bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating process and effectiveness of a low-intensity CBT intervention for women with gynaecological cancer (the EPELIT Trial)
Authors: Hulbert-Williams Nicholas J. , Hulbert-Williams Lee , Flynn Ryan James , Pendrous Rosina , MacDonald-Smith Carey , Mullard Anna , Swash Brooke , Evans Gemma , Price Annabel 
Published: March 2021

Background: Improving survival from gynaecological cancers is creating an increasing clinical challenge for long-term distress management. Psychologist-led interventions for cancer survivors can be beneficial, but are often costly. The rise of the Psychological Wellbeing Practitioner (PWP) workforce in the UK might offer a cheaper, but equally effective, intervention delivery method that is more sustainable and accessible. We aimed to test the effectiveness of a PWP co-facilitated intervention for reducing depression and anxiety, quality of life and unmet needs. Methods: We planned this trial using a pragmatic, non-randomised controlled design, recruiting a comparator sample from a second clinical site. The intervention was delivered over six-weekly sessions; data were collected from participants at baseline, weekly during the intervention, and at one-week and three-month follow-up. Logistical challenges meant that we only recruited 8 participants to the intervention group, and 26 participants to the control group. Results: We did not find significant, between-group differences for depression, quality of life or unmet needs, though some differences at follow-up were found for anxiety (p<.001). Analysis of potential intervention mediator processes indicated the potential importance of self-management self-efficacy. Low uptake into the psychological intervention raises questions about (a) patient-driven needs for group-based support, and (b) the sustainability of this intervention programme. Conclusions: This study failed to recruit to target; the under-powered analysis likely explains the lack of significant effects reported, though some trends in the data are of interest. Retention in the intervention group, and low attrition in the control group indicate acceptability of the intervention content and trial design; however a small baseline population rendered this trial infeasible in its current design. Further work is required to answer our research questions, but also, importantly, to address low uptake for psychological interventions in this group of cancer survivors. Trial registration: ClinicalTrials.gov, NCT03553784 (registered 14 June 2018).
Sedentary behaviour levels in adults with an intellectual disability: a systematic review protocol
Authors: Lynch Louise , McCarron Mary , McCallion Philip , Burke Eilish 
Published: March 2021

Background: Sedentary behaviour contributes to non-communicable diseases, which account for almost 71% of world deaths. Of these, cardiovascular disease is one of the largest causes of preventable death. It is not yet fully understood what level of sedentary behaviour is safe. People with an intellectual disability have poorer health than the general population with higher rates of multi-morbidity, obesity and inactivity. There is a paucity of evidence on whether this poorer health is due to sedentary behaviour or physical inactivity. This systematic review will investigate the sedentary behaviour levels of adults with an intellectual disability. Method: The PRISMA-P framework will be applied to achieve high-quality articles. An extensive search will be conducted in Medline, Embase, psycINFO and Cinahl and grey literature sources. All articles will be independently reviewed by two reviewers and a third to resolve disputes. Initially, the articles will be reviewed by title and abstract and then the full article will be reviewed using stringent inclusion criteria. All article data will be summarised in a standardised tabular format. The National Institute of Health’s quality assessment tool will be used to assess article quality. GRADE will be used to assess the quality of the evidence. The primary outcome of interest is the prevalence of sedentary behaviour levels for people with an intellectual disability. The definition of sedentary behaviour to be used for the purposes of this study is: ‘low physical activity as identified by metabolic equivalent (MET) or step levels or as measured by the Rapid Assessment of Physical activity questionnaire (RAPA) or the International Physical Activity questionnaire (IPAQ) or sitting for more than 3 hours per day’. Conclusion: This systematic review will provide a critical insight into the prevalence of sedentary behaviour in adults with an intellectual disability.
Potential of commercial SiN MPW platforms for developing mid/high-resolution integrated photonic spectrographs for astronomy
Authors: Gatkine Pradip , Jovanovic Nemanja , Hopgood Christopher , Ellis Simon , Broeke Ronald , Ławniczuk Katarzyna , Jewell Jeffrey , Wallace J. Kent , Mawet Dimitri 
Published: March 2021

