bluuebunny/crossref_metadata_2025_split huggingface dataset:
Driving digital health transformation in hospitals: a formative qualitative evaluation of the English Global Digital Exemplar programme
Authors: Krasuska Marta , Williams Robin , Sheikh Aziz , Franklin Bryony , Hinder Susan , TheNguyen Hung , Lane Wendy , Mozaffar Hajar , Mason Kathy , Eason Sally , Potts Henry , Cresswell Kathrin 
Published: December 2021

BackgroundThere is currently a strong drive internationally towards creating digitally advanced healthcare systems through coordinated efforts at a national level. The English Global Digital Exemplar (GDE) programme is a large-scale national health information technology change programme aiming to promote digitally-enabled transformation in secondary healthcare provider organisations by supporting relatively digitally mature provider organisations to become international centres of excellence.AimTo qualitatively evaluate the impact of the GDE programme in promoting digital transformation in provider organisations that took part in the programme.MethodsWe conducted a series of in-depth case studies in 12 purposively selected provider organisations and a further 24 wider case studies of the remaining organisations participating in the GDE programme. Data collected included 628 interviews, non-participant observations of 190 meetings and workshops and analysis of 9 documents. We used thematic analysis aided by NVivo software and drew on sociotechnical theory to analyse the data.ResultsWe found the GDE programme accelerated digital transformation within participating provider organisations. This acceleration was triggered by: (1) dedicated funding and the associated requirement for matched internal funding, which in turn helped to prioritise digital transformation locally; (2) governance requirements put in place by the programme that helped strengthen existing local governance and project management structures and supported the emergence of a cadre of clinical health informatics leaders locally; and (3) reputational benefits associated with being recognised as a centre of digital excellence, which facilitated organisational buy-in for digital transformation and increased negotiating power with vendors.ConclusionThe GDE programme has been successful in accelerating digital transformation in participating provider organisations. Large-scale digital transformation programmes in healthcare can stimulate local progress through protected funding, putting in place governance structures and leveraging reputational benefits for participating provider organisations, around a coherent vision of transformation.
Epidemiological methods used in the periodontal health research in military personnel: a systematic review
Authors: Bárcena García Millán , Cobo Plana J M , Rodríguez Cagiao G , Arcos González P I 
Published: December 2021

IntroductionPeriodontal disease is a prevalent pathology in military personnel worldwide. The objective is to analyse the methodological features of periodontal health research performed in military personnel in their home countries.MethodsA PRISMA systematic review of literature was carried out in PubMed, EMBASE and Web of Science databases on military periodontal health studies. Study design type, language, publication date, year, country, size and sample selection, age, sex, military, diagnostic procedure, examiners, periodontal, gingival and oral hygiene index were extracted.ResultsEighty-eight out of 5355 studies found were selected, published between 1921 and 2020, with samples ranging from 52 to 16 869 individuals, generally not randomised, and consisting mainly of men with a mean age of 25 years. Predominant studies were cross-sectional descriptive studies, carried out in the Army, on American military personnel, and in the English language. Most of the studies used the WHO periodontal probe handled by two or more examiners. The Löe and Silness gingival index and the Silness and Löe plaque index were the most used indexes to assess gingival condition and oral hygiene, respectively. Community Periodontal Index of Treatment Needs was the most widely used periodontal index.ConclusionsResearch on periodontal health carried out in military populations from the 1920s to the present has been performed from an almost exclusively descriptive approach. Issues such as the characteristics and representativeness of the samples, the epidemiological design and the different gingival-periodontal indexes used may limit the comparability of the study results.
Patterns of healthcare utilisation in children and young people: a retrospective cohort study using routinely collected healthcare data in Northwest London
Authors: Beaney Thomas , Clarke Jonathan , Woodcock Thomas , McCarthy Rachel , Saravanakumar Kavitha , Barahona Mauricio , Blair Mitch , Hargreaves Dougal S 
Published: December 2021

