bluuebunny/crossref_metadata_2025 huggingface dataset:
First-line pembrolizumab for lung cancer in a Spanish real-world study.
Authors: Burgos Amparo , Calleja Teresa , Ibáñez Cristina , Valencia Carmen María , Orallo Claudia , Titos Jose Carlos , Conde David , Diaz Sacramento , Matilla Belén , Lizeaga Garbiñe , Sánchez Carmen , Marin Pozo Juan Francisco , Jimenez Silvia , Jiménez Inmaculada , Díez Raúl , Garrido Margarita , Larrosa María , Martinez Maria Jose , Moreno Estela , Campelo Rosario Garcia
Published: June 2024

e23268

Background: KEYNOTE (KN) 024 trial showed that pembrolizumab significantly improves progression free survival (PFS) and overall survival (OS) in patients with previously untreated advanced non-small cell lung cancer (NSCLC) with a PD-L1 expression ≥ 50% without EGFR/ALK alterations. The main aim of this study is to report the outcomes (PFS and OS) of pembrolizumab in a real life setting. Methods: Multicenter retrospective study in 42 Spanish hospitals. Inclusion period: 01/2016 – 07/2020; cut-off date: 31/12/2021. Demographic, clinical and treatment-related data were retrospectively obtained from patients’ medical files. Statistical analysis was carried out using descriptive metrics and survival analysis techniques (Kaplan-Meier, log-rank test, Cox regression). Results: In our cohort of 1005 patients, 74.5% were males, mean age was 66.4 ± 9.7 and mean BMI 25.6 ± 4.6. The majority were current (35.6%) or former smokers (56.6%), with 11 % of patients with ECOG ≥ 2. Patients with a non squamous histology were 79.5% and 95.2% were classified as IV stage (30.3% had hepatic and/or brain metastases, 49.3% had ≥ 2 metastatic sites). Pembrolizumab dose was mainly fixed (83.1% of patients), while the number of treatment cycles was highly variable. 31.8% received concurrent radiotherapy, while previous corticoid (PCE), antibiotic and proton pump inhibitors (PPI) exposure were 18.2%, 7.7% and 40.7% respectively. With a median follow-up of 6.3 months, median OS and PFSwere 19 (95%CI: 16.2 – 21.3) and 8.7 (95%CI: 7.2 – 10.1) months. Several variables were associated with PFS and OS after univariate survival analysis. Age and previous antibiotic exposure were associated to worse OS but not to PFS. Multivariate analysis showed that ECOG ≥2 (HR 2.7 95%CI 2-3.5) and previous PPI exposure (HR 1.3 95%CI 1.1-1.6) were predictors of poor outcome. Conclusions: In our cohort, pembrolizumab showed lower OS and similar PFS than KN 024. Our results confirm that poor PS (ECOG) is a negative predictive factor for effectiveness. [Table: see text]
Trends in survival in solid malignancies with synchronous brain metastases: A population-based study.
Authors: Sharma Parth , Miller Tayla , Mahadevia Himil , Fatima Ifrah , Sharma Priyanka , Cheng An-Lin , Shrestha Anuj
Published: June 2024

e23299

Background: Brain metastasis in solid malignancies at diagnosis has a poor prognosis. Improvements in the treatment of solid malignancies and advancements in neuroimaging techniques have led to increased incidence of brain metastases. In our study, we examined survival outcomes in patients diagnosed with brain metastasis at the time of diagnosis of primary malignancy at four different sites in the year groups 2010 to 2014 and 2015 to 2020. Methods: Surveillance, Epidemiology, and End Results (SEER) Program 17 registry (November 2022 submission) database was analyzed for four primary sites of cancer based on their high propensity to develop brain metastases- lung and/or bronchus, breast, kidney and/or renal pelvis, and melanoma. Patients diagnosed with malignancy during autopsy or via death certificate and patients with incomplete survival data were excluded. R 4.3.1 software was used for all the analyses. Kaplan-Meier method was used for 2-year survival rate and overall survival analyses. Cox regression analysis was used for hazard ratios (HR). Results: A total of 29,056 and 37,437 cases were identified across the four cancer groups during the period 2010-2014 (Group 1) and 2015-2020 (Group 2), respectively. Lung and/or bronchus tumors comprised the majority of the cases (n = 58,324). 14,811 patients in Group 1 and 18,703 patients in Group 2 received chemotherapy. 8,741 patients in Group 1 and 12,533 patients in Group 2 received radiotherapy. In all the cancers combined, the median survival time in Group 1 was 4 months, and in Group 2 was 5 months. Patients in Group 2 had significantly better survival outcomes than Group 1 (HR:0.81, 95% CI:0.78-0.83, p < 0.001). Table 1 outlines the 2-year survival rates with overall survival p-value. Conclusions: Modest improvement in survival was found in patients diagnosed with synchronous brain metastases during 2015-2020 compared to patients diagnosed in 2010-2014. This slight improvement could be attributed to the improved systemic therapies for cancer, like immunotherapy, as well as advanced local therapy options for brain metastases, although the data for immunotherapy use is unavailable in the SEER database. Overall, the prognosis of synchronous brain metastases remains poor in both groups. Further studies and brain metastases inclusive clinical trials are warranted to improve outcomes in this population. [Table: see text]
ECOG-ACRIN EAZ171: Prospective Validation Trial of Germline Predictors of Taxane-Induced Peripheral Neuropathy in Black Women With Early-Stage Breast Cancer
Authors: Schneider Bryan P. , Zhao Fengmin , Ballinger Tarah J. , Garcia Sofia F. , Shen Fei , Virani Shamsuddin , Cella David , Bales Casey , Jiang Guanglong , Hayes Lisa , Miller Nadia , Srinivasiah Jayanthi , Stringer-Reasor Erica M. , Chitalia Ami , Davis Andrew A. , Makower Della F. , Incorvati Jason , Simon Melissa A. , Mitchell Edith P. , DeMichele Angela , Miller Kathy D. , Sparano Joseph A. , Wagner Lynne I. , Wolff Antonio C.
Published: June 2024

