bluuebunny/crossref_metadata_2025_split huggingface dataset:
Implementing spirometry and fractional exhaled nitric oxide testing in childhood asthma management in UK primary care: an observational study to examine training and implementation cost and impact on patient’s health use and outcome
Authors: Yang Yaling , Lo David KH , Beardsmore Caroline , Roland Damian , Richardson Matthew , Danvers Lesley , Wilson Andrew , Gaillard Erol A 
Published: July 2021

ObjectivesImplementation of guidelines into clinical practice is challenging and complex. This study aims to (1) identify the training needs and capacity requirements, and (2) explore the impact on healthcare utilisation and asthma-related quality of life of implementing both spirometry and fraction of exhaled nitric oxide in diagnosis of asthma among children in the UK primary care.MethodsTen UK general practitioner practices and a total of 612 children (5–16 years) with diagnosed or suspected asthma were invited to participate in this prospective observational study. The total times that the trainer and trainee clinical staff spent on developing the training package, providing and receiving, and performing and interpreting the two tests as part of routine child asthma review were collected, and costs were calculated. We compared healthcare utilisation and asthma-related and general health-related quality of life data between the 6 months before and after the asthma review guided by objective tests.ResultsThe average training cost for the 27 primary care clinical members was £1395. The average cost to implement and deliver the test-guided asthma review among the 612 included children was £22. In the 6 months following the tests-guided asthma review, both unplanned primary care attendance, and hospital admissions were reduced, and the asthma-related health status increased significantly.ConclusionThis study provides robust cost estimates of the resources needed to implement the National Institute for Health and Care Excellence asthma guideline. It also demonstrates the potential to save healthcare costs and improve health status among asthmatic children by implementing this guideline.
Veteran help-seeking behaviour for mental health issues: a systematic review
Authors: Randles Rebecca , Finnegan A 
Published: July 2021

IntroductionServing military personnel and veterans have been identified to have a high prevalence of mental health disorders. Despite this, only a significantly small number seek mental healthcare. With the UK beginning to invest further support to the armed forces community, identification of barriers and facilitators of help-seeking behaviour is needed.MethodsCorresponding literature search was conducted in PsycINFO, PsycArticles, Medline, Web of Science and EBSCO. Articles which discussed barriers and facilitators of seeking help for mental health concerns in the veteran population were included. Those which discussed serving personnel or physical problems were not included within this review. A total of 26 papers were analysed.ResultsA number of barriers and facilitators of help-seeking for a mental health issue within the veteran population were identified. Barriers included stigma, military culture of stoicism and self-reliance, as well as deployment characteristics of combat exposure and different warzone deployments. Health service difficulties such as access and lack of understanding by civilian staff were also identified. Facilitators to help combat these barriers included a campaign to dispel the stigma, including involvement of veterans and training of military personnel, as well as more accessibility and understanding from healthcare staff.ConclusionsWhile some barriers and facilitators have been identified, much of this research has been conducted within the USA and on male veterans and lacks longitudinal evidence. Further research is needed within the context of other nations and female veterans and to further indicate the facilitators of help-seeking among veterans.
Patient views of therapeutic interchange of ACE inhibitors in Australian primary care: a qualitative study
Authors: Marshall Tessa , Lim Hok , Lau Phyllis 
Published: July 2021