Integrated photonic spectrographs offer an avenue to extreme miniaturization of astronomical instruments, which would greatly benefit extremely large telescopes and future space missions. These devices first require optimization for astronomical applications, which includes design, fabrication, and field testing. Given the high costs of photonic fabrication, multi-project wafer (MPW) silicon nitride (SiN) offerings, where a user purchases a portion of a wafer, provide a convenient and affordable avenue to develop this technology. In this work, we study the potential of two commonly used SiN waveguide geometries by MPW foundries, i.e., square and rectangular profiles, to determine how they affect the performance of mid/high-resolution arrayed waveguide grating (AWG) spectrometers around 1.5 µm. Specifically, we present results from detailed simulations on the mode sizes, shapes, and polarization properties, and on the impact of phase errors on the throughput and cross talk as well as some laboratory results of coupling and propagation losses. From the MPW run tolerances and our phase-error study, we estimate that an AWG with R

∼

10,000

can be developed with the MPW runs, and even greater resolving power is achievable with more reliable, dedicated fabrication runs. Depending on the fabrication and design optimizations, it is possible to achieve throughputs

∼

60
%

using the SiN platform. Thus, we show that SiN MPW offerings are highly promising and will play a key role in integrated photonic spectrograph developments for astronomy.
Low-threshold supercontinuum generation in polycrystalline media
Authors: Vasilyev Sergey , Gu Jiahui , Mirov Mike , Barnakov Yury , Moskalev Igor , Smolski Viktor , Peppers Jeremy , Kolesik Miroslav , Mirov Sergey , Gapontsev Valentin 
Published: March 2021

Until recently, the generation of super-octave continua in bulk
materials at full repetition rates of femtosecond (fs) oscillators has
been limited to a few special cases of Kerr lens mode-locked
Ti:sapphire lasers. In 2019, we described a 3.4-octave fs source with
50 nJ pulse energy at the repetition rate of 78 MHz based on
polycrystalline Cr:ZnS [Vasilyev et al.,
Optica
6, 126 (2019)OPTIC82334-253610.1364/OPTICA.6.000126].
Here we explain the mechanism of fs supercontinuum generation in
transition-metal doped polycrystalline II-VI semiconductors at
relatively low (nJ-level) pulse energy. We demonstrate that this new
supercontinuum regime is enabled by a complex, yet well-reproducible,
interplay between the effects arising from the
third-order nonlinearity, the quadratic nonlinearities, and thermal
optical effects in the medium. We also demonstrate the control of fs
pulse propagation in disordered

χ

(
2
)

media via the control of the material
microstructure.
Modeling the spatial distribution of anthrax in southern Kenya
Authors: Otieno Fredrick Tom , Gachohi John , Gikuma-Njuru Peter , Kariuki Patrick , Oyas Harry , Canfield Samuel A. , Blackburn Jason K. , Njenga M. Kariuki , Bett Bernard 
Published: March 2021

BackgroundAnthrax is an important zoonotic disease in Kenya associated with high animal and public health burden and widespread socio-economic impacts. The disease occurs in sporadic outbreaks that involve livestock, wildlife, and humans, but knowledge on factors that affect the geographic distribution of these outbreaks is limited, challenging public health intervention planning.MethodsAnthrax surveillance data reported in southern Kenya from 2011 to 2017 were modeled using a boosted regression trees (BRT) framework. An ensemble of 100 BRT experiments was developed using a variable set of 18 environmental covariates and 69 unique anthrax locations. Model performance was evaluated using AUC (area under the curve) ROC (receiver operating characteristics) curves.ResultsCattle density, rainfall of wettest month, soil clay content, soil pH, soil organic carbon, length of longest dry season, vegetation index, temperature seasonality, in order, were identified as key variables for predicting environmental suitability for anthrax in the region. BRTs performed well with a mean AUC of 0.8. Areas highly suitable for anthrax were predicted predominantly in the southwestern region around the shared Kenya-Tanzania border and a belt through the regions and highlands in central Kenya. These suitable regions extend westwards to cover large areas in western highlands and the western regions around Lake Victoria and bordering Uganda. The entire eastern and lower-eastern regions towards the coastal region were predicted to have lower suitability for anthrax.ConclusionThese modeling efforts identified areas of anthrax suitability across southern Kenya, including high and medium agricultural potential regions and wildlife parks, important for tourism and foreign exchange. These predictions are useful for policy makers in designing targeted surveillance and/or control interventions in Kenya.We thank the staff of Directorate of Veterinary Services under the Ministry of Agriculture, Livestock and Fisheries, for collecting and providing the anthrax historical occurrence data.
Serious adverse events following treatment of visceral leishmaniasis: A systematic review and meta-analysis
Authors: Singh-Phulgenda Sauman , Dahal Prabin , Ngu Roland , Maguire Brittany J. , Hawryszkiewycz Alice , Rashan Sumayyah , Brack Matthew , Halleux Christine M. , Alves Fabiana , Stepniewska Kasia , Olliaro Piero L , Guerin Philippe J. 
Published: March 2021