PURPOSE

Black women experience higher rates of taxane-induced peripheral neuropathy (TIPN) compared with White women when receiving adjuvant once weekly paclitaxel for early-stage breast cancer, leading to more dose reductions and higher recurrence rates. EAZ171 aimed to prospectively validate germline predictors of TIPN and compare rates of TIPN and dose reductions in Black women receiving (neo)adjuvant once weekly paclitaxel and once every 3 weeks docetaxel for early-stage breast cancer.

METHODS

Women with early-stage breast cancer who self-identified as Black and had intended to receive (neo)adjuvant once weekly paclitaxel or once every 3 weeks docetaxel were eligible, with planned accrual to 120 patients in each arm. Genotyping was performed to determine germline neuropathy risk. Grade 2-4 TIPN by Common Terminology Criteria for Adverse Events (CTCAE) v5.0 was compared between high- versus low-risk genotypes and between once weekly paclitaxel versus once every 3 weeks docetaxel within 1 year. Patient-rated TIPN and patient-reported outcomes were compared using patient-reported outcome (PRO)–CTCAE and Functional Assessment of Cancer Therapy/Gynecologic Oncology Group–Neurotoxicity.

RESULTS

Two hundred and forty of 249 enrolled patients had genotype data, and 91 of 117 (77.8%) receiving once weekly paclitaxel and 87 of 118 (73.7%) receiving once every 3 weeks docetaxel were classified as high-risk. Physician-reported grade 2-4 TIPN was not significantly different in high- versus low-risk genotype groups with once weekly paclitaxel (47% v 35%; P = .27) or with once every 3 weeks docetaxel (28% v 19%; P = .47). Grade 2-4 TIPN was significantly higher in the once weekly paclitaxel versus once every 3 weeks docetaxel arm by both physician-rated CTCAE (45% v 29%; P = .02) and PRO-CTCAE (40% v 24%; P = .03). Patients receiving once weekly paclitaxel required more dose reductions because of TIPN (28% v 9%; P < .001) or any cause (39% v 25%; P = .02).

CONCLUSION

Germline variation did not predict risk of TIPN in Black women receiving (neo)adjuvant once weekly paclitaxel or once every 3 weeks docetaxel. Once weekly paclitaxel was associated with significantly more grade 2-4 TIPN and required more dose reductions than once every 3 weeks docetaxel.
Algebraic solution and thermodynamic properties for the one- and two-dimensional Dirac oscillator with minimal length uncertainty relations
Authors: Dagoudo Léonie , Dossa Finagnon Anselme , Avossevou Gabriel Yves Hugues
Published: June 2024

We study the quantum characteristics of the Dirac oscillator within the framework of Heisenberg's generalized uncertainty principle. This principle leads to the appearance of a minimal length of the order of the Planck length. Hidden symmetries are identified to solve the model algebraically. The presence of the minimal length leads to a quadratic dependence of the energy spectrum on the quantum number n, implying the hard confinement property of the system. Thermodynamic properties are calculated using the canonical partition function. The latter is well determined by the method based on Epstein's zeta function. The results reveal that the minimal length has a significant effect on the thermodynamic properties.
Navigating Complexities: Vitamin D, Skin Pigmentation, and Race
Authors: Singh Ospina Naykky , Diaz-Thomas Alicia , McDonnell Marie E , Demay Marie B , Pittas Anastassios G , York Elizabeth , Corrigan Maureen D , Lash Robert W , Brito Juan P , Murad M Hassan , McCartney Christopher R
Published: June 2024

Vitamin D plays a critical role in many physiological functions, including calcium metabolism and musculoskeletal health. This commentary aims to explore the intricate relationships among skin complexion, race, and 25-hydroxyvitamin D (25[OH]D) levels, focusing on challenges the Endocrine Society encountered during clinical practice guideline development. Given that increased melanin content reduces 25(OH)D production in the skin in response to UV light, the guideline development panel addressed the potential role for 25(OH)D screening in individuals with dark skin complexion. The panel discovered that no randomized clinical trials have directly assessed vitamin D related patient-important outcomes based on participants' skin pigmentation, although race and ethnicity often served as presumed proxies for skin pigmentation in the literature. In their deliberations, guideline panel members and selected Endocrine Society leaders underscored the critical need to distinguish between skin pigmentation as a biological variable and race and ethnicity as socially determined constructs. This differentiation is vital to maximize scientific rigor and, thus, the validity of resulting recommendations. Lessons learned from the guideline development process emphasize the necessity of clarity when incorporating race and ethnicity into clinical guidelines. Such clarity is an essential step toward improving health outcomes and ensuring equitable healthcare practices.
Gut Microbiome Alterations Accompany Metabolic Normalization Following Bariatric Surgery in ROHHAD Syndrome
Authors: Granato Alessandra , Ryan Paul M , Wong Anthony , Hamilton Jill K , Danska Jayne S
Published: June 2024

