bluuebunny/crossref_metadata_2025_split huggingface dataset:
Interventions to improve district-level routine health data in low-income and middle-income countries: a systematic review
Authors: Lee Jieun , Lynch Caroline A , Hashiguchi Lauren Oliveira , Snow Robert W , Herz Naomi D , Webster Jayne , Parkhurst Justin , Erondu Ngozi A 
Published: June 2021

BackgroundRoutine health information system(s) (RHIS) facilitate the collection of health data at all levels of the health system allowing estimates of disease prevalence, treatment and preventive intervention coverage, and risk factors to guide disease control strategies. This core health system pillar remains underdeveloped in many low-income and middle-income countries. Efforts to improve RHIS data coverage, quality and timeliness were launched over 10 years ago.MethodsA systematic review was performed across 12 databases and literature search engines for both peer-reviewed articles and grey literature reports on RHIS interventions. Studies were analysed in three stages: (1) categorisation of RHIS intervention components and processes; (2) comparison of intervention component effectiveness and (3) whether the post-intervention outcome improved above the WHO integrated disease surveillance response framework data quality standard of 80% or above.Results5294 references were screened, resulting in 56 studies. Three key performance determinants—technical, organisational and behavioural—were proposed as critical to RHIS strengthening. Seventy-seven per cent [77%] of studies identified addressed all three determinants. The most frequently implemented intervention components were ‘providing training’ and ‘using an electronic health management information systems’. Ninety-three per cent [93%] of pre–post or controlled trial studies showed improvements in one or more data quality outputs, but after applying a standard threshold of >80% post-intervention, this number reduced to 68%. There was an observed benefit of multi-component interventions that either conducted data quality training or that addressed improvement across multiple processes and determinants of RHIS.ConclusionHolistic data quality interventions that address multiple determinants should be continuously practised for strengthening RHIS. Studies with clearly defined and pragmatic outcomes are required for future RHIS improvement interventions. These should be accompanied by qualitative studies and cost analyses to understand which investments are needed to sustain high-quality RHIS in low-income and middle-income countries.
Experiences and perceptions of trial participants and healthcare professionals in the UK Frozen Shoulder Trial (UK FROST): a nested qualitative study
Authors: Srikesavan Cynthia , Toye Francine , Brealey Stephen , Goodchild Lorna , Northgraves Matthew , Charalambous Charalambos P , Rangan Amar , Lamb Sarah 
Published: June 2021

ObjectivesTo explore the experiences and perceptions of trial participants and healthcare professionals in the UK Frozen Shoulder Trial (UK FROST), a multicentre randomised controlled trial that compared manipulation under anaesthesia (MUA), arthroscopic capsular release (ACR) with a 12-week early structured physiotherapy programme (ESP) in people with unilateral frozen shoulder referred to secondary care.DesignNested qualitative study with semistructured interviews. We used constant comparison method to develop our themes.SettingThis qualitative study was nested within the UK FROST.Participants44 trial participants (ESP: 14; MUA: 15; ACR: 15), and 8 surgeons and 8 physiotherapists who delivered the treatments in the trial.ResultsTrial participants found UK FROST treatments acceptable and satisfactory in terms of content, delivery and treatment benefits. Participants in all arms experienced improvements in pain, shoulder movements, and function. Participants said they would choose the same treatment that they received in the trial.Surgeons and physiotherapists felt that the content and delivery of UK FROST treatments was not significantly different to their routine practice except for the additional number of physiotherapy sessions offered in the trial. They had mixed feelings about the effectiveness of UK FROST treatments. Both stressed the value of including hydrodilatation as a comparator of other treatment options. Physiotherapists raised concerns about the capacity to deliver the number of UK FROST physiotherapy sessions in routine clinical settings.Shared perceptions of trial participants, surgeons and physiotherapists were: (1) Pain relief and return of shoulder movements and function are important outcomes and (2) Adherence to exercises leads to better outcomes.ConclusionIn general, our findings indicated that trial participants, and surgeons and physiotherapists who delivered the treatments had positive experiences and perceptions in the UK FROST. Early qualitative investigations to explore the feasibility of delivering treatments in real-world settings are suggested in future trials in the frozen shoulder.Trial registration numberInternational Standard Randomised Controlled Trial Register, ID: ISRCTN48804508. Registered on 25 July 2014; Results
Association of Cardiovascular Disease Risk Factors with Late Cardiotoxicity and Survival in HER2-positive Breast Cancer Survivors
Authors: He Xuexin , Ji Jiali , Dai Xiaolan , Qdaisat Aiham Z. , Esteva Francisco J. , Hortobagyi Gabriel N. , Yeung Sai-Ching J. 
Published: June 2021

