The public sector is facing significant challenges regarding public services provision, including declination of users' trust and limited resources. An alternative approach to traditional public ...service provision with the potential to address these challenges is the co-creation of public services. Co-creation promises to foster innovative solutions to provide high-quality services that respond to users' needs. Considering this background, we aim at critically exploring public service co-creation via a scoping review, employing the PRISMA-ScR method. Our review focuses on 25 empirical studies out of 75 analyzed articles that examine the implementation of co-creation of (digital) public services and investigates how the empirical literature portrays the concept of public service co-creation. Our findings primarily suggest that co-creation can be implemented in a wide range of sectors and settings, to improve public services and to foster innovation, throughout the whole public service cycle, using a variety of digital, analog and hybrid co-creation tools and strategies. Yet, our review has also shown that there is still an implementation gap that needs to be bridged between knowing and doing in the context of public services co-creation in a digital setting.
We analysed changes in mean annual air temperature (MAAT), vegetation and biomass burning on a long and continuous lake-peat sediment record from the Colônia basin, southeastern Brazil, examining the ...responses of a wet tropical rainforest over the last 180 ka. Stronger southern atmospheric circulation up to the latitude of Colônia was found for the penultimate glacial with lower temperatures than during the last glacial, while strengthening of the South American summer monsoon (SASM) circulation started during the last interglacial and progressively enhanced a longer wet summer season from 95 ka until the present. Past MAAT variations and fire history were possibly modulated by eccentricity, although with signatures which differ in average and in amplitude between the last 180 ka. Vegetation responses were driven by the interplay between the SASM and southern circulation linked to Antarctic ice volume, inferred by the presence of a cool mixed evergreen forest from 180 to 45 ka progressively replaced by a rainforest. We report cooler temperatures during the marine isotope stage 3 (MIS 3: 57-29 ka) than during the Last Glacial Maximum (LGM: 23-19 ka). Our findings show that tropical forest dynamics display different patterns than mid-latitude during the last 180 ka.
Tuberculosis (TB) is a leading cause of mortality due to infectious disease, but the factors determining disease progression are unclear. Transcriptional signatures associated with type I IFN ...signalling and neutrophilic inflammation were shown to correlate with disease severity in mouse models of TB. Here we show that similar transcriptional signatures correlate with increased bacterial loads and exacerbate pathology during Mycobacterium tuberculosis infection upon GM-CSF blockade. Loss of GM-CSF signalling or genetic susceptibility to TB (C3HeB/FeJ mice) result in type I IFN-induced neutrophil extracellular trap (NET) formation that promotes bacterial growth and promotes disease severity. Consistently, NETs are present in necrotic lung lesions of TB patients responding poorly to antibiotic therapy, supporting the role of NETs in a late stage of TB pathogenesis. Our findings reveal an important cytokine-based innate immune effector network with a central role in determining the outcome of M. tuberculosis infection.
Objectives
This non‐interventional observational study described the current standard‐of‐care for transplant‐eligible newly diagnosed multiple myeloma (TE‐NDMM) patients in France, Germany, Spain, ...and Italy, and recorded the evolution in regimen adoption in distinct elements of frontline treatment during 2017–2020/2021.
Methods
Clinical information on ongoing (I) or previous (II) TE‐NDMM patients was extracted from the Cancerology database. Proportions of patients receiving regimens in each element and the evolution in regimen adoption were determined for the entire population and each country.
Results
Most common induction regimens among I patients were VRd in France (75.3%) and Spain (44.1%), VTd in Italy (65.2%), and regimens other than VRd/VTd/VCd in Germany. Maintenance was ongoing/planned for 78.3%, 62.3%, 65.2%, and 61.4% patients in France, Germany, Spain, and Italy, respectively. Among II patients, VRd induction increased from 27.0% in 2017 to 65.7% in 2019 in France, remained relatively low in Spain and Germany, and not present in Italy. In Italy and Spain, VTd induction declined from 72.4% and 58.3% in 2017 to 52.8% and 17.3% in 2019, respectively. VCd induction in Germany declined from 85.2% in 2017 to 64.1% in 2019.