Background
Despite a historical association with poor tolerability, a comprehensive review on safety of antileishmanial chemotherapies is lacking. We carried out an update of a previous systematic review of all published clinical trials in visceral leishmaniasis (VL) from 1980 to 2019 to document any reported serious adverse events (SAEs).

Methods
For this updated systematic review, we searched the following databases from 1st Jan 2016 through 2nd of May 2019: PUBMED, Embase, Scopus, Web of Science, Cochrane, clinicaltrials.gov, WHO ICTRP, and the Global Index Medicus. We included randomised and non-randomised interventional studies aimed at assessing therapeutic efficacy and extracted the number of SAEs reported within the first 30 days of treatment initiation. The incidence rate of death (IRD) from individual treatment arms were combined in a meta-analysis using random effects Poisson regression.

Results
We identified 157 published studies enrolling 35,376 patients in 347 treatment arms. Pentavalent antimony was administered in 74 (21.3%), multiple-dose liposomal amphotericin B (L-AmB) in 52 (15.0%), amphotericin b deoxycholate in 51 (14.7%), miltefosine in 33 (9.5%), amphotericin b fat/lipid/colloid/cholesterol in 31 (8.9%), and single-dose L-AmB in 17 (4.9%) arms. There was a total of 804 SAEs reported of which 793 (including 428 deaths) were extracted at study arm level (11 SAEs were reported at study level only). During the first 30 days, there were 285 (66.6%) deaths with the overall IRD estimated at 0.068 [95% confidence interval (CI): 0.041–0.114; I2 = 81.4%; 95% prediction interval (PI): 0.001–2.779] per 1,000 person-days at risk; the rate was 0.628 [95% CI: 0.368–1.021; I2 = 82.5%] in Eastern Africa, and 0.041 [95% CI: 0.021–0.081; I2 = 68.1%] in the Indian Subcontinent. In 21 study arms which clearly indicated allowing the inclusion of patients with HIV co-infections the IRD was 0.575 [95% CI: 0.244–1.355; I2 = 91.9%] compared to 0.043 [95% CI: 0.020–0.090; I2 = 62.5%] in 160 arms which excluded HIV co-infections.

Conclusion
Mortality within the first 30 days of VL treatment initiation was a rarely reported event in clinical trials with an overall estimated rate of 0.068 deaths per 1,000 person-days at risk, though it varied across regions and patient populations. These estimates may serve as a benchmark for future trials against which mortality data from prospective and pharmacovigilance studies can be compared. The methodological limitations exposed by our review support the need to assemble individual patient data (IPD) to conduct robust IPD meta-analyses and generate stronger evidence from existing trials to support treatment guidelines and guide future research.
Feasibility of integrating survivors of stroke into cardiac rehabilitation: A mixed methods pilot study
Authors: Regan Elizabeth W. , Handlery Reed , Stewart Jill C. , Pearson Joseph L. , Wilcox Sara , Fritz Stacy 
Published: March 2021