Abstract

Purpose:
Breast cancer and cardiovascular (CV) diseases often share the same risk factors. It is increasingly important to identify risk factors for CV events in patients with high-risk breast cancer and explore optimal treatment regimens.

Experimental Design:
Early HER2-positive breast cancer patients at our institution between January 1998 and October 2009 were reviewed. Primary outcome was late-severe-CV-event-free survival, and late severe CV events were defined as cardiovascular death, cardiomyopathy, symptomatic heart failure, and myocardial infarction developing 2+ years after breast cancer diagnosis. Kaplan–Meier plots, Cox proportional hazard regressions, and restricted mean survival time were used to evaluate outcomes.

Results:
We identified 2,448 consecutive eligible patients with a median follow-up time of 111.0 months (interquartile range, 52.0–151.8 months). One hundred and thirty-six patients had late severe CV events and 752 died of any cause [533 (70.9%) died of primary breast cancer; 12 (1.6%) died of cardiovascular disease]. Hypertension [HR, 1.546; 95% confidence interval (95% CI), 1.030–2.320; P = 0.036] and history of coronary artery disease (CAD; HR, 3.333; 95% CI, 1.669–6.656; P &lt; 0.001) were associated with worse late-severe-CV-event-free survival. Anthracycline-containing regimens (HR, 1.536; 95% CI, 0.979–2.411; P = 0.062) was not a significant risk factor for CV events in multivariate analysis. Regimens containing both anthracycline and anti-HER2 therapy were prognostic for better OS (HR, 0.515; 95% CI, 0.412–0.643; P &lt; 0.001).

Conclusions:
Hypertension and CAD history were independent prognostic factors for late severe CV events. Adding anti-HER2 agents to anthracycline-containing regimens did not substantially increase the risk for late severe cardiotoxicity and conferred better overall survival.
Single-Cell Analysis of the Pan-Cancer Immune Microenvironment and scTIME Portal
Authors: Hong Fang , Meng Qianqian , Zhang Weiyu , Zheng Ruiqin , Li Xiaoyun , Cheng Tao , Hu Deqing , Gao Xin 
Published: June 2021

Abstract

Single-cell sequencing opens a new era for the investigation of tumor immune microenvironments (TIME). However, at single-cell resolution, a pan-cancer analysis that addresses the identity and diversity of TIMEs is lacking. Here, we first built a pan-cancer single-cell reference of TIMEs with refined subcell types and recognized new cell type–specific transcription factors. We then presented a pan-cancer view of the common features of the TIME and compared the variation of each immune cell type across patients and tumor types in the aspects of abundance, cell states, and cell communications. We found that the abundance and the cell states of dysfunctional T cells were most variable, whereas those of regulatory T cells were relatively stable. A subset of tumor-associated macrophages (TAM), PLTP+C1QC+ TAMs, may regulate the abundance of dysfunctional T cells through cytokine/chemokine signaling. The ligand–receptor communication network of TIMEs was tumor-type specific and dominated by the tumor-enriched immune cells. We additionally developed the single-cell TIME (scTIME) portal (http://scTIME.sklehabc.com) with the scTIME-specific analysis modules and a unified cell annotation. In addition to the immune cell compositions and correlation analysis using refined cell type classifications, the portal also provides cell–cell interaction and cell type–specific gene signature analysis. Our single-cell pan-cancer analysis and scTIME portal will provide more insights into the features of TIMEs, as well as the molecular and cellular mechanisms underlying immunotherapies.
Percepção de Profissionais e Usuários de Unidades Básicas de Saúde sobre a Inserção do Nutricionista
Authors: Mota Juliana Ramos da , Oliveira Daniele dos Santos , Santos Adriana Correia dos , Chagas Bárbara Lúcia Fonseca , Voci Silvia Maria 
Published: June 2021