Conclusion
The use of bortezomib triplets in induction varied markedly over time and between selected countries.
Argentina is one of the main producers and exporters of grains and oilseeds, ranking third in soybean exports and fourth in barley ones. The 90% of this production occurs within the Argentine Pampas ...region (APR) under rainfed conditions, but its water consumption and pollution has not been studied in depth. Likewise, the link between soil moisture (SM) and Water Footprint (WF) generation is poorly studied at the global level. And yet, SM is a critical factor for the development of rainfed crops. This study aims to evaluate, at plot scale, the role of SM in the generation of the green (WFgreen) and grey (WFgrey) (WF). Additionally, it estimates the WF for rainfed barley and soybean crops in the Southeast of APR, where there are no reference values. Yields, water consumption and nitrogen (N) pollution load were estimated for different campaigns. Field data (weather, crop and production management) recorded in the study plots were used. Results indicated an average WFgreen of 1236 m3/t for soybeans and a WFgreen of 349 m3/t and WFgrey of 547 m3/t for barley. The study highlights the critical role of SM in both WF sub-indicators. Soil water availability, based on the evaporative fraction during critical growth stages, influenced yields and final WFgreen volumes. In addition, there was an effect on N uptake by crops. In the driest barley campaign, WFgrey increased by 234%. Insufficient SM restricted nutrient uptake, reducing yields and increasing N with the potential to leach or runoff. Consequently, it is suggested to adjust the WFgrey methodology incorporating SM fluctuations and unaccounted N losses. The study contributes to understand the WF drivers and highlights the need to assess them accurately. In particular, it aims to reduce the gaps surrounding the water consumption of rainfed crops, thereby supporting resource conservation and grain provisioning efforts.
Display omitted
•Soil water at critical growth stage mainly determines the green water footprint.•Omitting soil moisture underestimates nitrogen loss in grey water footprint.•Nitrogen uptake inhibition in the dry period increases the grey water footprint.•Water footprint variability at the county/plot scale is driven by soil moisture.•Plot-scale studies help to improve water footprint calculations.
The verb
to like
has fallen repeatedly under the gaze of scholars. One aspect which has stimulated vigorous discussion is its original use in impersonal constructions and its later change of argument ...structure along with the disappearance of impersonals from English. Nonetheless, evidence from current informal English shows that
like
is now used in constructions which bear a close resemblance to the older impersonals, although always displaying alternative spelling variants, especially
likey
. This paper seeks to further our understanding of the verb
to like
, focusing specifically on these new constructions. To this end I will use
likey
as a generic label to refer to such new uses and constructions, regardless of variations in spelling (unless otherwise stated). Using data from the
Corpus of Historical American English
and
iWeb Corpus
, the study will seek to answer the following research questions:
RQ1.
What are the morpho-syntactic features of the expression ‘me (no) likey’ in Present-Day English?
RQ2.
What is the origin of the sequence ‘me (no) likey’?
RQ3.
Where do phrasal patterns with
likey
fall on the continuum of idiomaticity (Michaelis, 2017)?
Purpose
By fusing knowledge-based theory, organizational learning theory and dynamics capability theory, this study aims to explore, on the one hand, the linkage between exploration, sensing and ...tacit knowledge, and on the other hand, exploitation, seizing and explicit knowledge. Thereby, it argues that not only tacit knowledge but also explicit knowledge contributes to competitive advantage for firms. This study also investigates how knowledge transforms into profitability.
Design/methodology/approach
The conceptual model is tested with a study sample of 153 industrial organizations using structural equation modelling.
Findings
Results confirm the importance of both tacit and explicit knowledge for achieving sustainable competitive advantages. Furthermore, both tacit and explicit knowledge transform into profitability, both directly and through product innovation and customer centricity which play partial mediating roles.
Practical implications
Explicit knowledge strategies can be easier to manage, implement and institutionalize than tacit knowledge strategies, which require human component and intervention to succeed. Managers should hence first implement explicit knowledge strategies to gain expeditious results. Further, with the advent of digital technologies and algorithms that can extract deep customer insights and organizational experiences which are highly tacit in nature and codifying the same into explicit knowledge, the importance of explicit knowledge is further enlarged.