BackgroundSurvivors of stroke are often deconditioned and have limited opportunities for exercise post-rehabilitation. Cardiac Rehabilitation (CR), a structured exercise program offered post-cardiac event in the United States (U.S.), may provide an opportunity for continued exercise.The purpose of this study was to examine the feasibility of integrating survivors of stroke into an existing, hospital-based CR program through an assessment of (1) recruitment, uptake and retention, (2) adherence and fidelity, (3) acceptability and (4) safety.MethodsA mixed methods design combined a single group, pre-post design, pilot feasibility study with an imbedded qualitative inquiry. Survivors of stroke were recruited into a standard 12-week, 36 visit CR program.ResultsFifty-three survivors were referred, 29 started and 24 completed the program. Program uptake rate was 55% and completion rate was 83%. Eleven completers and one non-completer participated in the qualitative interviews. Program completers attended an average of 25.25 (SD 5.82) sessions with an average of 38.93 (SD 5.64) exercise minutes per session while reaching targeted rate of perceived exertion levels. Qualitative themes included perceived benefits of an individualized program in a group setting, positive interactions with qualified staff, opportunities for socialization, and regular monitoring and staff attentiveness promoting feelings of safety.ConclusionsSurvivors of stroke were able to meet Medicare standard dosage (frequency and session duration) and rate of perceived intensity goals, and perceived the program as needed regardless of their mobility limitations or previous exercise experience. Primary challenges included managing referrals and uptake. Results support feasibility and benefit for survivors to integrate into U.S. CR programs.
Oropharyngeal meningococcal carriage in children and adolescents, a single center study in Buenos Aires, Argentina
Authors: Gentile Angela , Della Latta Maria Paula , Bloch Mercedes , Martorelli Luisina , Wisner Barbara , Sorhouet Pereira Cecilia , Regueira Mabel , Juarez Maria del Valle , Umido Veronica , Efron Adriana 
Published: March 2021

Background
Neisseria meningitidis (Nm) pharyngeal carriage is a necessary condition for invasive disease. We present the first carriage study in children in Buenos Aires, Argentina, considering 2017 as a transition year. Aims: to assess the rate of Nm carriage, to determine genogroup, clonal complex and outer membrane protein distribution, to determine carriage risk factors by age.

Methods
Cross-sectional study including children 1–17 yrs, at Ricardo Gutiérrez Children’s Hospital in Buenos Aires 2017. Oro-pharyngeal swabs were taken and cultured within a short time after collection. Genogroup was determined by PCR and clonal complex by MLST. Categorical variables were analyzed.

Results
A total of 1,751 children were included. Group 1: 943 children 1–9 yrs, 38 Nm were isolated; overall carriage 4.0%. Genogroup distribution: B 26.3%, W 5.3%, Y 2.6%, Z 5.3%, other groups 7.9% and capsule null (cnl) 52.6%. Participating in extracurricular activities was the only independent predictor of Nm carriage. Group 2: 808 children 10–17 yrs, 76 Nm were isolated; overall carriage 9.4%. Genogroup distribution: B 19.7%, C 5.3%, W 7.9%, Y 9.2%, Z 5.3%, other groups 7.9% and cnl 44.7%. Independent predictors of carriage: attending pubs/night clubs and passive smoking (adjusted OR: 0.55, 95%CI = 0.32–0.93; p = 0.025).

Conclusions
Overall carriage was higher in 10–17 yrs. The isolates presenting the cnl locus were prevalent in both age groups and genogroup B was the second most frequent.
Management and patient safety of complex elderly patients in primary care during the COVID-19 pandemic in the UK—Qualitative assessment
Authors: Alboksmaty Ahmed , Kumar Sonia , Parekh Ravi , Aylin Paul 
Published: March 2021

Objectives
The study aims to investigate GPs’ experiences of how UK COVID-19 policies have affected the management and safety of complex elderly patients, who suffer from multimorbidity, at the primary care level in North West London (NWL).

Design
This is a service evaluation adopting a qualitative approach.

Setting
Individual semi-structured interviews were conducted between 6 and 22 May 2020, 2 months after the introduction of the UK COVID-19 Action Plan, allowing GPs to adapt to the new changes and reflect on their impact.

Participants
Fourteen GPs working in NWL were interviewed, until data saturation was reached.

Outcome measures
The impact of COVID-19 policies on the management and safety of complex elderly patients in primary care from the GPs’ perspective.

