bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘Building on shaky ground’—challenges to and solutions for primary care guideline implementation in four provinces in South Africa: a qualitative study
Authors: Kredo Tamara , Cooper Sara , Abrams Amber Louise , Muller Jocelyn , Schmidt Bey-Marrié , Volmink Jimmy , Atkins Salla 
Published: May 2020

ObjectivesClinical guidelines support evidence-informed quality patient care. Our study explored perspectives of South African subnational health managers regarding barriers to and enablers for implementation for all available primary care guidelines.DesignWe used qualitative research methods, including semistructured, individual interviews and an interpretative perspective. Thematic content analysis was used to develop data categories and themes.SettingWe conducted research in four of nine South African provinces with diverse geographic, economic and health system arrangements (Eastern Cape, Western Cape, KwaZulu-Natal, Limpopo). South Africa is a middle-income country with high levels of inequality. The settings represented public sector rural and peri-urban health facilities.ParticipantsTwenty-two participants with provincial and district health management roles, that comprised implementation and/or training on primary care guidelines, were included.ResultsParticipants recommended urgent consideration of health system challenges, particularly financial constraints, impacting on access to the guidelines themselves and to medical equipment and supplies necessary to adhere to guidelines. They suggested that overcoming service delivery gaps requires strengthening of leadership, clarification of roles and enhanced accountability. Participants suggested that inadequate numbers of skilled clinical staff hampered guideline use and, ultimately, patient care. Quality assurance of training programmes for clinicians—particularly nurses—interdisciplinary training, and strengthening post-training mentorship were recommended. Furthermore, fit-for-purpose guideline implementation necessitates considering the unique settings of facilities, including local culture and geography. This requires guideline development to include guideline end users.ConclusionsGuidelines are one of the policy tools to achieve evidence-informed, cost-effective and universal healthcare. But, if not effectively implemented, they have no impact. Subnational health managers in poorly resourced settings suggested that shortcomings in the health system, along with poor consultation with end users, affect implementation. Short-term improvements are possible through increasing access to and training on guidelines. However, health system strengthening and recognition of socio-cultural–geographic diversity are prerequisites for context-appropriate evidence-informed practice.
Population Registry of Esophageal and Stomach Tumours in Ontario (PRESTO): protocol for a multicentre clinical and pathological database including 25 000 patients
Authors: Gupta Vaibhav , Levy Jordan , Allen-Ayodabo Catherine , Amirazodi Elmira , Davis Laura , Li Qing , Mahar Alyson , Coburn Natalie G 
Published: May 2020

IntroductionOesophagogastric cancers carry a high mortality, economic burden and rising incidence. There is a need to monitor and improve care for this disease. Pathologic information is a cornerstone of cancer diagnosis, treatment and prognosis. Few population-based studies combine pathology information and clinical outcomes. The objective of this study is to develop a clinical and pathological database of oesophagogastric cancers to study practice patterns, resource utilisation and clinical outcomes.Methods and analysisThe Population Registry of Esophageal and Stomach Tumours in Ontario (PRESTO) will include all patients with oesophagogastric cancer diagnosed from 2002 onwards within the province of Ontario. We estimate that the sample over the first 14 years of the study will include 26 000 patients. Pathologic information from diagnostic procedures, endomucosal resection specimens and surgical resection specimens is being abstracted into a purpose-built database. Pathology information will be linked to administrative data, which capture baseline demographics, patient-reported symptoms, physician billings, hospital visits, hospital characteristics, geography and vital statistics. The registry will be updated prospectively.Ethics and disseminationEthics approval for this study was obtained from the Sunnybrook Health Sciences Centre Research Ethics Board. The PRESTO database will enable the study of oesophagogastric cancer in Ontario under six themes of inquiry: treatment, surgical outcomes, pathology, survival, health system and resource utilisation and cost. This information will be a valuable addition to the global efforts to understand ways to optimise care for these diseases.
Cohort profile: the Singapore diabetic cohort study
Authors: Luo Miyang , Tan Linda Wei Lin , Sim Xueling , Ng Milly Khiam Hoon , Van Dam Rob , Tai E Shyong , Chia Kee Seng , Tang Wern Ee , Seah Darren EJ , Venkataraman Kavita 
Published: May 2020