Originality/value
By fusing three adjacent theories to establish a robust model specification, this study is able to demonstrate the contribution of explicit knowledge in the firm’s competitive advantages.
•Seventy-nine percent of program directors s agree exposure at the robotic console should be a residency requirement•Sixty-six percent indicate that robotic surgery negatively affects acquisition of ...other skills•Eighty-three percent agree robotic surgery training in residency provides net benefit•Academic programs program directors s had more support for robotic training than independent programs•Sixty-five percent suggest a minimum robotic surgery case requirement of at least 5
Robotic-assisted surgery (RAS) accounts for 15% of general surgery (GS) operations performed and is set to grow in prevalence. Currently, there are no training requirements or standard robotic curricula for GS residents. This study aimed to query GS program directors (PDs) on the necessity, extent, and potential impact of including RAS as a required component of residency training.
Analysis of responses to a 14-question web-based survey.
Survey was distributed to PDs via the Association of Program Directors in Surgery listserv in April and May 2021.
General surgery program directors
Among 140 respondents, 110 (78.6%) agreed that operating at the robotic console should be a GS residency requirement, yet 93 (66.4%) indicated that RAS exposure negatively impacts the acquisition of other necessary skills. Still, 116 (82.9%) agreed that RAS training provided a net benefit to GS residents, PDs at academic programs were more supportive than those at independent programs of RAS console training requirements (68.2% versus 46.7%, p = 0.048). The median response to the ideal proportion of abdominopelvic cases performed by graduation was 20% robotic, 40% laparoscopic, and 35% open. The suggested minimum number of robotic cases that should be performed by graduation was indicated to be 30 cases by 26% of respondents, 20 by 23%, 10 by 12%, 5 by 4%, and “no minimum” by 36%.
There is strong interest among PDs to institute RAS training requirements for GS residents. This study provides PD perspectives to help inform national conversations on whether and to what extent RAS requirements should be included in GS residency training.
New Findings
What is the topic of this review?
This review highlights the central and peripheral mechanisms that alter oxygen transport and utilisation and thereby contribute to exercise limitation ...in people with cystic fibrosis, considering also viable therapeutic targets for intervention.
What advances does it highlight?
Although traditionally considered a respiratory condition, pathological intramuscular and cardiovascular changes in people with cystic fibrosis appear to be key determinants of exercise intolerance up until the later stages of respiratory disease. Even young, habitually active patients with normal lung function experience multisystemic abnormalities, which play a role in exercise intolerance.
Cystic fibrosis (CF) is a complex condition, commonly associated with exercise limitation. The mechanisms responsible for this in CF are of interest, given that lower aerobic fitness is associated with an increased risk of being hospitalised with pulmonary exacerbation, a poorer quality of life and a poorer prognosis. Pathophysiological changes in lung function are considered central to CF, and may contribute to exercise limitation. However, it is now clear that the pathogenesis of exercise limitation in this population is multifactorial, with alterations in cardiovascular, muscle and pulmonary function contributing. Whilst some of these changes are attributable to respiratory disease per se, the CF transmembrane conductance regulator protein is also found in skeletal muscle and the vascular endothelium and can directly alter central and localised oxygen delivery, as well as the ability to effectively extract and utilise oxygen at the myocyte level. Since intense exercise poses considerable challenges to arterial oxygen content and/or blood flow and its supply to the working skeletal muscle, evaluating the exercise physiology of people with CF has helped us understand the mechanisms underlying exercise intolerance. Through several investigations over recent years, we have collectively demonstrated that people with CF exhibit reduced skeletal muscle oxygen extraction and utilisation during exercise, with a lesser contribution from haemodynamic or chronotropic mechanisms. Taken together, our findings highlight the importance of targeting mechanisms of skeletal muscle oxygen utilisation in CF to improve exercise tolerance and we offer potential therapeutic interventional strategies.
PDF