Rapid onset obesity with hypoventilation, hypothalamic, and autonomic dysregulation (ROHHAD) syndrome in childhood is characterized by abrupt onset weight gain and dysautonomia with variable neuroendocrine involvement. In the absence of definitive disease-modifying therapies, the primary management strategy remains symptom control. This case report describes the first successful correction of obesity, dysautonomia, and metabolic derangement in a patient with ROHHAD following Roux-en-Y gastric bypass. Anthropometrics, metabolic profiling, and stool microbiome composition were assessed in a longitudinal fashion. In the 48-month period following surgery, the patient body mass index (BMI) reduced by 9.5 kg/m2 and metabolic status improved, evidenced in weaning of insulin, and improved glycated hemoglobin, lipid profile, and hepatic enzymes. Chronic diarrhea resolved after surgery and prior to significant weight loss. Evaluation of stool bacterial composition and biomass demonstrated shifts in absolute abundance and taxonomic composition in longitudinal samples following surgery. This case demonstrates the potential efficacy of bariatric surgery in correcting the metabolic disruption of ROHHAD syndrome, producing long-term changes in gut microbiome composition and biomass.
Two Cases of Symptomatic Familial Hypocalciuric Hypercalcemia: Treatment Response to Calcimimetic Therapy
Authors: Shakesprere Jonathan , Shafiq Ramsha , Madahar Inderpreet , Quinn Hugh B , Thakkar Yashan , Haider Adnan
Published: June 2024

Familial hypocalciuric hypercalcemia (FHH) is marked by mild to moderate hypercalcemia, normal-elevated serum PTH levels, and relative hypocalciuria. Cinacalcet, a calcimimetic therapy, has been reported to reduce symptom burden and serum calcium levels in FHH. We report 2 adult males with chronic hypercalcemia, with initial concerns for primary hyperparathyroidism. Urine calcium screening and genetic testing confirmed FHH in both patients. Shortened QTc normalized while on cinacalcet in the first patient and reductions in serum calcium and PTH levels without symptomatic hypercalcemia were noted in the second patient. Calcimimetic therapy can potentially be offered to FHH patients, particularly those with hypercalcemia symptoms, serum calcium levels >1 mg/dL (0.25 mmol/L) above normal or at risk of cardiac arrhythmias. Cinacalcet treatment was overall well tolerated and significantly reduced serum calcium and PTH levels in 2 adult FHH patients over time. Calcimimetic therapy has shown promise in managing persistent hypercalcemia and potential adverse events in FHH patients. Potential barriers include indefinite treatment, cost, and possible adverse effects.
Neurocritical Care for Patients With Ischemic Stroke
Authors: Leslie-Mazwi T. M.
Published: June 2024

OBJECTIVE

Management of stroke due to large vessel occlusion (LVO) has undergone unprecedented change in the past decade. Effective treatment with thrombectomy has galvanized the field and led to advancements in all aspects of care. This article provides a comprehensive examination of neurologic intensive care unit (ICU) management of patients with stroke due to LVO. The role of the neurocritical care team in stroke systems of care and the importance of prompt diagnosis, initiation of treatment, and continued monitoring of patients with stroke due to LVO is highlighted.

LATEST DEVELOPMENTS

The management of complications commonly associated with stroke due to LVO, including malignant cerebral edema and respiratory failure, are addressed, stressing the importance of early identification and aggressive treatment in mitigating negative effects on patients’ prognoses. In the realm of medical management, this article discusses various medical therapies, including antithrombotic therapy, blood pressure management, and glucose control, outlining evidence-based strategies for optimizing patient outcomes. It further emphasizes the importance of a multidisciplinary approach to provide a comprehensive care model. Lastly, the critical aspect of family communication and prognostication in the neurologic ICU is addressed.

ESSENTIAL POINTS

This article emphasizes the multidimensional aspects of neurocritical care in treating patients with stroke due to LVO.
The Neurocritical Care Examination and Workup
Authors: Wahlster Sarah , Johnson Nicholas J.
Published: June 2024

OBJECTIVE

This article provides an overview of the evaluation of patients in neurocritical care settings and a structured approach to recognizing and localizing acute neurologic emergencies, performing a focused examination, and pursuing workup to identify critical findings requiring urgent management.

LATEST DEVELOPMENTS

After identifying and stabilizing imminent threats to survival, including respiratory and hemodynamic compromise, the initial differential diagnosis for patients in neurocritical care is built on a focused history and clinical examination, always keeping in mind critical “must-not-miss” pathologies. A key priority is to identify processes warranting time-sensitive therapeutic interventions, including signs of elevated intracranial pressure and herniation, acute neurovascular emergencies, clinical or subclinical seizures, infections of the central nervous system, spinal cord compression, and acute neuromuscular respiratory failure. Prompt neuroimaging to identify structural abnormalities should be obtained, complemented by laboratory findings to assess for underlying systemic causes. The indication for EEG and lumbar puncture should be considered early based on clinical suspicion.