PurposeThe diabetic cohort (DC) was set up to study the determinants of complications in individuals with type 2 diabetes and examine the role of genetic, physiological and lifestyle factors in the development of complications in these individuals.ParticipantsA total of 14 033 adult participants with type 2 diabetes were recruited from multiple public sector polyclinics and hospital outpatient clinics in Singapore between November 2004 and November 2010. The first round of follow-up was conducted for 4131 participants between 2012 and 2016; the second round of follow-up started in 2016 and is expected to end in 2021. A questionnaire survey, physical assessments, blood and urine sample collection were conducted at recruitment and each follow-up visit. The data set also includes genetic data and linkage to medical and administrative records for recruited participants.Findings to dateData from the cohort have been used to identify determinants of diabetes and related complications. The longitudinal data of medical records have been used to analyse diabetes control over time and its related outcomes. The cohort has also contributed to the identification of genetic loci associated with type 2 diabetes and diabetic kidney disease in collaboration with other large cohort studies. About 25 scientific papers based on the DC data have been published up to May 2019.Future plansThe rich data in DC can be used for various types of research to study disease-related complications in patients with type 2 diabetes. We plan to further investigate disease progression and new biomarkers for common diabetic complications, including diabetic kidney disease and diabetic neuropathy.
Improving quality of surgical and anaesthesia care at hospital level in sub-Saharan Africa: a systematic review protocol of health system strengthening interventions
Authors: Brima Nataliya , Davies Justine , Leather Andrew JM 
Published: May 2020

IntroductionOver 5 billion people in the world do not have access to safe, affordable surgical and anaesthesia care when needed. In order to improve health outcomes in patients with surgical conditions, both access to care and the quality of care need to be improved. A recent commission on high-quality health systems highlighted that poor-quality care is now a bigger barrier than non-utilisation of the health system for reducing mortality.AimTo carry out a systematic review to provide an evidence-based summary of hospital-based interventions associated with improved quality of surgical and anaesthesia care in sub-Saharan African countries (SSACs).Methods and analysisThree search strings (1) surgery and anaesthesia, (2) quality improvement hospital-based interventions and (3) SSACs will be combined. The following databases EMBASE, Global Health, MEDLINE, CINAHL, Web of Science and Scopus will be searched. Further relevant studies will be identified from national and international health organisations and publications and reference lists of all selected full-text articles. The review will include all type of original articles in English published between 2008 and 2019. Article screening, data extraction and assessment of methodological quality will be done by two reviewers independently and any disputes will be resolved by a third reviewer or team consensus. Three types of outcomes will be collected including clinical, process and implementation outcomes. The primary outcome will be mortality. Secondary outcomes will include other clinical outcomes (major and minor complications), as well as process and implementation outcomes. Descriptive statistics and outcomes will be summarised and discussed. For the primary outcome, the methodological rigour will be assessed.Ethics and disseminationThe results will be published in a peer reviewed open access journal and presented at national and international conferences. As this is a review of secondary data no formal ethical approval is required.PROSPERO registration numberCRD42019125570.
Research progress in the effects of pectus excavatum on cardiac functions
Authors: Liu Caixia , Wen Yunhong 
Published: May 2020

