bluuebunny/crossref_metadata_2025_split huggingface dataset:
Understanding transnational healthcare use in immigrant communities from a cultural systems perspective: a qualitative study of Dutch residents with a Turkish background
Authors: Şekercan Aydin , Harting Janneke , Peters Ron J G , Stronks Karien 
Published: September 2021

ObjectivesTransnational utilisation of healthcare by people with an immigrant background carries risks, including medicalisation and adverse iatrogenic outcomes. We investigated the drivers behind such transnational healthcare use from a cultural perspective on health systems.DesignQualitative interview study (2018).SettingTwo primary care practices in Amsterdam, the Netherlands.ParticipantsThirteen Dutch patients of Turkish background, who had obtained healthcare in Turkey, and who in general visited the primary care practice more than once a month.ResultsIn the respondents’ stories, we observed how: (1) cross-border healthcare use was encouraged by cultural mismatches between expected and provided services and by differing explanatory models of illness upheld by patients and Dutch providers; (2) both transnationalism in patients and entitlements to insurance reimbursement facilitated the use of Turkish health services to bypass perceived barriers in the Dutch system; (3) cultural mismatches were reinforced during general practitioner consultations after the patients’ return to the Netherlands, thereby inducing further service use abroad.ConclusionsAlthough cultural system influences are difficult to bridge, measures to reduce the unwelcome consequences of transnational healthcare use may include (1) strengthening the provision of culturally sensitive care in the country of residence and (2) restricting the reimbursement of care in the country of origin while maintaining the option to obtain care abroad.
Men and sexual and reproductive healthcare in the Nordic countries: a scoping review
Authors: Baroudi Mazen , Stoor Jon Petter , Blåhed Hanna , Edin Kerstin , Hurtig Anna-Karin 
Published: September 2021

ContextMen generally seek healthcare less often than women and, other than traditional gender norms, less is known about the explanation. The aim was to identify knowledge gaps and factors influencing men regarding sexual and reproductive healthcare (SRHC) in the Nordic countries.MethodsWe searched PubMed and SveMed+ for peer-reviewed articles published between January 2010 and May 2020. The analyses identified factors influencing men’s experiences of and access to SRHC.ResultsThe majority of the 68 articles included focused on pregnancy, birth, infertility and sexually transmitted infections including HIV. During pregnancy and childbirth, men were treated as accompanying partners rather than individuals with their own needs. The knowledge and attitudes of healthcare providers were crucial for their ability to provide SRHC and for the experiences of men. Organisational obstacles, such as women-centred SRHC and no assigned healthcare profession for men’s sexual and reproductive health issues, hindered men’s access to SRHC. Lastly, the literature rarely discussed the impact of health policies on men’s access to SRHC.ConclusionsThe literature lacked the perspectives of specific groups of men such as migrants, men who have sex with men and transmen, as well as the experiences of men in SRHC related to sexual function, contraceptive use and gender-based violence. These knowledge gaps, taken together with the lack of a clear entry point for men into SRHC, indicate the necessity of an improved health and medical education of healthcare providers, as well as of health system interventions.
Implementation of serological and molecular tools to inform COVID-19 patient management: protocol for the GENCOV prospective cohort study
Authors: Taher Jennifer , Mighton Chloe , Chowdhary Sunakshi , Casalino Selina , Frangione Erika , Arnoldo Saranya , Bearss Erin , Binnie Alexandra , Bombard Yvonne , Borgundvaag Bjug , Chertkow Howard , Clausen Marc , Devine Luke , Faghfoury Hanna , Friedman Steven Marc , Gingras Anne-Claude , Khan Zeeshan , Mazzulli Tony , McGeer Allison , McLeod Shelley L , Pugh Trevor J , Richardson David , Simpson Jared , Stern Seth , Strug Lisa , Taher Ahmed , Lerner-Ellis Jordan 
Published: September 2021

