bluuebunny/crossref_metadata_2025_split huggingface dataset:
Improving inpatient paediatric de-labelling of allergies to beta-lactams: a quality improvement study
Authors: Wong Jacqueline , Atkinson Adelle , Timberlake Kathryn , Beck Carolyn E , Maguire Bryan , Science Michelle 
Published: April 2024

ObjectiveTo evaluate the implementation of an antimicrobial stewardship programme-led inpatient beta-lactam allergy de-labelling programme using a direct oral provocation test (OPT).DesignOne-year quality improvement study using a before–after design.SettingFree-standing tertiary care paediatric hospital.PatientsPatients with a reported beta-lactam allergy admitted to the paediatric medicine inpatient unit.InterventionsFollowing standardised assessment and risk stratification of reported symptoms, patients with a low-risk history were offered an OPT. Beta-lactam allergy labels were removed if a reported history was considered non-allergic or after successful OPT.Main outcome measuresRemoval of inappropriate beta-lactam allergy labels.Results80 patients with 85 reported beta-lactam allergies were assessed. Median age was 8.1 years (IQR 4.8–12.9) and 34 (42%) were female. The majority (n=55, 69%) had an underlying medical condition. Amoxicillin was the most reported allergy (n=25, 29%). Reported reactions were primarily dermatological (n=65, 77%). Half of participants (n=40) were ineligible for OPT, with equal proportions due to clinical reasons or the nature of the reported reaction. Of the 40 eligible patients, 28 patients (70%) were de-labelled either by history alone (n=10) or OPT (n=18). All OPTs were successful. De-labelling allowed five additional patients (11% of those receiving antibiotics) to receive the preferred beta-lactam. Including patients who were subsequently assessed in the allergy clinic, almost half of all evaluated patients were de-labelled (n=37, 46%).ConclusionsAn antimicrobial stewardship programme-led programme using a direct OPT was feasible and safe for expanding beta-lactam allergy de-labelling to paediatric patients admitted to the paediatric medicine inpatient unit.
Is a smartphone application (BlueIce) acceptable and safe for university students who self-harm: an open study
Authors: Cliffe Bethany , Moore Emma , Whittle Kathryn , Stallard Paul 
Published: April 2024

BackgroundMany university students self-harm but few receive support. Smartphone apps have been identified as acceptable sources of support for students who self-harm, but the use of supportive self-harm apps is yet to be explored in this population.ObjectiveThis study sought to explore the acceptability and safety of a specific app (BlueIce) for university students who self-harm.MethodsThis was an exploratory, mixed methods study with 15 university students attending university well-being services with self-harming thoughts and/or behaviours. BlueIce was offered alongside the face-to-face support provided by the well-being service. Self-harming thoughts and behaviours, coping self-efficacy, and symptoms of anxiety and depression were measured before and after using BlueIce for 6 weeks. Follow-up interviews were also undertaken to explore how students perceived BlueIce in more depth.ResultsFollowing app use, there were statistically significant reductions in symptoms of anxiety (baseline M 12.47, SD 4.42; follow-up M 10, SD 4.16) t(14)=2.26, p=0.040, d=0.58 and depression (baseline M 16.5, SD 5.17, follow-up M 12.27, SD 3.66) t(13)=5.50, p<0.001, d=1.47. Qualitative findings showed participants found BlueIce to be acceptable, safe and helpful, and reported that they were more able to cope with difficult feelings and better understand their self-harm triggers following use of the app.ConclusionBlueIce was an acceptable, safe and helpful source of support for university students struggling with self-harm thoughts and/or behaviours. This builds on previous findings with adolescents and suggests that BlueIce could be a particularly acceptable and helpful resource for university students.
Reduce intraoperative albumin utilisation in cardiac surgical patients: a quality improvement initiative
Authors: Savadjian André J , Taicher Brad M , La Jong ok , Podgoreanu Mihai , Miller Timothy E , McCartney Sharon , Raghunathan Karthik , Shah Nirav , Mamoun Negmeldeen 
Published: April 2024