Results
Participants’ average experience was fourteen years working in primary care for the NHS. They stated that COVID-19 policies have affected primary care at three levels, patients’ behaviour, work conditions, and clinical practice. GPs reflected on the impact through five major themes; four of which have been adapted from the Safety Attitudes Questionnaire (SAQ) framework, changes in primary care (at the three levels mentioned above), involvement of GPs in policy making, communication and coordination (with patients and in between medical teams), stressors and worries; in addition to a fifth theme to conclude the GPs’ suggestions for improvement (either proposed mitigation strategies, or existing actions that showed relative success). A participant used an expression of “infodemic” to describe the GPs’ everyday pressure of receiving new policy updates with their subsequent changes in practice.

Conclusion
The COVID-19 pandemic has affected all levels of the health system in the UK, particularly primary care. Based on the GPs’ perspective in NWL, changes to practice have offered opportunities to maintain safe healthcare as well as possible drawbacks that should be of concern.
Planned missing data in early literacy interventions: A replication study with an additional gold standard
Authors: Rippe Ralph C. A. , Merkelbach Inge 
Published: March 2021

IntroductionIn a digital early literacy intervention RCT, children born late preterm fell behind peers when in a control condition, but outperformed them when assigned to the intervention. Results did however not replicate previous findings. Replication is often complicated by resource quality. Gold Standard measures are generally time-intensive and costly, while they closely align with, and are more sensitive to changes in, early literacy and language performance. A planned missing data approach, leaving these gold standard measures incomplete, might aid in addressing the origin(s) of non-replication.MethodsParticipants after consent were 695 p Dutch primary school pupils of normal and late preterm birth. The high-quality measures, in additional to simpler but complete measures, were intentionally administered to a random subsample of children. Five definitions of gold standard alignment were evaluated.ResultsTwo out of five gold standard levels improved precision compared to the original results. The lowest gold standard level did not lead to improvement: precision was actually diminished. In two gold standard definitions, an alphabetical factor and a writing-only factor the model estimates were comparable to the original results. Only the most precise definition of the gold standard level replicated the original results.ConclusionGold standard measures could only be used to improve model efficiency in RCT-designs under sufficiently high convergent validity.
Multilevel analysis of unhealthy bodyweight among women in Malawi: Does urbanisation matter?
Authors: Afolabi Rotimi Felix , Palamuleni Martin Enock 
Published: March 2021

Background
Underweight and overweight constitute unhealthy bodyweight and their coexistence is symptomatic of the dual burden of malnutrition (DBM) of high public health concern in many sub-Saharan Africa countries. Little is known about DBM and its correlates in Malawi, a country undergoing urbanisation. The study examined net effects of urban residence on unhealthy weights amidst individual- and community-level factors among women in Malawi.

Methods
Data on 7231 women aged 15–49 years nested within 850 communities extracted from 2015–16 Malawi Demographic and Health Survey were analysed. Women’s weight status measured by body mass index, operationally categorised as underweight, normal and overweight, was the outcome variable while urban-rural residence was the main explanatory variable. Multilevel multinomial logistic regression analysis was employed at 5% significant level; the relative-risk ratio (RR) and its 95% confidence interval (CI) were presented.

Results
Urban residents had a significantly higher prevalence of overweight than rural (36.4% vs. 17.2%; p< 0.001) but a -non-significant lower prevalence of underweight (6.2% vs. 7.4%; p = 0.423). Having adjusted for both individual- and community-level covariates, compared to rural, living in urban (aRR = 1.25; CI: 1.02–1.53) accounted for about 25% higher risk of being overweight relative to normal weight. Higher education attainment, being married and belonging to Chewa, Lomwe or Mang’anja ethnic group significantly reduced the risk of being underweight but heightened the risk of being overweight. Being older and living in wealthier households respectively accounted for about 3- and 2-times higher likelihood of being overweight, while breastfeeding (aRR = 0.65; CI: 0.55–0.76) was protective against overweight. Living in communities with higher poverty and higher education levels reduced and increased the risk of being overweight, respectively. Evidence of community’s variability in unhealthy weights was observed in that 11.1% and 3.0% respectively of the variance in the likelihood of being overweight and underweight occurred across communities.

Conclusions
The study demonstrated association between urban residence and women overweight. Other important associated factors of overweight included breastfeeding, community education- and poverty-level, while education attainment, marital status and ethnicity were associated with the dual unhealthy weight. Thus, both individual- and community-level characteristics are important considerations for policy makers in designing interventions to address DBM in Malawi.