IntroductionThere is considerable variability in symptoms and severity of COVID-19 among patients infected by the SARS-CoV-2 virus. Linking host and virus genome sequence information to antibody response and biological information may identify patient or viral characteristics associated with poor and favourable outcomes. This study aims to (1) identify characteristics of the antibody response that result in maintained immune response and better outcomes, (2) determine the impact of genetic differences on infection severity and immune response, (3) determine the impact of viral lineage on antibody response and patient outcomes and (4) evaluate patient-reported outcomes of receiving host genome, antibody and viral lineage results.Methods and analysisA prospective, observational cohort study is being conducted among adult patients with COVID-19 in the Greater Toronto Area. Blood samples are collected at baseline (during infection) and 1, 6 and 12 months after diagnosis. Serial antibody titres, isotype, antigen target and viral neutralisation will be assessed. Clinical data will be collected from chart reviews and patient surveys. Host genomes and T-cell and B-cell receptors will be sequenced. Viral genomes will be sequenced to identify viral lineage. Regression models will be used to test associations between antibody response, physiological response, genetic markers and patient outcomes. Pathogenic genomic variants related to disease severity, or negative outcomes will be identified and genome wide association will be conducted. Immune repertoire diversity during infection will be correlated with severity of COVID-19 symptoms and human leucocyte antigen-type associated with SARS-CoV-2 infection. Participants can learn their genome sequencing, antibody and viral sequencing results; patient-reported outcomes of receiving this information will be assessed through surveys and qualitative interviews.Ethics and disseminationThis study was approved by Clinical Trials Ontario Streamlined Ethics Review System (CTO Project ID: 3302) and the research ethics boards at participating hospitals. Study findings will be disseminated through peer-reviewed publications, conference presentations and end-users.
An Evaluation of the Medical Training Application Service as Experienced by Defence Medical Service Medical Officers
Authors: Owen J. P. 
Published: September 2021

AbstractObjectivesIn 2007 Defence Medical Service (DMS) Medical Officers (MOs) applying to train within hospital based specialities were selected using the Medical Training Application Service (MTAS). Recognising the problems being reported about MTAS, the Defence Postgraduate Medical Deanery (DPMD) conducted an evaluation in order to assess whether DMS MOs had also experienced problems with the MTAS process.MethodsDMS MO applicants were sent an email questionnaire, requesting both graded (Likert scale) and narrative responses, to gauge their opinion about the application service. The questionnaire covered the technical aspects of the process, the support available and the ability to demonstrate appropriate knowledge and skills.ResultsOnly 42 responses (32%) were received. However, having considered areas of potential bias, the graded questionnaire results and thematic analysis of the narrative responses showed a clear consensus amongst the applicants in many areas. More than three quarters (78%) of DMS applicants criticised the opportunity to record their abilities and achievements, and 91 % recorded that the questions were unable to differentiate between candidates. These views were mirrored in the narrative responses, with more than 130 statements covering five topic areas highlighting areas for improvement. Strong support was recorded for the work and advice provided by DPMD in support of the candidates.ConclusionsDMS MOs presented very negative opinions of their experiences of MTAS, highlighting their perceptions that they were unable to record their particular skills and experiences and that the questions were unable to discriminate between specialties. Particular difficulties were reported in presenting non-NHS experiences and skills.
Association between Obstructive Sleep Apnea and Type 2 Diabetes Mellitus: A Dose-Response Meta-Analysis
Authors: Yu Zhixiang , Cheng Jin-Xiang , Zhang Dong , Yi Fu , Ji Qiuhe 
Published: September 2021

Aim/Introduction. Obstructive sleep apnea (OSA) is a sleep-related breathing disorder that is characterized by repeated episodes of upper airway occlusion during sleep. The patients with OSA suffered from comprehensive oxidative stress in all systems. OSA might induce type 2 diabetes mellitus (T2DM), a kind of metabolism disorder. In this passage, we are exploring the dose-response relationship between OSA and T2DM. Materials and Methods. We screened four databases (PubMed, Embase, Cochran Library, and CNKI) for the observational studies about the OSA and T2DM. Studies were collected from database establishment to October 2020. We performed a traditional subgroup meta-analysis. What is more, linear and spline dose-response models were applied to assess the association between apnea-hypopnea index (AHI), an indicator to evaluate the severity of OSA, and the risk of T2DM. Review Manager, version 5.3, software and Stata 16.0 were used for the analysis. Result. Seven observational studies were included in the research. We excluded a study in the conventional meta-analysis. In the subgroup analysis, mild-dose AHI increased the risk of T2DM (odds ratio = 1.23, 95% confidence interval = 1.06–1.41,

