive screen for CPO. A small but significant (7.5%) proportion of patients were not detected on initial screening. Escherichia coli and Klebsiella were predominant. New-Delhi metallo β-lactamase and oxacillin carbapenemases were the main enzymatic mechanisms of resistance. Four (14.8%) patients developed bacteraemia with CPO (30- and 90-day survival 100% and 75%, respectively).

Conclusion:

A single negative screen does not rule out colonisation. A significant proportion of patients colonised with CPO develop bacteraemia. Vigilance is needed to prevent the nosocomial spread of CPO.
The Measurement Approaches to Partnership Success (MAPS) Questionnaire and Facilitation Guide: A Validated Measure of CBPR Partnership Success
Authors: Brush Barbara L. , Israel Barbara , Coombe Chris M. , Lee Shoou-Yih D. , Jensen Megan , Wilson-Powers Eliza , Gabrysiak Adena , Chandanabhumma P. Paul , Baker Elizabeth , Jones Marita , Lachance Laurie
Published: October 2023

Partnerships that effectively engage in certain key structural and process functions are more likely to meet their research goals and contribute to longer-term health equity outcomes. Ongoing evaluation of partnerships’ level of achievement of these key functions, along with their fidelity to the guiding principles of community-based participatory research (CBPR), is therefore essential to understand how they can achieve desired partnership outcomes. This article describes the validated Measurement Approaches to Partnership Success (MAPS) Questionnaire and the use of an accompanying Facilitation Guide in helping members of CBPR partnerships evaluate their partnership’s state of development and interpret findings to improve its structure, processes, and outcomes. We describe the conceptual framework guiding the development of the MAPS Questionnaire and its 81-item across seven key outcome dimensions, along with 28 items measuring precursor characteristics of CBPR partnership outcomes. The Facilitation Guide provides general guidelines for sharing, interpreting, and applying results within partnerships using a participatory process, definitions and items for each dimension, an example of presenting summary means, and dimension-specific reflective questions for discussion. We offer recommendations for practical uses of the MAPS Questionnaire and Facilitation Guide. Whether used as a comprehensive tool or by dimension, the MAPS Questionnaire is conceptually sound and empirically validated for evaluating how CBPR partnerships can achieve long-standing success. CBPR partnerships at any stage of development will find the MAPS Questionnaire and Facilitation Guide useful in measuring and interpreting indicators of partnership success, sharing results, and improving their ability to contribute to achieving health equity goals.
Mechanical thrombectomy with a new intermediate balloon catheter combining the BGC and DAC features: Initial clinical experience with the iNedit device
Authors: Tomasello Alejandro , Gramegna Laura Ludovica , Vega Pedro , Castaño Carlos , Moreu Manuel , Dominguez Carlos , Macho Juan
Published: October 2023

Introduction

The iNedit balloon distal access catheter is a novel thrombectomy device. It has an inner diameter of 0.058″, proximal outer diameter of 2.13 mm, and distal outer diameter of 1.67mm. It is compatible with a 0.088″ guide catheter and includes a balloon located 5 cm from the catheter tip, enabling proximal flow restriction and combined therapy with stent retrievers. We investigate the appraisal of the use, safety, and efficacy of the iNedit catheter in the first-in-human study.

Methods

In the preliminary cases that demanded training on the product previous to a multicentric study, prospective data were collected on 22 consecutive patients treated with the iNedit catheter to perform thrombectomy for acute ischemic stroke due to large vessel occlusion within 24 h. The outcome measures consisted of several evaluations of user experience rated on a 5-point scale ranging from 1 (bad) to 5 (excellent), as well as assessments of procedural safety outcomes such as artery perforation and arterial occlusion, procedural efficacy outcomes including first-pass effect (Thrombolysis In Cerebral Infarction [TICI] 2c/3) and final recanalization (TICI 2b/3), and clinical efficacy outcomes such as a 3-month 0–2 modified Rankin Scale (mRS).

Results

The mean age was 72 ± 12 years old; median National Institute Health Stroke Scale was 17 (11–19). Sites of primary occlusion were: 2 internal carotid artery, 12 M1-MCA, 7 M2-MCA, and one P1. Median score evaluation of the appraisal of use was 4- IQR [4–5]. The median number of passes was 1 [IQR 1–2]. First pass complete recanalization rate was 50% and the final recanalization rate was 94.45%. No artery perforation and arterial occlusion. Good functional outcome mRS 0–2 was achieved in 50% of patients.