ESSENTIAL POINTS

In neurocritical care, the initial evaluation is often fast paced, requiring assessment and management to happen in parallel. History, clinical examination, and workup should be obtained while considering therapeutic implications and the need for lifesaving interventions.
Emergent Management of Status Epilepticus
Authors: Rubinos Clio
Published: June 2024

OBJECTIVE

Status epilepticus is a neurologic emergency that can be life- threatening. The key to effective management is recognition and prompt initiation of treatment. Management of status epilepticus requires a patient-specific–approach framework, consisting of four axes: (1) semiology, (2) etiology, (3) EEG correlate, and (4) age. This article provides a comprehensive overview of status epilepticus, highlighting the current treatment approaches and strategies for management and control.

LATEST DEVELOPMENTS

Administering appropriate doses of antiseizure medication in a timely manner is vital for halting seizure activity. Benzodiazepines are the first-line treatment, as demonstrated by three randomized controlled trials in the hospital and prehospital settings. Benzodiazepines can be administered through IV, intramuscular, rectal, or intranasal routes. If seizures persist, second-line treatments such as phenytoin and fosphenytoin, valproate, or levetiracetam are warranted. The recently published Established Status Epilepticus Treatment Trial found that all three of these drugs are similarly effective in achieving seizure cessation in approximately half of patients. For cases of refractory and super-refractory status epilepticus, IV anesthetics, including ketamine and γ-aminobutyric acid–mediated (GABA-ergic) medications, are necessary. There is an increasing body of evidence supporting the use of ketamine, not only in the early phases of stage 3 status epilepticus but also as a second-line treatment option.

ESSENTIAL POINTS

As with other neurologic emergencies, “time is brain” when treating status epilepticus. Antiseizure medication should be initiated quickly to achieve seizure cessation. There is a need to explore newer generations of antiseizure medications and nonpharmacologic modalities to treat status epilepticus.
The Endosomal Sorting Complex, ESCRT, has diverse roles in blood progenitor maintenance, lineage choice and immune response
Authors: Ray Arindam , Rai Yashashwinee , Inamdar Maneesha S.
Published: June 2024

Most hematological malignancies are associated with reduced expression of one or more components of the Endosomal Sorting Complex Required for Transport (ESCRT). However, the roles of ESCRT in stem cell and progenitor maintenance are not resolved. Parsing signaling pathways in relation to the canonical role of ESCRT poses a challenge. The Drosophila hematopoietic organ, the larval lymph gland, provides a path to dissect the roles of cellular trafficking pathways such as ESCRT in blood development and maintenance. Drosophila has 13 core ESCRT components. Knockdown of individual ESCRTs showed that only Vps28 and Vp36 were required in all lymph gland progenitors. Using the well-conserved ESCRT-II complex as an example of the range of phenotypes seen upon ESCRT depletion, we show that ESCRTs have cell-autonomous as well as non-autonomous roles in progenitor maintenance and differentiation. ESCRT depletion also sensitized posterior lobe progenitors to respond to immunogenic wasp infestation. We also identify key heterotypic roles for ESCRT in position-dependent control of Notch activation to suppress crystal cell differentiation. Our study shows that the cargo sorting machinery determines the identity of progenitors and their adaptability to the dynamic microenvironment. These mechanisms for control of cell fate may tailor developmental diversity in multiple contexts.
Changes in body surface temperature reveal the thermal challenge associated with catastrophic moult in captive gentoo penguins
Authors: Lewden Agnès , Halna du Fretay Tristan , Stier Antoine
Published: June 2024

Once a year, penguins undergo a catastrophic moult, replacing their entire plumage during a fasting period on land or on sea-ice during which time individuals can lose 45% of their body mass. In penguins, new feather synthesis precedes the loss of old feathers, leading to an accumulation of two feather layers (double coat) before the old plumage is shed. We hypothesized that the combination of the high metabolism required for new feather synthesis and the potentially high thermal insulation linked to the double coat could lead to a thermal challenge requiring additional peripheral circulation to thermal windows to dissipate the extra heat. To test this hypothesis, we measured the surface temperature of different body regions of captive gentoo penguins (Pygoscelis papua) throughout the moult under constant environmental conditions. The surface temperature of the main body trunk decreased during the initial stages of the moult, suggesting greater thermal insulation. In contrast, the periorbital region, a potential proxy of core temperature in birds, increased during these same early moulting stages. The surface temperature of the bill, flipper and foot (thermal windows) tended to initially increase during the moult, highlighting the likely need for extra heat dissipation in moulting penguins. These results raise questions regarding the thermoregulatory capacities of penguins in the wild during the challenging period of moulting on land in the current context of global warming.
Thermo-physiological changes and reproductive investment in a liolaemid lizard at the extreme of the slow–fast continuum
Authors: Stellatelli Oscar A. , Bonavita Mauro I. , Victorel Candela , Gómez Alés Rodrigo , Moreno Azócar Débora L. , Block Carolina , Cruz Félix B.
Published: June 2024