BackgroundAlbumin continues to be used routinely by cardiac anaesthesiologists perioperatively despite lack of evidence for improved outcomes. The Multicenter Perioperative Outcomes Group (MPOG) data ranked our institution as one of the highest intraoperative albumin users during cardiac surgery. Therefore, we designed a quality improvement project (QIP) to introduce a bundle of interventions to reduce intraoperative albumin use in cardiac surgical patients.MethodsOur institutional MPOG data were used to analyse the FLUID-01-C measure that provides the number of adult cardiac surgery cases where albumin was administered intraoperatively by anaesthesiologists from 1 July 2019 to 30 June 2022. The QIP involved introduction of the following interventions: (1) education about appropriate albumin use and indications (January 2021), (2) email communications reinforced with OR teaching (March 2021), (3) removal of albumin from the standard pharmacy intraoperative medication trays (April 2021), (4) grand rounds presentation discussing the QIP and highlighting the interventions (May 2021) and (5) quarterly provider feedback (starting July 2021). Multivariable segmented regression models were used to assess the changes from preintervention to postintervention time period in albumin utilisation, and its total monthly cost.ResultsAmong the 5767 cardiac surgery cases that met inclusion criteria over the 3-year study period, 16% of patients received albumin intraoperatively. The total number of cases that passed the metric (albumin administration was avoided), gradually increased as our interventions went into effect. Intraoperative albumin utilisation (beta=−101.1, 95% CI −145 to −56.7) and total monthly cost of albumin (beta=−7678, 95% CI −10712 to −4640) demonstrated significant decrease after starting the interventions.ConclusionsAt a single academic cardiac surgery programme, implementation of a bundle of simple and low-cost interventions as part of a coordinated QIP were effective in significantly decreasing intraoperative use of albumin, which translated into considerable costs savings.
Early integration of basic palliative care in cancer: scoping review of cross-sectorial models – components, facilitators, barriers
Authors: Swenne Johanna Ingrid Elin , Hansen Torben Frøstrup , Nissen Ricko Damberg , Steffensen Karina Dahl , Stie Mette , Søndergaard Jens , Jensen Lars Henrik 
Published: April 2024

BackgroundShared care between oncology specialists and general practice regarding the delivery of palliative care (PC) is necessary to meet the demands for a cohesive PC. The primary objective of this study is to investigate models of cross-sectorial integration between primary care and oncology specialists that have been developed to promote early and basic PC and factors influencing the process.MethodA scoping review was conducted using publications dated up until April 2023. Searches were conducted in MEDLINE, CINAHL, Embase, Web of Science and ProQuest Dissertations and Theses. Complementary searches were performed via reference lists and grey literature. Explicit early PC models aimed at patients with cancer aged ≥18 years with healthcare professionals from primary care and oncology constituted the inclusion criteria. The screening of the papers was performed independently by two reviewers. The reporting adheres to the extension for scoping reviews of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses.ResultsThe search provided 5630 articles of which six met the eligibility criteria, each describing a different model of early and cross-sectorial, integrated PC. 12 active components were identified. Education of staff as well as good communication and cooperation skills are essential factors to succeed with integrated, early PC.ConclusionIntegration of PC between general practice and oncology specialists has potential. The components of basic PC have been established. Factors known to influence the process are trust, communication and a common goal. Further research is required into strategies for approaching different levels of integration.
Mild Hypoxia Accelerates Cerebral Cavernous Malformation Disease Through CX3CR1-CX3CL1 Signaling
Authors: Frias-Anaya Eduardo , Gallego-Gutierrez Helios , Gongol Brendan , Weinsheimer Shantel , Lai Catherine Chinhchu , Orecchioni Marco , Sriram Aditya , Bui Cassandra M. , Nelsen Bliss , Hale Preston , Pham Angela , Shenkar Robert , DeBiasse Dorothy , Lightle Rhonda , Girard Romuald , Li Ying , Srinath Abhinav , Daneman Richard , Nudleman Eric , Sun Hao , Guma Monica , Dubrac Alexandre , Mesarwi Omar A. , Ley Klaus , Kim Helen , Awad Issam A. , Ginsberg Mark H. , Lopez-Ramirez Miguel Alejandro 
Published: April 2024

BACKGROUND:
Heterogeneity in the severity of cerebral cavernous malformations (CCMs) disease, including brain bleedings and thrombosis that cause neurological disabilities in patients, suggests that environmental, genetic, or biological factors act as disease modifiers. Still, the underlying mechanisms are not entirely understood. Here, we report that mild hypoxia accelerates CCM disease by promoting angiogenesis, neuroinflammation, and vascular thrombosis in the brains of CCM mouse models.