Conclusions

In this initial clinical experience, iNedit device achieved a high rate of first-pass effect and final recanalization rate with no safety concerns, thus favoring a high percentage of good clinical outcomes.
Safety and efficacy of braided stents as stent monotherapy for the treatment of small intracranial aneurysms
Authors: Capirossi Carolina , Radu Razvan A , Gascou Gregory , Lefevre Pierre-Henri , Dargazanli Cyril , Machi Paolo , Costalat Vincent , Cagnazzo Federico
Published: October 2023

Background

The safety and efficacy of low-profile braided stent as stent monotherapy require further investigation.

Objective

To analyze patient outcomes after treatment with braided stents used as “light” flow diverters.

Material/Methods

Retrospective study to evaluate the occlusion rate of aneurysms treated with braided stent and remodeling of covered side branches and perforators. Several factors potentially influencing aneurysm occlusion were analyzed.

Results

Thirty-five aneurysms in 31 patients were included. Six aneurysms (17.1%) had an acute subarachnoid hemorrhage. Braided stent was used as retreatment among 9 previously coiled aneurysms (25.7%). A total occlusion was achieved in 18 aneurysms (51.4%), entry remnant in 3 aneurysms (8.6%), incomplete filling in 6 aneurysms (17.1%) and complete filling in 8 aneurysms (22.9%). None of the aneurysms ruptured during the follow-up period. Of 32 stents deployed, we observed 3 cases (9.4%) of asymptomatic mild stenosis and 3 cases (10.7%) of narrowing of covered branches among 28 covered arteries. There were no cases of perforator infarction and no mortality or permanent morbidity associated with the treatment. Moreover, aneurysms <2.5 mm, aneurysms with a neck <1.8 mm, those with a mean aspect-ratio of 1.4, and lateral wall aneurysms had a higher frequency of adequate occlusion.

Conclusion

Braided stents used as stent monotherapy appear to be sufficiently effective in the treatment of very small intracranial aneurysms, despite a lower overall occlusion rate compared to a standard flow diversion strategy. However, given the low morbidity rate, this strategy may be an alternative to flow-diverter stents for small and distally located lesions.
‘Doing school food!’: a practical toolkit for adopting a whole school food approach
Authors: Rose K , O’Malley C , Lake AA , Lalli GS
Published: October 2023

Aims:

The dietary intake and reported eating behaviours of adolescents in the UK are a public health concern. Schools are identified as an ideal ‘place’ setting to promote health and improve young peoples’ nutrition outcomes. A gap in the understanding of how healthy secondary school food policy can be implemented, sustainable and effective, may hamper progress to improving school food provision and nutrition education in the UK. Research was conducted to understand the factors which influence healthy school food provision and the adolescent’s food choice to inform and develop a practical framework for schools.

Methods:

This research involves the development of a practical toolkit which synthesises evidence generated from a mixed methods study and a systematic review. This was informed by an exploration of the secondary school food environment as a potentially ‘obesogenic’ setting, the effectiveness of school food interventions and policy in Europe and UK, included young people’s (11–18 years of age) eating behaviours and priorities in food choice. A pragmatic approach was taken in the integration of evidence, using ecological and behaviour change theory, and joint display principles.

Result:

A six-phase practical toolkit is presented, guided by ‘What Good Looks Like’ and ‘Whole Systems Approach to Obesity’ principles which can be used to translate the evidence from this research into good school food practice.

Conclusion:

Improving secondary school food provision across the school day and having a coherent whole school food approach to healthy eating have the potential to significantly improve a young person’s food choice, therefore impacting the nutrient intake of adolescents in the UK. This toolkit helps working towards operationalising this idea.
The efficacy of preoperative tranexamic acid administration among patients undergoing arthroscopic rotator cuff repair: A systematic review and meta-analysis of randomized controlled trials
Authors: Alyousef Mahdi Yousef , Alaqaili Sadiq Issa , Alzayer Mohammed Ali , Alsultan Ali Sultan , Abusultan Ammar J , Alzahrani Mohammad M , Alqahtani Saad M
Published: October 2023

Aim

To conduct a systematic review and meta-analysis of randomized controlled trials (RCTs) that investigated the effectiveness of tranexamic acid (TXA) among patients undergoing arthroscopic rotator cuff repair (ARCR).

Methods

Five databases were screened until December 18, 2022. The included RCTs were assessed for risk of bias, and the endpoints were summarized as mean difference/standardized mean difference (MD/SMD) or risk ratio (RR) with the 95% confidence interval (CI) in a random-effects model.