Gravid female lizards often experience reduced thermal preferences and impaired locomotor performance. These changes have been attributed to the physical burden of the clutch, but some authors have suggested that they may be due to physiological adjustments. We compared the thermal biology and locomotor performance of the lizard Liolaemus wiegmannii 1 week before and 1 week after oviposition. We found that gravid females had a thermal preference 1°C lower than that of non-gravid females. This was accompanied by a change in the thermal dependence of maximum running speed. The thermal optimum for locomotor performance was 2.6°C lower before oviposition than after. At relatively low temperatures (22 and 26°C), running speeds of females before oviposition were up to 31% higher than for females after oviposition. However, at temperatures above 26°C, females achieved similar maximum running speeds (∼1.5 m s−1) regardless of reproductive stage. The magnitude of the changes in thermal parameters and locomotor performance of L. wiegmannii females was independent of relative clutch mass (clutches weighed up to 89% of post-oviposition body mass). This suggests that the changes are not simply due to the clutch mass, but are also due to physiological adjustments. Liolaemus wiegmannii females simultaneously adjusted their own physiology in a short period in order to improve locomotor performance and allocated energy for embryonic development during late gravid stage. Our findings have implications for understanding the mechanisms underlying life histories of lizards on the fast extreme of the slow–fast continuum, where physiological exhaustion could play an important role.
Using an expert survey and user feedback to construct PRECHECK: A checklist to evaluate preprints on COVID-19 and beyond
Authors: Turoman Nora , Heyard Rachel , Schwab Simon , Furrer Eva , Vergauwe Evie , Held Leonhard
Published: June 2024

Background The quality of COVID-19 preprints should be considered with great care, as their contents can influence public policy. Surprisingly little has been done to calibrate the public’s evaluation of preprints and their contents. The PRECHECK project aimed to generate a tool to teach and guide scientifically literate non-experts to critically evaluate preprints, on COVID-19 and beyond. Methods To create a checklist, we applied a four-step procedure consisting of an initial internal review, an external review by a pool of experts (methodologists, meta-researchers/experts on preprints, journal editors, and science journalists), a final internal review, and a Preliminary implementation stage. For the external review step, experts rated the relevance of each element of the checklist on five-point Likert scales, and provided written feedback. After each internal review round, we applied the checklist on a small set of high-quality preprints from an online list of milestone research works on COVID-19 and low-quality preprints, which were eventually retracted, to verify whether the checklist can discriminate between the two categories. Results At the external review step, 26 of the 54 contacted experts responded. The final checklist contained four elements (Research question, study type, transparency and integrity, and limitations), with ‘superficial’ and ‘deep’ evaluation levels. When using both levels, the checklist was effective at discriminating a small set of high- and low-quality preprints. Its usability for assessment and discussion of preprints was confirmed in workshops with Bachelors students in Psychology and Medicine, and science journalists. Conclusions We created a simple, easy-to-use tool for helping scientifically literate non-experts navigate preprints with a critical mind and facilitate discussions within, for example, a beginner-level lecture on research methods. We believe that our checklist has potential to help guide decisions about the quality of preprints on COVID-19 in our target audience and that this extends beyond COVID-19.
Development and evaluation of prevention bundle for neonatal healthcare-associated infections: an interventional study
Authors: Rani Usha , Lewis Leslie E , Chawla Kiran , Naha Anup , Kumar Praveen
Published: June 2024

Background Neonatal healthcare-associated infection (HAI) globally is the leading preventable cause of neonatal mortality. Neonatal mortality in India is also very high. Considering that HAIs can be prevented globally, there are disparities in resources; the current study aimed at developing locally feasible and effective prevention bundles for neonatal HAIs. Methods A mixed-method study was conducted at one tertiary care teaching hospital's level IV Neonatal Intensive Care Unit. The study explores the causes of neonatal HAIs, current processes, benchmark practices, gaps in current practices with HAIs, root-cause analysis and system process mapping, and failure mode effect analysis. Observations, interviews, brainstorming activities, and a survey were conducted. Written and audio-video recorded prevention bundle was developed and implemented using a quasi-experimental study design. Results Process standardisation, healthcare worker training, hand hygiene practices, nursing care process and vascular access process were identified as key improvement areas to prevent neonatal HAIs. Out of eighteen identified processes, three processes were standardised. All the healthcare providers were trained at three-time intervals of three months each. After implementing the prevention bundle, there was a significant decline in the rate of HAIs, reducing it from 9.6 to 7.0 per 100 admissions >48 hours. The bacteraemia rate fell from 5.2 per 1000 patient days to 2.6 per 1000 patient days and was statistically significant on a two-tailed student t-test with 95% CI with p-value=0.00073. Conclusions Our developed prevention bundle for neonatal HAIs was significantly effective and reproducible for healthcare workers' training and development. Considering variations in global infection control practices and resources constraint, it is effective to develop a local prevention bundle for neonatal HAIs.
A qualitative exploration of patients’ perception regarding the comprehensive dental services availed at a primary health center
Authors: Rao B Shushma , Shenoy Ramya , Dasson Bajaj Parul , Rao Ashwini , Pai Mithun , Jodalli Praveen , BR Avinash , KS Aparna , Shinaj Navya , Musheer Shagufta
Published: June 2024