ObjectivesWith a growing role for health services in managing population health, there is a need for early identification of populations with high need. Segmentation approaches partition the population based on demographics, long-term conditions (LTCs) or healthcare utilisation but have mostly been applied to adults. Our study uses segmentation methods to distinguish patterns of healthcare utilisation in children and young people (CYP) and to explore predictors of segment membership.DesignA retrospective cohort study.SettingRoutinely collected primary and secondary healthcare data in Northwest London from the Discover database.Participants378 309 CYP aged 0–15 years registered to a general practice in Northwest London with 1 full year of follow-up.Primary and secondary outcome measuresAssignment of each participant to a segment defined by seven healthcare variables representing primary and secondary care attendances, and description of utilisation patterns by segment. Predictors of segment membership described by age, sex, ethnicity, deprivation and LTCs.ResultsParticipants were grouped into six segments based on healthcare utilisation. Three segments predominantly used primary care, two moderate utilisation segments differed in use of emergency or elective care, and a high utilisation segment, representing 16 632 (4.4%) children accounted for the highest mean presentations across all service types. The two smallest segments, representing 13.3% of the population, accounted for 62.5% of total costs. Younger age, residence in areas of higher deprivation and the presence of one or more LTCs were associated with membership of higher utilisation segments, but 75.0% of those in the highest utilisation segment had no LTC.ConclusionsThis article identifies six segments of healthcare utilisation in CYP and predictors of segment membership. Demographics and LTCs may not explain utilisation patterns as strongly as in adults, which may limit the use of routine data in predicting utilisation and suggest children have less well-defined trajectories of service use than adults.
Acquired HIV drug resistance among children and adults receiving antiretroviral therapy in Tanzania: a national representative survey protocol
Authors: Rugemalila Joan , Kamori Doreen , Maokola Werner , Mizinduko Mucho , Barabona Godfrey , Masoud Salim , Mlunde Linda B , Mutagonda Ritah Francis , Ruhago George , Mushi Jeremiah , Sambu Veryeh , Ueno Takamasa , Mutayoba Beatrice , Njau Prosper , Nagu Tumaini , Aboud Said , Sunguya Bruno F 
Published: December 2021

IntroductionTanzania is making an enormous effort in scaling-up of antiretroviral therapy (ART). However, people living with HIV (PLHIV) continue to succumb to the challenge of drug resistance. Evidence on drug resistance for a national survey is unavailable in Tanzania. Therefore, we sought to assess viral suppression (vs) rates and magnitude of acquired drug resistance (ADR) among PLHIV.Methods and analysisA national survey will be conducted from 26 July to 29 October 2021 in 22 regions, recruiting 2160 participants. These will include adults on ART for 9–15 months and ≥48 months and children on ART for 9–15 months and ≥36 months. A standardised questionnaire will capture participants’ demographic and clinical data. Plasma and dried blood spot will be prepared for viral load testing and drug resistance genotyping. Statistical analyses to determine the burden of ADR, characteristics and factors associated therewith will be done using STATA V.15.Ethics and disseminationEthical approval has been obtained from the National Health Research Ethics Committee of Tanzania (NIMR/HQ/R.8a/Vol.IX/3432). Appropriate participant informed consent or parental consent and assent will be obtained. Dissemination will include a survey report, conference presentations, policy briefs and peer-reviewed publications.
Killing efficacy of a new hypothermic corneal storage medium against the micro-organisms frequently found in human donor cornea intended for transplantation
Authors: Giurgola Laura , Gatto Claudio , Honisch Claudia , Rossi Orietta , Ragazzi Eugenio , D'Amato Tothova Jana 
Published: December 2021