ObjectivesIn Australia, therapeutic interchange of angiotensin-converting enzyme (ACE) inhibitors could generate savings for patients and the Pharmaceutical Benefits Scheme (PBS). The PBS subsidises nine drugs in the ACE inhibitor class. These drugs are therapeutically equivalent, but the price varies between each drug. Patients are key players in successful therapeutic interchange programmes, but little is known about their views. This study aims to explore patient views of therapeutic interchange of ACE inhibitors in Australian primary care.DesignQualitative exploratory research study using semi-structured interviews, asking participants about therapeutic interchange and their attitude towards hypothetically switching ACE inhibitors. Data were analysed thematically.SettingAustralian primary care.ParticipantsFourteen adults in Australia currently taking an ACE inhibitor, recruited via general practices and pharmacies, social media and professional networks.FindingsFive key themes were identified: participants’ limited understanding of medication; the expectation that a new drug would be ‘the same’; the view that choice, convenience and fear of change outweigh the cost; altruism; and trust in health professionals, particularly participants’ own general practitioner (GP).ConclusionsPatients’ limited understanding of medication changes poses a barrier to therapeutic interchange. Clinicians should explore patients’ understanding and expectations of therapeutic interchange. Counselling from trusted health professionals, particularly GPs, could ameliorate concerns. Policymakers implementing therapeutic interchange programmes should ensure a trusted GP directs medication changes.
Citizen engagement initiatives in precision health in the European Union member states: a scoping review
Authors: Pezzullo Angelo Maria , Sassano Michele , Hoxhaj Ilda , Pastorino Roberta , Boccia Stefania 
Published: July 2021

IntroductionPrecision health requires citizens that are empowered to orient health decisions towards their personal values, aware of the benefits and risks, and committed to sharing their personal data to trustful institutions. Effective citizen engagement initiatives are fundamental for the success of a precision health approach.ObjectiveTo provide an overview of citizen engagement initiatives in precision health in European Union (EU) member states.DesignScoping review.MethodsThe electronic databases PubMed, Web of Science, CINAHL and Embase were searched to include articles published in English. Furthermore, desk research was conducted in English, Dutch, French, Italian and Spanish. Articles or reports regarding ongoing initiatives of citizen engagement in precision health conducted in EU member states and published from January 2015 to July 2020 were considered eligible. A quality assessment of the retrieved entries using Critical Appraisal Skills Programme tool was conducted.ResultsWe identified nine documents, which reported eight ongoing citizen engagement initiatives, with substantial variability. Government agencies, non-governmental organisations and scientific societies were the main organisers and funders. Most of the initiatives were conducted in the UK. Genomics was the most emphasised aspect of precision health in these initiatives. Among the identified initiatives, both in-person and digital means were reported.ConclusionOur work provides an overview of current citizen engagement initiatives in the EU that can be useful for stakeholders interested in designing and developing precision health projects enriched by meaningful citizen participation.PROSPERO registration numberCRD42020193866.
Systematic review of clinician-directed nudges in healthcare contexts
Authors: Last Briana S , Buttenheim Alison M , Timon Carter E , Mitra Nandita , Beidas Rinad S 
Published: July 2021

ObjectiveNudges are interventions that alter the way options are presented, enabling individuals to more easily select the best option. Health systems and researchers have tested nudges to shape clinician decision-making with the aim of improving healthcare service delivery. We aimed to systematically study the use and effectiveness of nudges designed to improve clinicians’ decisions in healthcare settings.DesignA systematic review was conducted to collect and consolidate results from studies testing nudges and to determine whether nudges directed at improving clinical decisions in healthcare settings across clinician types were effective. We systematically searched seven databases (EBSCO MegaFILE, EconLit, Embase, PsycINFO, PubMed, Scopus and Web of Science) and used a snowball sampling technique to identify peer-reviewed published studies available between 1 January 1984 and 22 April 2020. Eligible studies were critically appraised and narratively synthesised. We categorised nudges according to a taxonomy derived from the Nuffield Council on Bioethics. Included studies were appraised using the Cochrane Risk of Bias Assessment Tool.ResultsWe screened 3608 studies and 39 studies met our criteria. The majority of the studies (90%) were conducted in the USA and 36% were randomised controlled trials. The most commonly studied nudge intervention (46%) framed information for clinicians, often through peer comparison feedback. Nudges that guided clinical decisions through default options or by enabling choice were also frequently studied (31%). Information framing, default and enabling choice nudges showed promise, whereas the effectiveness of other nudge types was mixed. Given the inclusion of non-experimental designs, only a small portion of studies were at minimal risk of bias (33%) across all Cochrane criteria.ConclusionsNudges that frame information, change default options or enable choice are frequently studied and show promise in improving clinical decision-making. Future work should examine how nudges compare to non-nudge interventions (eg, policy interventions) in improving healthcare.
Development and use of mobile messaging for individuals with musculoskeletal pain conditions: a scoping review protocol
Authors: Scotti Requena Simone , Sterling Michele , Elphinston Rachel A , Ritchie Carrie , Robins Sarah , R Armfield Nigel 
Published: July 2021