Introduction Comprehensive oral care is a service centered around the patient, and individuals who need it the most often face limited access. Patient perception acts as a guide for enhancing quality, ensuring patients’ future intent to utilize the services and facilitating recommendations to others. The present study aimed to assess the patients’ perception of comprehensive dental services availed at a Primary Health Center (PHC). Methods This qualitative study was based on a phenomenological interpretive approach, and judgment sampling method was employed. A validated interview guide, developed from relevant literature was employed in the local language to conduct interviews among adults visiting the PHC, gathering their views regarding the services provided. The interviews were audio recorded on a digital voice recorder, and files were password protected. Content saturation guided the determination of the final number of participants interviewed. After translating and transcribing the interviews, thematic analysis and coding were performed using ATLAS. ti 23 for Windows. Results A total of 12 participants were included in the study, following data saturation. Among them, there were 8(66.7%) female and 4(33.3%) male participants. Ten overarching main themes were discerned through the assigned codes, including positive views, neutral views, negative views, previous dental clinics visited, previous experience with dental treatment, treatments sought at the center, referrals, source of information about the dental center, subsequent visits and suggestions for improvement. Conclusions The findings of this study revealed a positive patient perception of the comprehensive dental services offered at the PHC. Through insightful interviews, various strengths, and areas for improvement regarding the center and care provision were identified. These insights provide valuable suggestions that can be applied to elevate the utilization of dental services, ensuring continuous improvement in patient care.
Exploring α−ψ−ϕ contractive mapping: novel fixed point theorems in complete b-metric spaces
Authors: Raji Tamene , Ali Nasir , Hanchalu Gudeta , Tolasa Fikadu Tesgera , Seboka Berhanu
Published: June 2024

Background This paper explores α-ψ-ϕ contractive mappings, extending the field of self-map and fixed-point theorems. Methods We analyze α-ψ-ϕ contractive mappings using rigorous mathematical proofs and logical deductions. Results A key main result is established, supported by intuitive corollaries and practical examples, highlighting the applicability of our findings. Conclusions Our work provides a fresh perspective on contractive mappings, simplifying complex mathematical concepts and enriching the literature on fixed-point theorems.
refinement of a lemma by Aron, Cascales, and Kozhushkina on Asplund operators
Authors: Kirme Jaagup
Published: June 2024

We prove a refinement of a lemma by Aron, Cascales, and Kozhushkina on Asplund operators. Refinements of a Bishop–Phelps–Bollobás type theorem for Asplund operators with values in spaces C0(L) by the same authors, and an extension of this theorem for Asplund operators with values in uniform algebras by Cascales, Guirao, and Kadets, follow.
A review of the relationships between safety risk factors, practical solutions, and sustainable construction
Authors:   University of Lahore Department of Technology, Lahore, Pakistan, Noshin Sadaf , Aslam Hafiz M. Shahzad , Rehman Atteq ur ,   University of Lahore Department of Technology, Lahore, Pakistan, Ahmad Abrar ,   NTDC Department, Lahore, Pakistan, Yasin Mazhar ,   University of Lahore Department of Technology, Lahore, Pakistan, Hamza Ali ,   University of Lahore Department of Technology, Lahore, Pakistan
Published: June 2024

Sustainability encompasses environmental, economic, and social dimensions, with safety standing as a crucial facet within the construction industry's social sustainability framework. This study addresses this vital concern by comprehensively analyzing published research on prominent safety risk factors and effective mitigation measures in construction projects, considering their influence on the industry's sustainability. A systematic literature review spanning 2008 to 2023 examined 32 pertinent articles from reputable journals. The review revealed 25 identified safety risk factors and 20 corresponding effective measures. These were categorised into labour, environmental, technical, and financial risks, forming the basis for a network diagram illustrating their interrelationships and associated mitigation strategies. Moreover, the study introduced a sustainability criterion, evaluating the various safety risk factor categories, and highlighting labour and environmental risks as the most significant concerns among the factors assessed. Finally, the research proposes future research directions aimed at elevating safety and sustainability within construction projects.
Recycled concrete aggregate and cinder gravel as base course construction materials
Authors:   Kaffa Zone Transport & Road Building Department, Kaffa, Bonga, Ethiopia, Sahile Atnafu , Agon Elmer C. ,   Jimma University; Faculty of Civil and Environmental Engineering, Jimma, Ethiopia, Geremew Anteneh ,   Jimma University; Faculty of Civil and Environmental Engineering, Jimma, Ethiopia, Gudina Oluma ,   Jimma University; Faculty of Civil and Environmental Engineering, Jimma, Ethiopia
Published: June 2024

In this research, the potential use of recycled concrete aggregate (RCA) and CG as a base course construction material was investigated. A laboratory test involving the mechanical stabilization of RCA and CG was conducted to examine their physical properties. Eight samples of RCA blended with CG in varying proportions from 0% to 100 % with 10 % variation were studied. The laboratory test results indicate that 100 % CG yields specific gravity (SG), aggregate crushing value (ACV), aggregate impact value (AIV), Los Angeles abrasion (LAA), flakiness index (FI), elongation index (EI), plasticity index (PI), water absorption, soundness, and California bearing ratio (CBR) values of 2,54 %, 38,37 %, 20,10 %, 33,17 %, 5,59 %, 12,09 %, 0,90 %, 3,52 %, 10,60 %, and 38,08 %, respectively. The results for 100% RCA show SG, ACV, AIV, LAA, FI, EI, PI, water absorption, soundness, and CBR values of 2,70 %, 9,56 %, 5,30 %, 9,20 %, 15,30 %, 15,84 %, NP, 0,23 %, 1,49 %, and 105,87 %, respectively. These results also fail to meet the gradation requirements based on ERA standard specifications. Therefore, mechanical stabilization was adopted to improve the physical properties of the samples. Blending 60 % RCA with 40 % CG resulted in SG, ACV, AIV, LAA, FI, EI, PI, water absorption, soundness, and CBR values of 2,65 %, 19,46 %, 10,70 %, 10,88 %, 16,15 %, 22,01 %, NP, 0,26 %, 2,09 %, and 101,98 %, respectively. At this proportion, the gradation aligns with the required ERA standard specifications for GB2 and GB3 materials. Therefore, CG up to 40 % by weight with 60 % RCA is viable for road base course construction, especially when readily available or nearby.
Policy processes in China: a systematic review of the multiple streams framework
Authors: van den Dool Annemieke , Qiu Tianlei
Published: June 2024