Este estudo teve como objetivo analisar a importância da inserção do nutricionista em Unidades Básicas de Saúde (UBS), bem como as dificuldades de acesso aos seus serviços a partir da percepção de profissionais e usuários do serviço de saúde. Foi realizado um estudo de corte transversal de abordagem quantitativa e qualitativa, para o qual foram entrevistados profissionais e usuários de duas unidades básicas de saúde de Aracaju-SE utilizando-se um roteiro semiestruturado específico pré-testado e com gravação de áudio. Para a análise das informações foi utilizada a técnica do Discurso do Sujeito Coletivo (DSC) proposta por Lefèvre e Lefèvre. Os resultados obtidos demonstraram que os profissionais e usuários têm conhecimento da importância do nutricionista nas UBS para melhoria da qualidade de vida da comunidade bem como para as trocas de informações e agregação de seu conhecimento aos demais profissionais da unidade, porém os mesmos relataram dificuldades para a ampliação e acesso a esse serviço, tais como: recursos humanos insuficientes, demora e burocracia no agendamento, e a falta de divulgação da presença do nutricionista nas unidades. Concluímos que, embora com sua importância reconhecida, a inserção do nutricionista na UBS esbarra em dificuldades relacionadas à burocracia, a falta de informação e aspectos relacionados à gestão.
All the research that’s fit to print: Open access and the news media
Authors: Schultz Teresa 
Published: June 2021

Abstract
The goal of the open access (OA) movement is to help everyone access scholarly research, not just those who can afford to. However, most studies looking at whether OA has met this goal have focused on whether other scholars are making use of OA research. Few have considered how the broader public, including the news media, uses OA research. I sought to answer whether the news media mentions OA articles more or less than paywalled articles by looking at articles published from 2010 through 2018 in journals across all four quartiles of the Journal Impact Factor using data obtained through Altmetric.com and Web of Science. Gold, green and hybrid OA articles all had a positive correlation with the number of news mentions received. News mentions for OA articles did see a dip in 2018, although they remained higher than those for paywalled articles.
How cumulative is technological knowledge?
Authors: Persoon Peter , Bekkers Rudi , Alkemade Floor 
Published: June 2021

Abstract
Technological cumulativeness is considered one of the main mechanisms for technological progress, yet its exact meaning and dynamics often remain unclear. To develop a better understanding of this mechanism, we approach a technology as a body of knowledge consisting of interlinked inventions. Technological cumulativeness can then be understood as the extent to which inventions build on other inventions within that same body of knowledge. The cumulativeness of a technology is therefore characterized by the structure of its knowledge base, which is different from, but closely related to, the size of its knowledge base. We analytically derive equations describing the relation between the cumulativeness and the size of the knowledge base. In addition, we empirically test our ideas for a number of selected technologies, using patent data. Our results suggest that cumulativeness increases proportionally with the size of the knowledge base, at a rate that varies considerably across technologies. Furthermore, this rate is inversely related to the rate of invention over time. This suggests that cumulativeness increases relatively slowly in rapidly growing technologies. In sum, the presented approach allows for an in-depth, systematic analysis of cumulativeness variations across technologies and the knowledge dynamics underlying technology development.
Effectiveness of topical silicone gel and pressure garment therapy for burn scar prevention and management in children 12-months postburn: A parallel group randomised controlled trial
Authors: Wiseman Jodie , Simons Megan , Kimble Roy , Ware Robert S , McPhail Steven M , Tyack Zephanie 
Published: June 2021