ObjectiveTo study the in vitro killing efficacy of Kerasave (AL.CHI.MI.A Srl), a medium provided with amphotericin B tablet for hypothermic storage of human donor corneas, against relevant contaminants associated with postkeratoplasty infections.Methods and AnalysisThe antimicrobial activity of Kerasave was determined after 0, 3 and 14 days of incubation at 2°C–8°C, inoculating Kerasave and the control medium with 105–106colony forming units (CFU) ofCandida albicans(CA),Fusarium solani(FS),Aspergillus brasiliensis(AB),Staphylococcus aureus(SA),Enterococcus faecalis(EF),Bacillus subtilis spizizenii(BS),Pseudomonas aeruginosa(PA),Enterobacter cloacae(EC) andKlebsiella pneumoniae(KP). Log10reductions at different time intervals were determined by assessing the number of viable CFU using the serial dilution plating technique.ResultsAfter 3 days, Kerasave induced the highest log10decrease in the concentrations of KP, PA, CA and EC (5.37, 4.15, 2.97 and 2.67, respectively; all p<0.001). The log10decreases of SA and EF were 2.27 and 2.11, respectively (all p<0.001). The lowest log10decrease was observed in BS, AB and FS concentrations (0.25, 0.30 and 0.67, respectively; p<0.001 for BS and AB and p=0.004 for FS). After 14 days, the microbial count of CA, FS, SA, EF, PA and EC further decreased (p=0.006 for FS; p<0.001 for the others).ConclusionKerasave effectively reduced or kept unchanged the microbial concentration of almost all tested strains after 3 days. Thus, this novel medium represents a valuable tool to control the microbial contamination of human donor corneas during hypothermic storage for up to 14 days before transplantation.
New solution generating algorithm for isotropic static Einstein-Gauss-Bonnet metrics
Authors: Maharaj Sunil D. , Hansraj Sudan , Sahoo Parbati 
Published: December 2021

AbstractThe static isotropic gravitational field equation, governing the geometry and dynamics of stellar structure, is considered in Einstein–Gauss–Bonnet (EGB) gravity. This is a nonlinear Abelian differential equation which generalizes the simpler general relativistic pressure isotropy condition. A gravitational potential decomposition is postulated in order to generate new exact solutions from known solutions. The conditions for a successful integration are examined. Remarkably we generate a new exact solution to the Abelian equation from the well known Schwarzschild interior seed metric. The metric potentials are given in terms of elementary functions. A physical analysis of the model is performed in five and six spacetime dimensions. It is shown that the six-dimensional case is physically more reasonable and is consistent with the conditions restricting the physics of realistic stars.
Is higher education an engine of opportunity, or a perpetuator of privilege?
Authors: Guzdial Mark 
Published: December 2021

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Mark Guzdial considers the goals of computer science education and the role(s) of educators within that.
Endoscopic Delivery Method Using a Retrieval Net for Patients with Small-Bowel Capsule Endoscopy Stagnation in the Stomach
Authors: Sumioka Akihiko , Oka Shiro , Tsuboi Akiyoshi , Hirata Issei , Iio Sumio , Tanaka Hidenori , Yamashita Ken , Kotachi Takahiro , Yuge Ryo , Urabe Yuji , Tanaka Shinji 
Published: December 2021

With the increasing use of capsule endoscopy (CE), screening tests for the small bowel can be performed with minimal invasiveness. However, occasionally, the entire small bowel cannot be observed because of decreased peristalsis of the stomach. For such cases, we perform delivery of CE by an endoscope. We retrospectively examined the usefulness of the endoscopic delivery method using a retrieval net for patients with CE stagnation in the stomach. From 2,270 patients who underwent small-bowel CE at Hiroshima University Hospital from January 2013 to January 2020, 29 consecutive patients (1.3% of the total number) in whom the small bowel could not be observed due to CE stagnation in the stomach at the time of the initial CE underwent the endoscopic delivery method using a retrieval net for secondary small-bowel CE. This study included 16 male (55%) and 13 female (45%) patients with a mean age of

69.2
±
13.2

years

. 11 patients (38%) had a history of gastrointestinal surgical resection. The entire small bowel could be observed in 19 patients (66%), and CE reached the terminal ileum in the remaining patients. A history of gastrointestinal surgical resection was significantly more frequent in the group where the entire small bowel could not be observed. The rate of small-bowel lesion detection was 55% (16/29). There were no adverse events associated with our endoscopic delivery method. Thus, the endoscopic delivery method using a retrieval net for patients with initial CE stagnation in the stomach may be safe and useful for the detection of small-bowel lesions.
Activation of PI3K/AKT Pathway Is a Potential Mechanism of Treatment Resistance in Small Cell Lung Cancer
Authors: Jin Ying , Chen Yamei , Tang Huarong , Hu Xiao , Hubert Shawna M. , Li Qian , Su Dan , Xu Haimiao , Fan Yun , Yu Xinmin , Chen Qixun , Liu Jinshi , Hong Wei , Xu Yujin , Deng Huan , Zhu Dapeng , Li Pansong , Gong Yuhua , Xia Xuefeng , Gay Carl M. , Zhang Jianjun , Chen Ming 
Published: December 2021