IntroductionPrevious reviews of mobile messaging for individuals with musculoskeletal pain have shown positive effects on pain and disability. However, the configuration of digital content, method of presentation and interaction, dose and frequency needed for optimal results remain unclear. Patient preferences concerning such systems are also unclear. Addressing these knowledge gaps, incorporating evidence from both experimental and observational studies, may be useful to understand the extent of the relevant literature, and to influence the design and outcomes of future messaging systems. We aim to map information that could be influential in the design of future mobile messaging systems for individuals with musculoskeletal pain conditions, and to summarise the findings of efficacy, effectiveness, and economics derived from both experimental and observational studies.Methods and analysisWe will include studies describing the development and/or use of mobile messaging to support adults (≥18 years) with acute or chronic musculoskeletal pain. We will exclude digital health studies that lack a mobile messaging component, or those targeted at other health conditions unrelated to the bones, muscles and connective tissues, or involving surgical or patients with cancer, or studies involving solely healthy individuals. Our sources of information will be online databases and reference lists of relevant papers. We will include papers published in English in the last 10 years. Two pairs of independent reviewers will screen, select and extract the data, with any disagreements mediated by a third reviewer. We will report the results according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for scoping reviews checklist. We will synthesise the findings in a tabular format and provide a descriptive summary.Ethics and disseminationFormal ethical approval is not required. We will disseminate the findings through publication in a peer-reviewed journal, relevant conferences, and relevant consumer forums.Trial registrationOpen Science Frameworkhttps://osf.io/8mzya; DOI: 10.17605/OSF.IO/8MZYA.
Dichotomous impact of affinity on the function of T cell engaging bispecific antibodies
Authors: Poussin Mathilde , Sereno Arlene , Wu Xiufeng , Huang Flora , Manro Jason , Cao Shanshan , Carpenito Carmine , Glasebrook Andrew , Powell Jr Daniel J , Demarest Stephen J 
Published: July 2021

BackgroundBispecific T cell engagers represent the majority of bispecific antibodies (BsAbs) entering the clinic to treat metastatic cancer. The ability to apply these agents safely and efficaciously in the clinic, particularly for solid tumors, has been challenging. Many preclinical studies have evaluated parameters related to the activity of T cell engaging BsAbs, but many questions remain.Main bodyThis study investigates the impact of affinity of T cell engaging BsAbs with regards to potency, efficacy, and induction of immunomodulatory receptors/ligands using HER-2/CD3 BsAbs as a model system. We show that an IgG BsAb can be as efficacious as a smaller BsAb format both in vitro and in vivo. We uncover a dichotomous relationship between tumor-associated antigen (TAA) affinity and CD3 affinity requirements for cells that express high versus low levels of TAA. HER-2 affinity directly correlated with the CD3 engager lysis potency of HER-2/CD3 BsAbs when HER-2 receptor numbers are high (~200 K/cell), while the CD3 affinity did not impact potency until its binding affinity was extremely low (<600 nM). When HER-2 receptor numbers were lower (~20 K/cell), both HER-2 and CD3 affinity impacted potency. The high affinity anti-HER-2/low CD3 affinity BsAb also demonstrated lower cytokine induction levels in vivo and a dosing paradigm atypical of extremely high potency T cell engaging BsAbs reaching peak efficacy at doses >3 mg/kg. This data confirms that low CD3 affinity provides an opportunity for improved safety and dosing for T cell engaging BsAbs. T cell redirection also led to upregulation of Programmed cell death 1 (PD-1) and 4-1BB, but not CTLA-4 on T cells, and to Programmed death-ligand 1 (PD-L1) upregulation on HER-2HI SKOV3 tumor cells, but not on HER-2LO OVCAR3 tumor cells. Using this information, we combined anti-PD-1 or anti-4-1BB monoclonal antibodies with the HER-2/CD3 BsAb in vivo and demonstrated significantly increased efficacy against HER-2HI SKOV3 tumors via both combinations.ConclusionsOverall, these studies provide an informational dive into the optimization process of CD3 engaging BsAbs for solid tumors indicating that a reduced affinity for CD3 may enable a better therapeutic index with a greater selectivity for the target tumor and a reduced cytokine release syndrome. These studies also provide an additional argument for combining T cell checkpoint inhibition and co-stimulation to achieve optimal efficacy.
MBGEM: a stack of borated GEM detector for high efficiency thermal neutron detection
Authors: Muraro A. , Claps G. , Croci G. , Lai C. C. , De Oliveira R. , Altieri S. , Cancelli S. , Gorini G. , Hall-Wilton R. , Höglund C. , Cippo E. Perelli , Robinson L. , Svensson P. , Murtas F. 
Published: July 2021