The multiple stream framework (MSF) helps explain why policy makers address some issues but not others. Although the framework was originally developed in the USA, scholars argue that it has universal explanatory power across political systems and have called for applications to authoritarian settings. In response, we conduct a systematic review of China-focused MSF research, including 22 English-language articles and 156 Chinese-language articles. We show an increase in publications and identify education and social policy as the two most studied areas. Based on the reviewed articles, we highlight four key themes pertaining to China’s policy process: the dominance of the political stream, the limited role of the national mood, managerial issues in the problem stream, and stream dependence. In addition to a need to conceptualise and test how these aspects shape policy outputs and outcomes, we argue that, if the framework is to contribute to a better understanding of China’s policy process, future MSF research should not only venture into unexplored policy areas but also ought to be more explicit and transparent in terms of operationalisation and focus more on analysing causal relationships. Other research priorities include comparative and critical analysis of MSF hypotheses in other non-democracies.
Early experiences of peer support workers starting employment in a mental health charity: a case study
Authors: Wilson Sophie
Published: June 2024

In recent years a plethora of job roles has emerged across the voluntary and community sector (VCS) and public sector that explicitly request lived experience (LE) of mental health challenges. These roles are often situated in the ‘frontline’ workforce providing direct support to people accessing services. This article shares early learning about the experiences of people who have lived experience of mental health challenges employed as paid peer support workers (PSWs) within a mental health charity.

The findings are drawn from fieldwork conducted over a three-month period with five recently employed PSWs, conducted as a component of the author’s doctoral study. The data corpus included interviews, fieldwork observation notes from ‘walk the frontline’ (WTF) activities, and the collation of WhatsApp voice notes sent by the PSWs to the researcher.

The article presents nine key themes that emerged from the data and categorises these into three areas: Firm up – those that were broadly positive denoting good practice; Fine tune – those that require further refinement; and Focus – those which signal a need for concentrated attention and further exploration.

Taking these findings into account, a tentative schematic model is offered which suggests sequential ‘conditions’ to be considered when developing PSW programmes. This has relevance to voluntary sector organisations (VSOs) who are considering recruiting and deploying PSWs to support frontline service delivery.
Political Cleavages and the Competition over Epistemic Authority
Authors: Müller Thomas
Published: June 2024

This chapter explores the dynamics of competition that shape inter-organizational relations in world politics. Global governance is characterized by a competition over authority in which diverse actors produce knowledge about governance objects. Does this competition make the epistemic practices of the actors more similar or more distinct? To answer this question, the chapter treats organizational fields as political fields and elaborates on how cleavages – deep political divides – affect the field dynamics. Using the evolution of military expenditure statistics as an empirical example, the chapter argues that cleavages make governance-related forms of field-wide isomorphism less likely while limiting the spread of practices that are politically contested, thus fostering persistent diversity in the practices. By doing so, the chapter contributes to a better understanding not only of how competition structures IOR but also of how IOR affects the ordering of world politics.
Methodology: From Research Results to Recommendations
Authors: Zupančič Rok , Kočan Faris , Andresen Kenneth , Bojarska Katarzyna , Dacosta Ricardo , Farrell Seamus , Fiedler Anke , Hoxha Abit , Ioannidis Nikandros , Kirk Niamh , Martín Irene , Milioni Dimitra L. , Panos Dionysis , Paradés Marta , Rawski Tomasz , Triga Vasiliki , Vučko Tjaša
Published: June 2024

This chapter explains the logic used to move from research findings to specific policy recommendations. First, it explains the process of creating the first version of the recommendations, which was based solely on the project’s research findings. It explains the process of drafting the first version of the policy recommendations and how the decision about the four major topical foci was made. The second section explains how relevant interlocutors (policy makers and stakeholders) were involved in the process of revising the earlier versions of the recommendations. The third and final section describes how some of the interlocutors were additionally recruited for interviews and how some other perspectives from people who were not directly involved in this process were included in the final version of the recommendations.
Bosnia and Herzegovina: From Coexistence to Unresolvable Past?
Authors: Zupančič Rok , Kočan Faris , Andresen Kenneth , Bojarska Katarzyna , Dacosta Ricardo , Farrell Seamus , Fiedler Anke , Hoxha Abit , Ioannidis Nikandros , Kirk Niamh , Martín Irene , Milioni Dimitra L. , Panos Dionysis , Paradés Marta , Rawski Tomasz , Triga Vasiliki , Vučko Tjaša
Published: June 2024

This chapter offers a non-exhaustive list of recommendations for Bosnia and Herzegovina. First, it explains a methodological approach to writing these specific recommendations. Second, it outlines the role of the European Union in addressing the contested histories in Bosnia and Herzegovina though different time periods: during the war (1992–5), post-war (1995–2008) and from the signing of the Stabilisation and Association Agreement onward. Third, it offers possible policy recommendations for addressing some of the current challenges arising from the country’s troubled past that could take the stabilization of this Southeastern European country a step further.
Kosovo: Troubled Past and Its Path to Moving On
Authors: Zupančič Rok , Kočan Faris , Andresen Kenneth , Bojarska Katarzyna , Dacosta Ricardo , Farrell Seamus , Fiedler Anke , Hoxha Abit , Ioannidis Nikandros , Kirk Niamh , Martín Irene , Milioni Dimitra L. , Panos Dionysis , Paradés Marta , Rawski Tomasz , Triga Vasiliki , Vučko Tjaša
Published: June 2024