AbstractPurpose:Here, we have investigated treatment resistance mechanisms in small cell lung cancer (SCLC) by focusing on comparing the genotype and phenotype in tumor samples of treatment-resistant and treatment-sensitive SCLC.Experimental Design:We conducted whole-exome sequencing on paired tumor samples at diagnosis and relapse from 11 patients with limited-stage (LS)-SCLC and targeted sequencing of 1,021 cancer-related genes on cell-free DNA at baseline and paired relapsed samples from 9 additional patients with LS-SCLC. Furthermore, we performed label-free mass spectrometry–based proteomics on tumor samples from 28 chemo-resistant and 23 chemo-sensitive patients with extensive-stage (ES)-SCLC. The main findings were validated in vitro in chemo-sensitive versus chemo-resistant SCLC cell lines and analyses of transcriptomic data of SCLC cell lines from a public database.Results:Genomic analyses demonstrated that at relapse of LS-SCLC, genes in the PI3K/AKT signaling pathway were enriched for acquired somatic mutations or high-frequency acquired copy-number variants. Pathway analysis on differentially upregulated proteins from ES-SCLC cohort revealed enrichment in the HIF-1 signaling pathway. Importantly, 7 of 62 PI3K/AKT pathway genes containing acquired somatic copy-number amplifications were enriched in HIF-1 pathway. Analyses of transcriptomic data of SCLC cell lines from public databases confirmed upregulation of PI3K/AKT and HIF-1 pathways in chemo-resistant SCLC cell lines. Furthermore, chemotherapy-resistant cell lines could be sensitive to PI3K inhibitors in vitro.Conclusions:PI3K/AKT pathway activation may be one potential mechanism underlying therapeutic resistance of SCLC. This finding warrants further investigation and provides a possible approach to reverse resistance to chemo/radiotherapy.
“But Such a Mind, Mak’st God Thy Guest”
Authors: Hrdlicka Steven 
Published: December 2021

Abstract
Ben Jonson’s Eupheme poems and Anthony van Dyck’s portrait of Venetia Digby as Prudence have often been seen as art works fiercely at odds, and that particularly Jonson’s overall brash dismissal of the visual arts is epitomized in his poems in praise of Venetia’s life. Yet ample evidence within Eupheme supports the idea that not only are Jonson’s poems in peculiar ekphrastic conversations with Van Dyck’s painting but that Jonson conceives of the ekphrasis as a device for guiding viewers and readers into rare contemplative poetic spaces. The nature of the interplay between Van Dyck’s painting and Jonson’s poems shares similarities to how Jonson conceived of the courtly masque as a cooperative, unitive experience of visual and verbal elements. In addition, the influence of emblems of Alciato on Jonson’s poetry is instructive in this regard, as these emblems exhibit a cooperative interplay between discrete visual and verbal (body and soul) elements. Issues arising from the artistic cooperative interplay between the body and the soul are linked to the Catholic theology of prudence through the subject of both Jonson and Van Dyck’s works. Specific Catholic contexts hitherto not considered are suggested for both the painting and poems, and especially Jonson’s poem “To My Muse” (the last poem in Eupheme), but these theological contexts are also established in relation to the two titles of Jonson’s poems, which take for their subject Venetia’s body and mind. Furthermore, various loose ends such as the dating of Van Dyck’s painting and the idea that Sir Kenlem had commissioned it to reconstruct Venetia Digby’s reputation are brought up and considered throughout the essay with an eye to these contexts.
Medicine, God, and the Unseen in Eleventh/Seventeenth-Century Morocco
Authors: Stearns Justin 
Published: December 2021