AbstractA new position-sensitive thermal neutron detector based on boron-coated converters has been developed as an alternative to today’s standard $$^3\mathrm{He}$$

3

He

-based technology for application to thermal neutron scattering. The key elements of the development are the boron-coated GEM foils (Sauli in Nucl Instrum Methods Phys Res Sect A Accel Spectrom Detect Assoc Equip 386:531, 1997) that are used as a multi-layer neutron converter via the $$^{10}\mathrm{B}(n,\alpha )^7\mathrm{Li}$$

10

B

(
n
,
α
)

7

Li

reaction together with an efficient collection of the produced secondary electrons. This paper reports the test performed on a 3 layers converter prototype coupled to a GEMPix detector (Murtas in Radiat Meas 138:106421, 2020), carried out in order to study the possibility to produce a large-scale multi-layer neutron detector capable to reach high detection efficiency with high spatial resolution and able to sustain the high neutron flux expected in the new neutron spallation source under development like the ESS.
Germplasm Bred for Resistance to Striga hermonthica Exhibited High Resistance Levels to Striga asiatica Compared to Commercial Checks
Authors: Dhliwayo Vimbayi , Gasura Edmore , Nyakurwa Cacious Stanford , Mabasa Stanford , Mashingaidze Arnold Bray , Setimela Peter 
Published: July 2021

Parasitic weeds belonging to the Orobanchaceae family are a menace in Sub-Saharan African (SSA). Specifically, the two witchweeds from the genus Striga, S. hermonthica and S. asiatica, are jointly responsible for land abandonments and cereal yield reductions in the SSA. Factorial experiments involving fourteen maize genotypes and two levels of Striga asiatica infestation (infested and noninfested) were conducted under pot and laboratory experiments at the Department of Plant Production Sciences and Technologies, University of Zimbabwe, during the 2014/2015 season. A 14 × 2 factorial pot experiment was arranged in a 7 × 4 α-lattice design replicated four times, whereas the laboratory agar gel was arranged in a complete randomized design with four replications. Results revealed significant differences (

p

< 0.05) for S. asiatica and genotype main effects for the recorded traits. S. asiatica-infested genotypes had lower biomasses than noninfested ones. However, the University of Zimbabwe bred hybrids such as Ax31, Ax28, Ax7, and Ax32 had similar plant heights and stem, leaf, and cob biomass across the two Striga levels unlike the local checks, particularly SC513, SC537, and SC637, under Striga infestation. Moreover, these genotypes also had the least Striga germination percentage and furthest germination distance indicating that they are resistant/tolerant to Striga asiatica. The University of Zimbabwe bred hybrids, using Striga hermonthica resistance from the International Institute of Tropical Agriculture, exhibited resistance/tolerance to Striga asiatica compared to local checks. Therefore, these varieties could offer a better and viable Striga spp. control option to farmers in both S. hermonthica and S. asiatica endemic areas.
A urgência da reinvenção da Reforma Sanitária Brasileira em defesa do Sistema Único de Saúde
Authors: Cohn Amélia , Gleriano Josué Souza 
Published: July 2021