METHODS:
We used genetic studies, RNA sequencing, spatial transcriptome, micro–computed tomography, fluorescence-activated cell sorting, multiplex immunofluorescence, coculture studies, and imaging techniques to reveal that sustained mild hypoxia via the CX3CR1-CX3CL1 (CX3C motif chemokine receptor 1/chemokine [CX3C motif] ligand 1) signaling pathway influences cell-specific neuroinflammatory interactions, contributing to heterogeneity in CCM severity.

RESULTS:

Histological and expression profiles of CCM neurovascular lesions (

Slco1c1-iCreERT2;Pdcd10
fl/fl
; Pdcd10
BECKO

) in male and female mice found that sustained mild hypoxia (12% O
2
, 7 days) accelerates CCM disease. Our findings indicate that a small reduction in oxygen levels can significantly increase angiogenesis, neuroinflammation, and thrombosis in CCM disease by enhancing the interactions between endothelium, astrocytes, and immune cells. Our study indicates that the interactions between CX3CR1 and CX3CL1 are crucial in the maturation of CCM lesions and propensity to CCM immunothrombosis. In particular, this pathway regulates the recruitment and activation of microglia and other immune cells in CCM lesions, which leads to lesion growth and thrombosis. We found that human CX3CR1 variants are linked to lower lesion burden in familial CCMs, proving it is a genetic modifier in human disease and a potential marker for aggressiveness. Moreover, monoclonal blocking antibody against CX3CL1 or reducing 1 copy of the
Cx3cr1
gene significantly reduces hypoxia-induced CCM immunothrombosis.

CONCLUSIONS:

Our study reveals that interactions between CX3CR1 and CX3CL1 can modify CCM neuropathology when lesions are accelerated by environmental hypoxia. Moreover, a hypoxic environment or hypoxia signaling caused by CCM disease influences the balance between neuroinflammation and neuroprotection mediated by CX3CR1-CX3CL1 signaling. These results establish
CX3CR1
as a genetic marker for patient stratification and a potential predictor of CCM aggressiveness.
Toward a Green Energy System: How Does Carbon Capture,  Utilization,  and Storage Technology Innovation Promote Green Total Factor Productivity?
Authors: Dong Kangyin , Wang Jianda , Zhao Congyu , Taghizadeh-Hesary Farhad , Phoumin Han 
Published: April 2024

Abstract
Using a panel data set from 2007 to 2019, we empirically evaluate the impact of carbon capture, utilization, and storage (CCUS) technology innovation on green total factor productivity (GTFP). The findings show that (1) CCUS technology innovation significantly improves GTFP. (2) CCUS technology innovation significantly contributes to GTFP by promoting industrial structure upgrading and carbon emissions efficiency. (3) Environmental regulation plays a positive moderating role in the nexus between CCUS technology innovation and GTFP. The findings of this paper provide guidance for China to achieve green energy transition and build a green energy system.
Technological Progress and Wage Share of Old Workers
Authors: Park Donghyun , Shin Kwanho 
Published: April 2024

Abstract
Technological progress may be less beneficial for older workers than younger workers. In this paper, we empirically examine the relationship between technological change and the wage share of old workers. More specifically, we look at five different types of technological advancement using data from 30 European and Asian countries at the forefront of global population aging. Our findings indicate that recent technological developments centered on information and communication technology, software, and robots do not adversely affect old workers. One possible explanation is that old workers may be more open to and capable of learning new technologies than widely presumed.
Histories of Ancient Israel: Present State and Future Potential
Authors: Leonard-Fleckman Mahri 
Published: April 2024