Results

Seven RCTs with 510 patients (TXA = 261 and control/placebo = 249) were analyzed. The overall risk of bias was “low” and “unclear” in four and three RCTs, respectively. The mean operative time (n = 5 RCTs, MD = −9.64 min, 95% CI [−15.74, −3.54], p = 0.002) and mean postoperative pain score on postoperative day 1 (n = 5 RCTs, MD = −0.56, 95% CI [−1.06, −0.05], p = 0.03) were significantly reduced in the TXA group compared with the control group. However, there were no significant differences between both groups regarding visual clarity, amount of irrigation solution, and estimated intraoperative blood loss.

Conclusion

Among patients undergoing ARCR, preoperative TXA did not reduce intraoperative blood loss or improve visual clarity. However, TXA administration correlated with significant reductions (statistically) in operative time and postoperative day 1 pain score compared with the control group. Level of evidence: Level I; Systematic Review and Meta-analysis of Randomized Controlled Trials
PD-L1 expression-related PI3K pathway correlates with immunotherapy efficacy in gastric cancer
Authors: Liu Langbiao , Niu Lei , Zheng Xue , Xiao Fei , Sun Huaibo , Deng Wei , Cai Jun
Published: October 2023

Background:

The programed death ligand-1 combined positive score (PD-L1 CPS), the only FDA-approved biomarker for immune checkpoint inhibitor therapy in gastric cancer (GC) patients, is an important but imperfect predictive biomarker. The molecular characteristics of tumors that influence the PD-L1 CPS are largely unknown and would be helpful for screening patients who would benefit from immunotherapy.

Methods:

PD-L1 immunohistochemistry (IHC) and targeted next-generation sequencing techniques were used to compare genomic alterations in 492 GC patients in two groups (PD-L1 CPS ⩾ 1, positive; CPS < 1, negative). Screened PD-L1 expression-related factors were analyzed for immunotherapy efficacy in three distinct GC cohorts from public databases.

Results:

Positive PD-L1 expression occurred in 40% of GC patients and was associated with a higher proportion of phosphatidylinositol 3-kinase (PI3K), SWItch/Sucrose NonFermentable (SWI/SNF), lysine demethylase (KDM), and DNA (cytosine-5)-methyltransferase (DNMT) (all p < 0.01), pathway alterations. Compared to wild-type GC patients, those with PI3K pathway alterations had a higher response rate ( p = 0.002) and durable clinical benefit rate with immunotherapy ( p = 0.023, p = 0.038) as well as longer progression-free survival ( p = 0.084, p = 0.0076) and overall survival ( p = 0.2, p = 0.037) with immunotherapy.

Conclusion:

This study revealed PD-L1 expression-related factors in the tumor genome in a GC cohort. Alterations in the PI3K pathway associated with PD-L1 positivity were shown to be associated with better immunotherapy efficacy in three distinct GC cohorts from public databases. Our results provide a potential avenue for patient selection and rational immune combination development for GC patients.
Designing a comprehensive minimum dataset for patients with COVID-19 in Iranian hospital information systems
Authors: Salmani Hosna , Sharafi Sadegh , Almanie Ahlam , Niknam Fatemeh , Naseri Zeynab , Mobarak Sara , Jelvay Saeed
Published: October 2023

Background:

The Minimum Data Set (MDS) plays a vital role in data exchange, collection and quality improvement. In the context of the COVID-19 pandemic, there is a need for a tailored MDS that aligns with the specific information needs of the Iranian community and integrates seamlessly into the country’s Hospital Information Systems (HIS).

Objective:

The study aimed to develop a comprehensive MDS for COVID-19 patients in Iran, with objectives to identify essential data elements and integrate the MDS into HIS, enhancing data exchange and supporting decision-making.

Method:

This study employed a comparative-descriptive approach to design COVID-19 patient data elements based on World Health Organisation and Centers for Disease Control and Prevention guidelines. The Delphi technique involved 35 experts in two rounds for checklist refinement. The finalised MDS consisted of 9 main terms and 80 sub-terms, analysed using descriptive statistics and IBM SPSS software.

Results:

Of 35 experts involved with the study, 69% were male and 31% female, and Health Information Management experts were the majority (34%). The refined MDS for COVID-19 in Iran comprises 50 data elements, while 30 elements were excluded. The MDS includes 8 main terms and 80 sub-terms, with unanimous approval for identity, underlying disease, and treatment sections.

Conclusion:

The customised MDS for COVID-19 patients in Iran addresses data collection challenges and supports effective disease prevention and management. By providing comprehensive and reliable information, the MDS enhances healthcare quality, facilitates timely access to medical records, and fosters integrated health services.