Abstract
In the late seventeenth century, the head of the Salihiyya Sufi lodge in the far south of Morocco, Abu al-ʿAbbas Sidi Ahmad al-Salihi al-Dar‘i (d. 1144/1731), wrote a poem of over a thousand lines on medicine, a long composition that went on to enjoy great popularity. The Worthy Gift of Medicine (al-Hadiya al-maqbula fi l-tibb) drew on a wide range of sources, including the Arab-Galenic tradition and Prophetic medicine, and in the fashion of the time, al-Salihi wrote a long commentary to fully explain it. Al-Salihi’s medical writings thus provide a productive entry point into the nature of medical writing and practice in early modern Morocco, as well as the historiographical narratives that have structured the ways in which they have been studied.
Beyond the Duality of Normativity and Pragmatism
Authors: Grimmel Andreas , Gurol Julia 
Published: December 2021

Abstract
One of the EU’s key foreign policy objectives is to promote the values enshrined in its treaties, such as democracy, the rule of law and human rights. The EU’s self-conception of being a “rule maker” rather than a “rule taker” in international relations, however, is increasingly contested both by internal (e.g., democratic backsliding or a general tendency towards nationalist politics) as well as external challenges (e.g., the return of bilateralism or the rise of new actors). China’s Belt and Road Initiative (bri) is often understood as the most serious opposition on the external side to the EU’s model of international cooperation and global governance, in that it promotes a pragmatic instead of a norm-based approach, at least at first glance. The Chinese foreign policy model that the bri reflects, explicitly favours open membership, flexibility and economic gains over multilateral institutions and norm-based action. By drawing on original interviews and analysing central policy documents, this article shows how the juxtaposition of normativity and pragmatism has shaped the political and academic discourse on the EU’s foreign policy and idea of global governance. It argues that this duality of normativity versus pragmatism is misleading because it overlooks the fact that the EU and China both (a) constitute the framework for a certain practice and (b) are rooted in practice. Drawing on Kagan’s cultural thesis of foreign policy, it questions the real meaning of this juxtaposition and applies a practice-based reading to the EU’s and China’s modes of foreign policy making. The article further shows that scrutinising foreign policy through the prism of practice can provide a more context-sensitive and encompassing understanding of how the EU and China construct their foreign policies as well as of possible conflicts that arise from them.
The Treatment of Cultural Services in Latin American Countries’ Trade Agreements
Authors: Gagné Gilbert , Ducasse Delphine 
Published: December 2021

Abstract
Cultural products (including goods and services) encompass visual, performing and literary arts as well as newspapers, magazines, books, movies, video and music recordings, radio and television, and now multimedia. To the extent that they are associated with the cultural identity of various States, their treatment in international trade has been debated as to whether, or the extent to which, they should be exempted from trade regulations. The proliferation of preferential trade agreements (PTAs) has further complexified this debate. The article summarizes the provisions relating to cultural services in Latin American PTAs and discusses the scope of these provisions, notably in light of the cultural policy measures involved and States’ ability to conduct cultural policies. The focus is on Chile, Colombia, Mexico and Peru as these are the leading countries in the negotiation of PTAs in Latin America as regards the number of agreements and the scope of cultural provisions.
Does International Law Need a Conscience? Evaluating the India–South Africa Proposal to Suspend TRIPS Obligations and the COVID-19 Vaccines
Authors: Thampapillai Dilan , Wall Sam 
Published: December 2021

Abstract
There is undoubtedly a consensus within the international community that ‘vaccine nationalism’ is an undesirable state of affairs. However, states are self-interested actors and in the absence of constraints imposed by international economic law this pursuit of rational self-interest is likely to result in an outcome that is unjust on a global scale. The recent proposal by India and South Africa to suspend TRIPS obligations for the duration of the COVID-19 pandemic has been rejected within the WTO. This proposal constitutes a recognition of the inadequacies surrounding the TRIPS compulsory licensing scheme. Yet, the immersion of intellectual property law within international investment law together with the proliferation of free trade agreements containing TRIPS-plus obligations would likely have made such a proposal unworkable. We argue that the fundamental problem is that the TRIPS Agreement lacks a defined concept of conscience that governs both its operation and interpretation. Such a principle exists in the common law within the field of private law. The principle, in its various doctrinal iterations, navigates the tensions between different parties while serving an underlying purpose of justice within the common law. It has much to offer international intellectual property law.