P

< 0.05). Moderate-dose AHI increased the risk of T2DM with a higher odds ratio (OR = 1.35, 95% CI = 1.13–1.61,

P

< 0.05). Moderate-to-severe-dose AHI increased the risk of T2DM with a higher odds ratio (OR = 2.14, 95% CI = 1.72–2.67,

P

< 0.05). Severe-dose AHI increased the risk of T2DM with a higher odds ratio (OR = 2.19 95% CI = 1.30–3.68,

P

< 0.05). Furthermore, the spline and linear dose-response meta-analysis results revealed that the risk of T2DM increased with increasing AHI values. Conclusion. Through the dose-response meta-analysis, we found a potential dose-response relationship existed between the severity of OSA and the risk of T2DM. This relationship in our passage should be considered in the prevention of T2DM in the future.
Percepción de los residentes sobre el impacto de la pandemia COVID 19 en la formación en profesionalismo
Authors: González-Anglada María Isabel , Huelmos-Rodrigo Ana Isabel , García-Pérez Fernando , Martín-Fernández Jesús , Sanmartín-Fenollera Patricia , Garmendia-Fernández Cristina , Morán-Barrios Jesús 
Published: September 2021

Introducción: el profesionalismo es clave para construir la identidad de los profesionales sanitarios. El objetivo de este trabajo ha sido conocer en un colectivo de residentes, la influencia de la primera ola de la pandemia por SARS-CoV2 en sus competencias del profesionalismo. Materiales y métodos: estudio descriptivo transversal mediante cuestionario electrónico, remitido a 167 residentes, para medir su percepción sobre el impacto de la pandemia COVID-19 en el profesionalismo, con una escala verbal de cuatro niveles: excelente, por encima de lo esperado, lo esperado, por debajo de lo esperado. Se realizó, además, una pregunta abierta de “reflexión personal” analizada cualitativamente mediante un proceso de triangulación. La encuesta se hizo en el Hospital Universitario Fundación Alcorcón en los dos meses siguientes a la primera ola pandémica. Resultados: respondieron 59 residentes (35,3%) de 21 especialidades. Sus lugares de trabajo fueron muy variados. Los atributos del profesionalismo valorados por encima de esperado o excelente fueron: trabajo en equipo (74,6%), empatía (71,2%) y responder a las necesidades del paciente por encima de las propias (69,5%). Se encontró por debajo de lo esperado la gestión de las emociones (22%). Discusión: la pandemia COVID-19 ha contribuido a reforzar la identidad profesional de los residentes, manifestándose a través de muchas dimensiones del profesionalismo. La gestión de las emociones fue la que obtuvo menor valoración.
Prediction of Stroke Infarct Growth Rates by Baseline Perfusion Imaging
Authors: Wouters Anke , Robben David , Christensen Soren , Marquering Henk A. , Roos Yvo B.W.E.M. , van Oostenbrugge Robert J. , van Zwam Wim H. , Dippel Diederik W.J. , Majoie Charles B.L.M. , Schonewille Wouter J. , van der Lugt Aad , Lansberg Maarten , Albers Gregory W. , Suetens Paul , Lemmens Robin 
Published: September 2021

Background and Purpose:
Computed tomography perfusion imaging allows estimation of tissue status in patients with acute ischemic stroke. We aimed to improve prediction of the final infarct and individual infarct growth rates using a deep learning approach.

Methods:
We trained a deep neural network to predict the final infarct volume in patients with acute stroke presenting with large vessel occlusions based on the native computed tomography perfusion images, time to reperfusion and reperfusion status in a derivation cohort (MR CLEAN trial [Multicenter Randomized Clinical Trial of Endovascular Treatment for Acute Ischemic Stroke in the Netherlands]). The model was internally validated in a 5-fold cross-validation and externally in an independent dataset (CRISP study [CT Perfusion to Predict Response to Recanalization in Ischemic Stroke Project]). We calculated the mean absolute difference between the predictions of the deep learning model and the final infarct volume versus the mean absolute difference between computed tomography perfusion imaging processing by RAPID software (iSchemaView, Menlo Park, CA) and the final infarct volume. Next, we determined infarct growth rates for every patient.