Este artigo teve como objetivo discutir os desafios para a Reforma Sanitária Brasileira e para o Sistema Único de Saúde na atualidade. Resgatou-se a literatura mais atual sobre o tema, recuperaram-se alguns de seus traços fundamentais enquanto processo histórico e de seus atores e remeteu-se à conjuntura política atual no que diz respeito ao Sistema Único de Saúde. A partir de um estudo exploratório de corte histórico fundado na literatura pertinente, o propósito foi fomentar reflexões sobre o tema baseadas naquelas análises sobre o movimento sanitário, contribuindo com novos olhares para a questão da saúde como direito frente aos desafios que o Sistema Único de Saúde enfrenta. Reconheceram-se os avanços do movimento sanitário na construção do sistema, com a ampliação do acesso e da cobertura à atenção à saúde segundo os preceitos da saúde como direito, ao mesmo tempo em que se sinalizaram as limitações históricas para o alcance de seus princípios e diretrizes e as disputas políticas e sociais da atualidade, com vistas a apontar novas possibilidades para a Reforma Sanitária Brasileira. Concluiu-se pela urgência da atualização das propostas originais da reforma, da recuperação de sua dimensão de luta política, da ampliação de alianças com diferentes segmentos sociais em defesa do Sistema Único de Saúde e de retomar a saúde enquanto questão social no interior dos movimentos de resistência democrática, buscando-se novos espaços e sujeitos políticos em defesa do Sistema Único de Saúde.
To Mohassess, For the Wall
Authors: Al-e Ahmad Jalal 
Published: July 2021

Abstract
“To Mohassess, For the Wall” is an article written in 1964 by Jalal Al-e Ahmad, one of the most influential and charismatic Iranian intellectuals of the time. Three years before writing this article, Al-e Ahmad had published Weststruckness, discussing the Iranians’ cultural alienation caused by the dependence on the west. In “To Mohassess, For the Wall”, Al-e Ahmad shifts his analysis to Iranian painting, arguing that Iranian painters during the 1960s merely repeat Western cultural processes and strategies instead of constructing Iranian ones. The context for Al-e Ahmad's argument is the Pahlavi regime's radical program of rapid modernization, which in the area of the arts was systematically expanded. Critical, provocative or problematic, the article offers a crucial window into the adoption of Western-style modernism by Iranian painters during the 1960s and into how an “insider” intellectual such as Al-e Ahmad evaluated the modernization of Iranian art before the background of what he perceived as the critical neglect of Iranian traditions. The text is addressed to Bahman Mohassess, a painter whom Al-e Ahmad considered to be one of the few who had not been coopted by the cultural policies of the Shah's regime.
Prevalence, epidemiology and clinical outcome of Candida auris infections: Experience from a tertiary care hospital in Jaipur
Authors: Bacchani Daisy , Rajni Ekadashi , Garg Vishnu K , Sharma Richa , Mamoria Ved P 
Published: July 2021

Candida auris is identified as an emerging pathogen worldwide. It is multidrug resistant and causes invasive healthcare-associated infections. Our retrospective study was conducted to determine the prevalence and epidemiology of C. auris infections in a tertiary care hospital in Jaipur. 24 clinical C. auris strains were included, most being from urine. The majority patients needed intensive care and had at least one underlying co-morbid condition. A history of broad-spectrum antibiotic or antifungal usage was present in 85%. Fluconazole, voriconazole, amphotericin B and 5-fluorocytosine resistance was seen in 96, 42, 33 and 8% isolates respectively. No echinocandin resistance was noted.