Objective: The longer-term effectiveness of silicone and pressure burn scar interventions was evaluated at 12-months postburn. Design: Parallel group, randomised trial. Setting: Hospital outpatient clinics, research centre. Participants: Children referred for burn scar management following grafted or spontaneously healed acute burn injuries or scar reconstruction surgery. Interventions: Participants were randomised to: (1) topical silicone gel only, (2) pressure garment only, or (3) combined topical silicone gel and pressure garment. Main measures: Primary outcomes were scar thickness (blinded ultrasound measurement) and itch intensity (caregiver proxy-report, numeric rating scale). Results: Of 153 participants randomised who received the interventions (silicone n = 51, pressure garment n = 49, combined n = 53), 86 were followed-up at 12-months postburn ( n = 34, n = 28, n = 24). No differences were identified for the primary outcomes using intention-to-treat analysis. Scar thickness mean difference (95% confidence interval) = 0.00 cm (−0.04, 0.05); −0.03 cm (−0.07, 0.02); 0.03 cm (−0.02, 0.08) and scar itch = 0.09 (−0.88, 1.06); −0.21 (−1.21, 0.79); 0.30 (−0.73, 1.32) for silicone vs pressure; silicone vs combined and combined vs pressure respectively. No serious adverse effects occurred. Conclusion: Similar to short-term results, the combined intervention offered no statistically or clinically significant benefit for improving the primary outcomes compared to each intervention alone. No differences in the primary outcomes were identified between the silicone and pressure alone groups.
Biomechanical Effects of Δ9-Tetrahydrocannabinol (THC) and Cannabidiol (CBD), the Major Constituents of Cannabis, in a Sprague Dawley Rat Achilles Tendon Surgical Repair Model: A Pilot Study
Authors: Stauch Christopher M. , Ammerman Brittany , Sepulveda Diana , Aynardi Michael C. , Garner Matthew R. , Lewis Gregory , Morgan Daniel , Dhawan Aman 
Published: June 2021

Background: The use of cannabis is common among athletes and the US population at large. Cannabinoids are currently being evaluated as alternatives to opioid medications for chronic pain management. However, the effects of recreational and/or medical use of delta-9-tetrahydrocannabinol (THC) and cannabidiol (CBD) on musculoskeletal injury and healing remain largely unknown. Hypothesis/Purpose: The purpose of this study was to evaluate the biomechanical effects of CBD and THC on tendon-to-tendon healing in a rat Achilles tendon repair model. The hypothesis was that rats administered CBD would demonstrate decreased tensile load to failure of surgically repaired Achilles tendons compared with the THC and control groups. Study Design: Controlled laboratory study. Methods: A total of 33 Sprague Dawley rats underwent Achilles tendon surgical transection and repair and were randomized to receive subcutaneous injection of THC, CBD, or vehicle once daily starting on the day of surgery and for 5 total days. After sacrifice, biomechanical tensile load-displacement testing was performed to determine Achilles tendon load to failure and stiffness. Data were analyzed by 1-way analysis of variance. Results: The THC group demonstrated the highest median load to failure, 18.7 N (95% CI, 15.3-19.2 N); the CBD group had the second highest at 16.9 N (95% CI, 15.1-19.8 N), and the control group had the lowest at 14.4 N (95% CI, 12.1-18.3 N). Stiffness was highest in the THC group at 4.1 N/mm (95% CI, 2.7-5.1 N/mm) compared with 3.6 N/mm (95% CI, 2.9-4.1 N/mm) for the CBD group and 3.6 N/mm (95% CI, 2.8-4.3 N/mm) for the control group. No statistically significant differences for strength and stiffness were observed between the groups. Conclusion: In this pilot study using an animal tendon-to-tendon repair model, neither THC nor CBD resulted in altered biomechanical characteristics compared to control. Clinical Relevance: Cannabinoids do not appear to adversely affect Achilles tendon healing.
The Minimal Clinically Important Difference (MCID) for the WOMAC and Factors Related to Achievement of the MCID After Medial Opening Wedge High Tibial Osteotomy for Knee Osteoarthritis
Authors: Kim Man Soo , Koh In Jun , Choi Keun Young , Sung Yong Gyu , Park Dong Chul , Lee Hyo Jin , In Yong 
Published: June 2021