Results:

We included 127 patients from the MR CLEAN (derivation) and 101 patients of the CRISP study (validation). The deep learning model improved final infarct volume prediction compared with the RAPID software in both the derivation, mean absolute difference 34.5 versus 52.4 mL, and validation cohort, 41.2 versus 52.4 mL (
P
<0.01). We obtained individual infarct growth rates enabling the estimation of final infarct volume based on time and grade of reperfusion.

Conclusions:
We validated a deep learning-based method which improved final infarct volume estimations compared with classic computed tomography perfusion imaging processing. In addition, the deep learning model predicted individual infarct growth rates which could enable the introduction of tissue clocks during the management of acute stroke.
Presence and Communication in Hybrid Virtual and Augmented Reality Environments
Authors: Li Yue , Ch'ng Eugene , Cobb Sue , See Simon 
Published: September 2021

Abstract
The use of virtual reality (VR) and augmented reality (AR) in connected environments is rarely explored but may become a necessary channel of communication in the future. Such environments would allow multiple users to interact, engage, and share multidimensional data across devices and between the spectrum of realities. However, communication between the two realities within a hybrid environment is barely understood. We carried out an experiment with 52 participants in 26 pairs, within two environments of 3D cultural artifacts: (1) a Hybrid VR and AR environment (HVAR) and (2) a Shared VR environment (SVR). We explored the differences in perceived spatial presence, copresence, and social presence between the environments and between users. We demonstrated that greater presence is perceived in SVR when compared with HVAR, and greater spatial presence is perceived for VR users. Social presence is perceived greater for AR users, possibly because they have line of sight of their partners within HVAR. We found positive correlations between shared activity time and perceived social presence. While acquainted pairs reported significantly greater presence than unacquainted pairs in SVR, there were no significant differences in perceived presence between them in HVAR.
Trends and projection of heavy snowfall in Hokkaido, Japan as an application of self-organizing map
Authors: Inatsu Masaru , Kawazoe Sho , Mori Masato 
Published: September 2021

AbstractThis paper showed the frequency of local-scale heavy winter snowfall in Hokkaido, Japan, its historical change, and its response to global warming using self-organizing map (SOM) of synoptic-scale sea-level pressure anomaly. Heavy snowfall days were here defined as days when the snowfall exceeded 10 mm in water equivalent. It was shown that the SOMs can be grouped into three categories for heavy snowfall days: 1) a passage of extratropical cyclones to the south of Hokkaido, 2) a pressure pattern between the Siberian high and the Aleutian low, and 3) a low-pressure anomaly just to the east of Hokkaido. Groups 1 and 2 were associated with heavy snowfall in Hiroo (located in southeastern Hokkaido) and in Iwamizawa (western Hokkaido), respectively, and heavy snowfall in Sapporo (western Hokkaido) was related to Group 3. The large-ensemble historical simulation reproduced the observed increasing trend in Group 2 and future projection revealed that Group 2 was related to a negative phase of the Western Pacific pattern and the frequency of this group would increase in the future. Heavy snowfall days associated with SOM Group 2 would also increase due to the increase in water vapor and preferable weather patterns in global warming climate, in contrast to the decrease of heavy snowfall days in other sites associated with SOM Group 1.
Precipitation unevenness in gauge observations and eight reanalyses from 1979 to 2018 over China
Authors: Wu Guocan , Li Yun , Qin Shun , Mao Yuna , Wang Kaicun 
Published: September 2021