BackgroundPectus excavatum, the most common chest wall deformity in children, accounts for nearly 90% of congenital malformations of chest wall. Initially, both parents and doctors paid more attention to the influence of this deformity on patient appearance and psychology. Following deeper studies of pectus excavatum, researchers found that it also affected cardiac functions. The purpose of this review aims to present recent research progress in the effects of pectus excavatum on cardiac functions.Data sourcesBased on aspects of CT, ultrasound cardiography (UCG) and MRI, all the recent literatures on the influence of pectus excavatum on cardiac function were searched and reviewed.ResultsModerate and severe pectus excavatum did have a negative effect on cardiac function. Cardiac rotation angle, cardiac compression index, right atrial and tricuspid annulus size, septal motion and myocardial strain are relatively effective indexes to evaluate cardiac function.ConclusionsPectus excavatum did have a negative effect on cardiac function; so surgeons should actively diagnose and treat such patients in clinical work. However, further research is needed on to explore the measures and indicators that can reflect the changes of cardiac function in patients objectively, accurately, effectively and timely.
An experimental study of water droplets deformation and collision with airfoil
Authors: Li Wen , Miao Bo , Zhu Chun-Ling , Zhao Ning 
Published: May 2020

When aircraft pass through the clouds that contain super cooled water droplets during aviation, the droplets collide with the wing surface and ice is formed, which induces a significant threat to aviation safety. Studies on droplet movement in gaseous medium are prerequisite for deicing/anti-icing researches. So, in this work, an experimental study is performed on water droplet deformation as the droplets approach the leading edge of an airfoil. This experiment is carried out in a vertical wind tunnel, with a NACA0012 airfoil model assembled 4.3 m downstream of the droplet generator. The influence of Weber number (ranging from 0.2 to 36) on the deformation of a 2 mm diameter droplet is thoroughly investigated. The results indicate that droplets maintain initial form with Weber number under 10; after that droplet deforms into remarkable bag deformation as Weber number reaches to 19, and bag-stamen deformation mode as Weber number is above 20. This observed correlation between Weber number and deformation mode is validated through comparing with published simulation results. Furthermore, using the high-speed camera, clear images of the droplet structure during the deformation process are taken and are shown in detail in this work.
Influence of PECVD-TiO2 film morphology and topography on the spectroscopic ellipsometry data fitting process
Authors: Li Dayu , Zhang Wentao , Goullet A. 
Published: May 2020

TiO2 films of different thickness are deposited on silicon substrate at low temperature and pressure by a Helicon-PECVD reactor. The evolution of film morphology and topography is observed by scanning electron microscopy (SEM) and atomic force microscopy (AFM), meanwhile the spectroscopic ellipsometry (SE) measurements are performed to investigate the film growth mechanism and optical constants. The SEM and AFM observations show that all the films exhibit a columnar structure, moreover all the columns are vertical grown and well-organized when the thickness below [Formula: see text][Formula: see text]80 nm. As the thickness is increased to [Formula: see text][Formula: see text]150 nm, 250 nm and 450 nm, the column size is increased in the top layers, the whole film morphology becomes inhomogeneous, which leads to a decreased density and rougher surface. By fitting the SE measurements, a suitable gradient physical model is found to describe the film morphologies, the model consists of a native SiO2 layer on Si substrate, a mediate layer mixed TiO2 with void whose concentration gradient changed from bottom to top, and a top roughness layer. For thick films ([Formula: see text][Formula: see text]450 nm), the absorption and scattering on the rough surface is considered in order to keep the precision of SE fits. It is found that the optical index is decreased with film thickness, which is related to the evolution of structure in the top layers.
Structural, morphological and magnetic properties of Ni–Cu–Co ferrites by the Sm3+ ions substitution
Authors: Yu Lichao , Sun Aimin , Suo Nanzhaxi , Zuo Zhuo , Zhao Xiqian , Zhang Wei 
Published: May 2020