This chapter starts with a short historic overview of Kosovo’s troubled past, with a special emphasis on actions during the 1990s and relationship between Kosovo Serbs and Kosovo Albanians. It explains the methodology and data collection for this chapter and gives detailed information about the interlocutors that cooperated in the discussions. It emphasizes also the limits to the chapter, namely the small number of respondents from political representatives in the EU in Kosovo and lack of Kosovo Serbians’ cooperation. Furthermore, this chapter explains the background of the EU’s approach to the troubled past in Kosovo, the process of EU integration and Europeanization and gives an assessment of the status quo. In a similar way as other chapters it gives a non-exclusive list of policy recommendations for Kosovo in four areas – history, media, politics, and arts and culture.
Germany: The Wall is Dead, Long Live the Wall!?
Authors: Zupančič Rok , Kočan Faris , Andresen Kenneth , Bojarska Katarzyna , Dacosta Ricardo , Farrell Seamus , Fiedler Anke , Hoxha Abit , Ioannidis Nikandros , Kirk Niamh , Martín Irene , Milioni Dimitra L. , Panos Dionysis , Paradés Marta , Rawski Tomasz , Triga Vasiliki , Vučko Tjaša
Published: June 2024

The chapter aims to provide an impetus for rethinking the (post-)socialist practice of remembrance in Germany. First, it provides an overview of the data on which the further explanations are built. The following section considers the role of the European Union in East Germany and how the European Union deals with (post-)socialist memory. It explains also how East Germany struggles with its integration in the European Community and later in the European Union and what role does the socialist remembrance play. How the theoretical approach of agonistic memory can be implemented in concrete terms is discussed in the following section by presenting policy recommendations for action in four areas – history, media, politics, and arts and culture.
Ireland beyond Ethnopolitics: Recommendations for All-Island Integration
Authors: Zupančič Rok , Kočan Faris , Andresen Kenneth , Bojarska Katarzyna , Dacosta Ricardo , Farrell Seamus , Fiedler Anke , Hoxha Abit , Ioannidis Nikandros , Kirk Niamh , Martín Irene , Milioni Dimitra L. , Panos Dionysis , Paradés Marta , Rawski Tomasz , Triga Vasiliki , Vučko Tjaša
Published: June 2024

This chapter begins with a brief discussion of the methodological considerations that are similar through all chapters. It then moves on to discuss the existing EU policy responses to the conflict in Northern Ireland from a historical perspective, corresponding to the different phases, starting with the Civil Rights period (1968–72), the Troubles (1973–98), the key event of the Good Friday Agreement (1998–2016) and concluding with the current phase of the fraught Brexit negotiations (2016–). Having set the context, the fourth section discusses the four key policy areas, laying out a series of policy proposals.
Conclusion
Authors: Zupančič Rok , Kočan Faris , Andresen Kenneth , Bojarska Katarzyna , Dacosta Ricardo , Farrell Seamus , Fiedler Anke , Hoxha Abit , Ioannidis Nikandros , Kirk Niamh , Martín Irene , Milioni Dimitra L. , Panos Dionysis , Paradés Marta , Rawski Tomasz , Triga Vasiliki , Vučko Tjaša
Published: June 2024

The concluding chapter summarizes the gist of policy recommendations and looks for similarities across case studies. It also pinpoints and discusses the specificities of each case study’s troubled pasts. These policy recommendations, which could also be understood as strategies for transformational policy reforms in four investigated areas, are developed to reflect upon the possible strategies for dealing with the troubled pasts of different countries. In doing so, the recommendations and strategies proposed are grounded on the analysis of mnemonical and historical trajectories to understand how different types of discourses (for example, oral and official history, journalistic-led discourses, political and civil society-led discourses) on past conflicts inform the present and how those discourses are reproduced, negotiated and (re)appropriated amidst the European integration process and an ever-closer Union among peoples.
Democracy and the Public Sphere
Authors: Trenz Hans-Jörg
Published: June 2024

The malfunctions of the contemporary media and the public sphere and its disruptive effects on democracy, social order and individual well-being are among the most popular and controversial topics in political communication research. How imminent is the threat of the end of democracy, what empirical evidence can be found to support the claim that democracy is under threat, and how can democracy be restored? Discussing these topics in the transformation of contemporary democracies leads the author to an exploration of the changing landscapes of media and public communication, and the creative and destructive ways individuals and social groups make use of new digital and social media in democratic politics. The book seeks to advance a critical theory of the public sphere in the digital age. It provides the reader with a thorough analysis of contemporary transformations of the public sphere and the media, picking up on several challenges, among them the digital transformation of the public sphere and the struggle over privacy and data security, the populist backlash against liberal values, the struggle over democratic representation and the phenomenon of post-truth politics during the COVID-19 pandemic. The author collects supporting evidence for the thesis of a decline in democracy but avoids jumping to conclusions regarding the end of democracy, instead arguing that the future of democracy depends on the viability of the public sphere as we enter the new digital age.