AbstractPrecipitation is spatially and temporally unevenly distributed. The unevenness of precipitation is crucial for climate change, as well as for water resource management, environmental risk reduction and industrial/agricultural production. In this study, gauge observations and eight reanalysis products are used to examine the unevenness of precipitation from 1979 to 2018 over China. The results show that all the reanalysis datasets can reproduce the spatial pattern of the annual number of wet days and precipitation intensity, as shown in the observations; however, most reanalyses overestimate the former and underestimate the latter. The mean cumulative fractions of the precipitation amount on the wettest 1, 5, and 10 days to annual total are approximately 9.3%, 29.8% and 45.1% in the gauge observations, and are 6.6%±0.8%, 22.1%±2.5% and 34.3%±3.5% in the reanalyses. The mean cumulative fractions of precipitation amount on the wettest 1, 5, and 10 days to annual total displays a small negative trend based on gauge observations over China (-0.06%/decade, -0.10%/decade and -0.10%/decade, respectively), but are positive and stronger in the eight current reanalyses (0.08% ± 0.08%/decade, 0.25%±0.08%/decade and 0.35%±0.10%/decade). The Japanese 55-year reanalysis is the best in quantifying the annual variability of the cumulative fractions of precipitation on the wettest 1, 5, and 10 days over China, while the ERA-Interim is the best in reflecting their trends. The reanalyses agree best with the observations in reflecting cumulative fractions of precipitation in the Yangtze River Basin and the worst in the Northwest China.
Biceps Tenodesis Versus Superior Labral Anterior and Posterior (SLAP) Lesion Repair for the Treatment of SLAP Lesion in Overhead Athletes: A Systematic Review and Meta-analysis
Authors: Shin Myung Ho , Baek Samuel , Kim Tae Min , Kim HyunTae , Oh Kyung-Soo , Chung Seok Won 
Published: September 2021

Background: Superior labral anterior and posterior (SLAP) lesions are common injuries in overhead athletes. As a surgical treatment for SLAP lesions, SLAP repair has been traditionally performed. Recently, biceps tenodesis has been performed as an alternative treatment option; however, there is no review for outcome comparisons between these 2 procedures in overhead athletes. Purpose: The aim of this study was to compare the outcomes of SLAP repair versus biceps tenodesis, especially in overhead athletes with SLAP lesions. Study Design: Systematic review and meta-analysis; Level of evidence, 4. Methods: An electronic literature search was performed in Medline, Embase, Scopus, and the Cochrane Library. The studies were appraised using the Methodological Index for Non-randomized Studies (MINORS) tool. Studies that had a minimum follow-up of 2 years, included only patients with SLAP lesions without other major shoulder pathologies, and included only patients who engaged in overhead sports were included. The functional outcomes of the American Shoulder and Elbow Surgeons (ASES) score, rate of return to sport, rate of return to preinjury level of sport, and complication rate were subjected to meta-analysis. Results: A total of 332 articles were identified, and 13 were included in the systematic review. Even though the postoperative ASES scores were slightly higher in the biceps tenodesis group than in the SLAP repair group, no statistically significant differences were found between the groups (biceps tenodesis, 95% CI = 91.71-96.75, I2 = 0.00; SLAP repair, 95% CI = 85.47-94.46, I2 = 16.3; P = .085) The rate of return to sport and the return to preinjury level of sport were slightly higher in the biceps tenodesis group than in the SLAP repair group; however, in meta-analysis these factors did not reach statistical significance (return to sport: biceps tenodesis, 95% CI = 0.66-0.91, I2 = 0.00; SLAP repair, 95% CI = 0.68-0.93, I2 = 70.23; P = .94) (return to preinjury level of sport: biceps tenodesis, 95% CI = 0.61-0.89, I2 = 17.78; SLAP repair, 95% CI = 0.53-0.82, I2 = 58.07; P = .37). The biceps tenodesis group showed a lower complication rate compared with the SLAP repair group without statistical significance (biceps tenodesis, 95% CI = 0.013-0.145, I2 = 0.00; SLAP repair, 95% CI = 0.049-0.143, I2 = 0.00; P = .25). Conclusion: The results of biceps tenodesis, compared with SLAP repair, were not inferior in the surgical treatment of overhead athletes with SLAP lesions with regard to the ASES score, rate of return to sport, rate of return to preinjury level of sport, and complication rate. Further high-level, randomized controlled studies are needed to confirm this result.