In this experiment, samarium ion was doping into nickel–copper–cobalt ferrite system by sol–gel self-propagation. The prepared chemical formula is [Formula: see text]-[Formula: see text] ([Formula: see text], 0.025, 0.05, 0.075 and 0.1). The X-ray diffraction (XRD) analysis of the samples confirms the formation of a cubic spinel structure. The average crystallite sizes are about 66–88 nm for all the prepared samples. Fourier transform infrared spectroscopy (FTIR) measurements showed all the prepared samples had Fe–O absorption peaks. This finding further confirms that the prepared sample has a spinel structure. The morphological changes of the samples were characterized by scanning electron microscopy (SEM) and transmission electron microscopy (TEM). According to the characterization results, the surface morphology shows spherical grains. Energy-dispersive X-ray spectroscopy (EDX) test results showed that the as-prepared pure samples contained Ni, Cu, Co, Fe elements, whereas other samples contained Sm elements and the contents were different. This indicates that the prepared samples are purer and the doping amount has been increased. The magnetic parameters of samples were measured by vibration sample magnetometer (VSM) at room temperature. The analysis of magnetic parameters shows that the saturation magnetization [Formula: see text] and remanent magnetization [Formula: see text] of the sample decrease with the increase of the doping amount of samarium ions. From the magnetic parameters, it can be concluded that [Formula: see text]-doped Ni–Cu–Co ferrites have low magnetic properties.
Pressure Overload Greatly Promotes Neonatal Right Ventricular Cardiomyocyte Proliferation: A New Model for the Study of Heart Regeneration
Authors: Ye Lincai , Wang Shoubao , Xiao Yingying , Jiang Chuan , Huang Yanhui , Chen Huiwen , Zhang Haibo , Zhang Hao , Liu Jinfen , Xu Zhuoming , Hong Haifa 
Published: May 2020

Background

Current mammalian models for heart regeneration research are limited to neonatal apex amputation and myocardial infarction, both of which are controversial.
RNA
seq has demonstrated a very limited set of differentially expressed genes between sham and operated hearts in myocardial infarction models. Here, we investigated in rats whether pressure overload in the right ventricle, a common phenomenon in children with congenital heart disease, could be used as a better animal model for heart regeneration studies when considering cardiomyocyte proliferation as the most important index.

Methods and Results

In the rat model, pressure overload was induced by pulmonary artery banding on postnatal day 1 and confirmed by echocardiography and hemodynamic measurements at postnatal day 7.
RNA
sequencing analyses of purified right ventricular cardiomyocytes at postnatal day 7 from pulmonary artery banding and sham‐operated rats revealed that there were 5469 differentially expressed genes between these 2 groups. Gene ontology and Kyoto Encyclopedia of Genes and Genomes analysis showed that these genes mainly mediated mitosis and cell division. Cell proliferation assays indicated a continuous overproliferation of cardiomyocytes in the right ventricle after pulmonary artery banding, in particular for the first 3 postnatal days. We also validated the model using samples from overloaded right ventricles of human patients. There was an approximately 2‐fold increase of Ki67/
pHH
3/aurora B‐positive cardiomyocytes in human‐overloaded right ventricles compared with nonoverloaded right ventricles. Other features of this animal model included cardiomyocyte hypotrophy with no fibrosis.

Conclusions
Pressure overload profoundly promotes cardiomyocyte proliferation in the neonatal stage in both rats and human beings. This activates a regeneration‐specific gene program and may offer an alternative animal model for heart regeneration research.
Why Did Marx Declare the Revolution Permanent?
Authors: Lih Lars T. 
Published: May 2020

Abstract
Why did Marx declare the revolution permanent? A careful examination of the celebrated passages from March 1850 in their immediate rhetorical context shows that he intended to affirm the tactical principles laid down earlier in the Communist Manifesto – as opposed to standard ‘anti-stagist’ interpretations that present the Permanenz locution of 1850 as a break with these principles. Among such principles: keeping eyes firmly fixed on the prize – the permanent final goal of a complete overhaul of society – is essential to maintaining a proper perspective on history’s way-stations, that is, the necessary but subordinate revolutionary tasks and allies; and public declaration of the permanent goal is essential for preserving the independence of the workers’ movement and thus for carrying out the proletariat’s world-historical mission of creating a classless society.
“A Rare Pearl Passed from Hand to Hand”
Authors: Leezenberg Michiel 
Published: May 2020