Abstract
This review considers the state of historical studies of ancient Israel in light of the publication of two recent books on the subject. While this recent scholarship nuances and advances our understanding of the history of the southern Levant, it also reveals ongoing methodological tensions due to the field’s long-running commitments to post-Enlightenment, European (especially German) approaches to the historical analysis of biblical texts. Simultaneously, these two histories point towards some productive ways in which we might move forward in the study of the history of ancient Israel. These productive potentials include reevaluating our historical methods across specialties and approaches and seeking alternative approaches to history writing that make space for fragmentation, multiplicity, and irresolution.
Jesus the Spirit Baptizer
Authors: Macchia Frank D. 
Published: April 2024

Abstract
In pouring forth the Spirit, Christ fulfills his mission to baptize others “in the Holy Spirit.” In so doing, he also opens himself to history, to his ecclesial and cosmic identity, in a new way, but in a way that is faithful to that which has gone before. Though fundamentally defined by his own sojourn in the Spirit to Pentecost as the divine Son of his Father in flesh, victorious over sin and death, he is now, at Pentecost, to be experienced in contextually diverse ways. Pentecost is therefore the pivot point from the Christ as bearer of the Spirit who gave himself for the salvation of the world to Christ as the one who pours forth the Spirit so as to take humanity in all of its diversity up into the divine communion. In what follows I will attempt to sketch in broad strokes my thoughts on Christology.
The Supply of Digital Authoritarianism to Africa: an Empirical Study
Authors: Achinivu Chibuzo 
Published: April 2024

Abstract
Over the last two decades, there has been a remarkable increase in the practice of digital authoritarianism in Africa. Yet researchers remain divided as to the drivers of this trend, especially as it relates to its international origins. Some scholars have portrayed China as a foreign supply-side driver of the technologies and the practice of digital authoritarianism in Africa. However, others argue that such origins are overstated, contending that little evidence exists for a direct role of China in Africa’s increasing turn towards digital authoritarianism. In this paper, I use a norm diffusion and order project approach to propose and test an innovative theory of China’s strategic supply of its model of digital authoritarianism to Africa. China, I argue, supplies such technologies and expertise to Africa to shape international norms in a manner that favors its geopolitical goals. Consequently, I hypothesize that the more likely an African country is a regional norm diffuser, the more likely it will be that China supplies it with its model of digital authoritarianism. To test this theory, I conduct a statistical panel analysis of African countries for the years 2000–2020. My results confirm my hypothesis and present novel findings that have implications for technology governance, African politics, China’s rise, and China’s strategic contestation of international norms.
Education and Democracy in Sub-Saharan Africa
Authors: Grimmer Lasse 
Published: April 2024

Abstract
The relationship between education and democracy has been empirically researched since the late 1950s, with most evidence stemming from global datasets. Initial results showed no relationship between education and democracy after looking at the within-country estimation. But, as more advanced statistical methods emerged, addressing endogeneity problems of the within-country estimation, a statistically significant relationship between education, measured through average years of total schooling, and democracy appeared. However, all studies have looked at the association broadly, and only a handful have applied this nexus to the context of Sub-Saharan Africa. By creating a new dataset incorporating thirty countries, this study shows that education is statistically significantly associated with democracy in Sub-Saharan Africa. Results are robust to multiple other covariates and mirror the ones reported in the academic literature. This study echoes the continued focus on education, especially in light of recent developments and multiple organisations announcing that democracy declined worldwide.
The Multitude, the People, and Popular Sovereignty: Pufendorf and Locke in Reply to Hobbes
Authors: Harris James 
Published: April 2024

Abstract
In the early iterations of his political thought, The Elements of Law and De Cive, Hobbes proposed a new account of the nature of the people. In Section 2 I describe Pufendorf’s critical response. Pufendorf’s theory of the people is a neglected aspect of the political argument of the De Jure. Just as neglected is Locke’s theory of the people in Two Treatises of Government, though there is better reason for neglect in Locke’s case, in so far as he fails in his major work of political philosophy to present anything resembling a theory of the people at all. In Section 3 I bring Locke’s thinking about the people into clearer focus. In the concluding Section 4 I explore some of the weaknesses of his position.
Curricular Conundrum: The Jesuit Ratio studiorum and Mary Ward’s Attempts to Balance Latin, Prayer, and Lace
Authors: Brown Laura Feitzinger 
Published: April 2024