Background: Many approaches have been used to determine the minimal clinically important difference (MCID) in patients undergoing total knee arthroplasty, but the MCID for outcome measures after medial opening wedge high tibial osteotomy (MOWHTO) for the treatment of medial compartment knee osteoarthritis (OA) has not been reported. Purpose: To define the MCID for the Western Ontario and McMaster Universities Arthritis Index (WOMAC) after MOWHTO and to identify risk factors for not achieving the MCID. Study Design: Case-control study; Level of evidence, 3. Methods: Among patients with medial compartment knee OA who underwent MOWHTO, 174 patients who were followed for 2 years were included in the study. The MCID and substantial clinical benefit (SCB) for the WOMAC were determined using the anchor-based method with a 15-item questionnaire. Preoperative OA severity was measured by the Kellgren-Lawrence (K-L) grading system, and the acceptable range of the postoperative weightbearing line ratio was 50% to 70%. Patients were divided into 2 groups based on whether the MCID and SCB were achieved, and then factors related to failure to achieve the MCID and SCB were analyzed using multivariate logistic regression analysis. Results: The MCID for the WOMAC was 4.2 points for the pain subscale, 1.9 points for the stiffness subscale, 10.1 points for the function subscale, and 16.1 points for the total. Additionally, the SCB for the WOMAC was 6.4 for pain, 2.6 for stiffness, 16.4 for function, and 25.3 for the total. Overall, 116 (66.7%), 99 (56.9%), 127 (73.0%), and 128 (73.6%) patients achieved the MCID for the WOMAC pain, stiffness, function, and total, respectively, after MOWHTO. The odds of not achieving the MCID for the WOMAC total were 1.09 times greater (95% CI, 1.05-1.13; P < .001) in patients with a low preoperative WOMAC total score (cutoff values: 10.5 for pain, 3.5 for stiffness, 34.5 for function, and 51.0 for the total), 11.77 times greater (95% CI, 3.68-37.70; P < .001) in patients with K-L grade 4 OA compared with K-L grades 2 or 3 OA, and 8.39 times greater (95% CI, 2.98-23.63; P < .001) in patients with undercorrection or overcorrection. A low preoperative WOMAC score, K-L grade 4 OA, and undercorrection or overcorrection were also associated with not achieving the SCB for the WOMAC total (all P < .05). Conclusion: Patients treated with a MOWHTO require a 16.1-point improvement in the WOMAC total score to achieve a MCID from the procedure. Low preoperative WOMAC scores, severe OA, and undercorrection or overcorrection were related to failure to achieve the MCID.
Impact of Sex on COVID-19 Media Exposure, Anxiety, Perceived Risk, and Severity in Middle-Aged and Older Adults
Authors: Curtis Ashley F. , Rodgers Mikayla , Miller Mary Beth , McCrae Christina S. 
Published: June 2021

Objectives To examine associations between COVID-19 media exposure and anxiety/perceived risk/severity and investigate their dependency on sex in middle-aged/older adults. Methods Adults aged 50+ years completed online surveys: Coronavirus Anxiety Scale, COVID-19 media exposure, COVID-19 media dependency for health information, and COVID-19 perceived risk and severity. Multiple regressions examined independent and interactive (with sex) associations between COVID-19 media exposure/dependency and COVID-19 anxiety/perceived risk and severity. Analyses controlled for age, education, race, total medical conditions, and COVID-19 status. Results Higher COVID-19 media exposure was associated with higher COVID-19 anxiety among men (not women) and higher perceived risk/severity in both sexes. Higher COVID-19 media dependency was associated with higher COVID-19 anxiety and perceived risk/severity in both sexes. Conclusion In middle-aged/older adults, the use/dependency of media for COVID-19 information may be linked to negative psychological health and increased COVID-19 perceived risk and severity. Men may be at increased risk of anxiety related to media exposure.
Conceptual aerodynamic design of an executive supersonic passenger aircraft – ESPA
Authors: Lawrence Jeremy P , Hutchinson Rhys J , Joiner Keith F 
Published: June 2021

Despite 50 years of technological advancement since the inception of Concorde, research on supersonic passenger aircraft has only recently resulted in design and flight test of several small 12- to 55-passenger business jets with supersonic cruises between Mach 1.2 and 2.2. Analytical research designs of larger 300-passenger aircraft have been conducted only to speeds of Mach 2.0 and 2.2, mainly avoiding moving beyond turbojet propulsion. This research extends on an earlier multifactor regression sizing study to determine in greater design detail what the configuration of a 200-passenger Mach 3.0 aircraft could be using extant technology. This research article is the first part of two and covers the conceptual aircraft design evolution focussing on the aerodynamics, wing and fuselage. In contrast, the second article covers engine conceptual design and placement. Wing shape optimization is performed using fundamental CFD analysis to arrive at a configuration suitable for both subsonic and supersonic flight. Noise considerations and shock wave formation drive further design iterations based on the research literature. The viability of this research design informs a future multidisciplinary optimization like those recently published in the literature for smaller supersonic business jets.