Abstract
Pascale Casanova’s notion of the “world republic of letters” systematically transcends national boundaries, as well as the opposition between internalist structural analyses and externalist political reductions, arguing that individual works of literature acquire their meaning only against the background of this transnational literary field with its own, irreducibly literary forms of domination. Yet, I will argue, Casanova’s work is not yet sufficiently transnational and not sufficiently historicizing; specifically, it overlooks non-Western cosmopolitan traditions and premodern vernacularization processes. As a case study, I will discuss the vernacularization of Georgian, Kurdish, and Armenian within the Persianate cosmopolitan, and on the consecration of national epics in these three languages. These examples suggest an approach to the literary field that allows for greater geographical width and historical depth; it also invites us to look for more radical historical variability in the concept of literature itself.
Community integration and related factors among people with mental illness in Japan: Multiple regression analysis stratified by social isolation level
Authors: Shioda Ai , Yamauchi Keita 
Published: May 2020

Backgroud and Aim: Community integration is an essential for people with mental illness that affects their health and quality of life. The objective of this study is to find the factors useful in improving community integration of people with mental illness. Methods: The study method was self-reporting questionnaires for people with mental illness living in the community. The decision tree analysis revealed that people with mental illness into high or low social isolation level strata. Multiple regression analyses stratified by using two social isolation levels were conducted. Results: Common factors among the strata were living environment of formal care accessibility and daily life activity. Specific factors for social isolation low-level stratum were self-efficacy for coping with symptoms, self-efficacy for social relationships, healthy lifestyle habits, treatment, exchange daily life information with friends and family members. Specific factors for social isolation high-level stratum were self-efficacy for daily living, self-efficacy for treatment-related behavior and satisfaction with formal care. All specific factors were positively associated with community integration. Conclusions: The findings suggest the devising interventions to enhance community integration by social isolation level among people with mental illness.
Memory improvement in multiple sclerosis after an extensive cognitive rehabilitation program in groups with a multicenter double-blind randomized trial
Authors: Brissart Helene , Omorou Abdou Y , Forthoffer Natacha , Berger Eric , Moreau Thibault , De Seze Jerome , Morele Elodie , Debouverie Marc 
Published: May 2020

Objective: The aim of this study is to determine the effectiveness of an extended cognitive rehabilitation program in group’s sessions in multiple sclerosis. Design: Double-blind multicenter randomized trial. Participants: People with multiple sclerosis of 18 to 60 years, Expanded Disability Status Scale ⩽6.0, mild to moderate cognitive impairment. Interventions: They were randomized into cognitive rehabilitation program (ProCog-SEP) or in a placebo program. ProCog-SEP comprises 13 group’s sessions over 6 months and includes psychoeducational advices and cognitive exercises. Placebo program included non-cognitive exercises. No strategy and no cognitive advice were provided. Main measures: The primary endpoint was the percentage of verbal memory learning measured by the Selective Reminding Test. A comprehensive neuropsychological assessment is carried out before and after interventions by a neuropsychologist blinded to intervention. Effectiveness of the ProCog-SEP versus Placebo has been verified using linear regression models. Results: In total, 128 participants were randomized and 110 were included in the study after planning session in groups; 101 completed this trial (77.2% females); mean age: 46.1 years (±9.6); disease duration: 11.8 years (±7.5). ProCog-SEP was more effective in increasing in learning index (9.21 (95% confidence interval (CI): 1.43, 16.99); p = 0.02) and in working memory on manipulation (0.63 (95% CI: 0.17, 1.09); p = 0.01), and updating capacities (–1.1 (95% CI: –2.13, –0.06); p = 0.04). No difference was observed for other neuropsychological outcomes. Regarding quality of life outcomes, no change was observed between the two groups. Conclusion: These findings suggest that ProCog-SEP could improve verbal learning abilities and working memory in people with multiple sclerosis. These improvements were observed with 13 group sessions over 6 months.