Abstract
The 1599 Jesuit Ratio Studiorum effectively organized its educational mission. Catholic Englishwoman Mary Ward (1585–1645) adapted the Ratio as she sought to build a new order for women based on the Jesuit rule and open Catholic schools for girls across Europe. Despite remarkable success, she faced increasing opposition from Jesuits and other leaders. Scholars have explored objections raised against her schools; however, little research addresses objections to teaching girls Latin. In this article, I argue that Ward’s attempts to teach Latin ran into subtle cultural complications because of gendered expectations regarding the language’s uses and abuses, conflicts over time devoted to prayer, and parental and societal expectations regarding young women’s acquisition of handwork skills. Exploring these complications helps illuminate not only Ward’s adaptation of the Jesuit approach to teaching but also nuances in her own spirituality, especially regarding the relationship between active and contemplative lives.
Nutritional composition of three edible caterpillars in the Democratic Republic of Congo
Authors: Numbi G.M. , Kambashi B.M. , Bindelle J. , Francis F. , Megido R.C. 
Published: April 2024

Abstract
The role of edible caterpillars in human nutrition is increasingly undeniable, given their contribution to food security, especially in sub-Saharan Africa. However, some local species are almost unknown and the lack of data on their nutritional composition limits the integration of consumption in consumer diets. This article therefore focuses on the nutritional profiles of three edible caterpillar species from DR-Congo: Aegocera rectilinea, Epidonta sp and Imbrasia truncata. Data on protein content and amino acid profiles were discussed, with particular emphasis on threonine, lysine, methionine, cysteine and histidine; fat content and fatty acid profiles were examined, with particular attention to omega-6 and omega-3 fatty acids and the PUFA/SFA ratio; Finally a discussion of essential minerals in insects, with particular emphasis on Fe and Zn, as well as anti-nutritional factors such as phytic acid, oxalates and tannins, which may have a negative effect on the bioavailability of these trace elements were discussed. The results of this study should induce a change in behavior in terms of the valorization of these edible insects as food in DR-Congo, via their popularization through workshops carried out in their production and consumption areas, while encouraging rational harvesting practices with a view to their sustainable use.
Avant-Garde Egypt
Authors: Bru Sascha 
Published: April 2024

Abstract
This article opens with a discussion of contemporary avant-garde art, which according to many critics distinguishes itself by a turn to history, that is by a (seemingly paradoxical) backward-looking stance. Relativizing the ‘newness’ of this turn to history and the past in early twenty-first-century avant-garde art, the article then unearths the early twentieth-century avant-garde’s often neglected fascination with cultures that historically predate that of Europe. Zooming in on the historical avant-garde’s widespread interest in ancient Egypt in particular, the article highlights the “anarcheological impulse” that may well characterize the treatment of the (long-gone) past in all avant-garde exploits, be they early twentieth or twenty-first-century.
The Red Dressing Gown
Authors: Pickard Susan 
Published: April 2024

Abstract
This article explores Beauvoir’s evolving attitude toward aging and old age, specifically the shift from a fear and horror of aging toward a positive acceptance, and links this transformation to the death of her mother. It suggests that Beauvoir resolved her intense and complex relationship with her mother when the latter was dying, replacing melancholia with mourning and abjection with recognition. Escaping from the attraction and fears inherent in the identity of the “dutiful daughter,” henceforth she faced aging with equanimity.
Saving the Unsavable or Self-Translating to Exist? An Investigation into Self-Translation in Sicilian Context
Authors: Kampert Magdalena 
Published: April 2024

Abstract
This article investigates whether self-translation can be a tool of cultural legitimization and contribute to the vitality of minority languages broadly understood, using the example of 21st-century Sicilian poetry. Building on research in biocultural diversity, language maintenance and revitalization, and (self-)translation, the article briefly outlines the issue of language maintenance and the ambivalent role of self-translation in minority-language settings. It then considers the status of Sicilian and its vitality, and analyzes examples of self-translation from Sicilian into Italian in mainstream publishing and social media. The analysis underscores the dynamics of literary production and dissemination, as well as the associated publication practices. The Sicilian context shows that self-translation may be a tool for linguistic sustainability through publication formats that give prominence to minority languages. Bilingual editions and social media, in particular, may offer new opportunities for language maintenance.