bluuebunny/crossref_metadata_2025_split huggingface dataset:
The unpredictable journeys of spreading, sustaining and scaling healthcare innovations: a scoping review
Authors: Côté-Boileau Élizabeth , Denis Jean-Louis , Callery Bill , Sabean Meghan 
Published: September 2019

AbstractInnovation has the potential to improve the quality of care and health service delivery, but maximising the reach and impact of innovation to achieve large-scale health system transformation remains understudied. Interest is growing in three processes of the innovation journey within health systems, namely the spread, sustainability and scale-up (3S) of innovation. Recent reviews examine what we know about these processes. However, there is little research on how to support and operationalise the 3S. This study aims to improve our understanding of the 3S of healthcare innovations. We focus specifically on the definitions of the 3S, the mechanisms that underpin them, and the conditions that either enable or limit their potential. We conducted a scoping review, systematically investigating six bibliographic databases to search, screen and select relevant literature on the 3S of healthcare innovations. We screened 641 papers, then completed a full-text review of 112 identified as relevant based on title and abstract. A total of 24 papers were retained for analysis. Data were extracted and synthesised through descriptive and inductive thematic analysis. From this, we develop a framework of actionable guidance for health system actors aiming to leverage the 3S of innovation across five key areas of focus, as follows: (1) focus on the why, (2) focus on perceived-value and feasibility, (3) focus on what people do, rather than what they should be doing, (4) focus on creating a dialogue between policy and delivery, and (5) focus on inclusivity and capacity building. While there is no standardised approach to foster the 3S of healthcare innovations, a variety of practical frameworks and tools exist to support stakeholders along this journey.
Association between coffee consumption and risk of bladder cancer in a meta-analysis of 16 prospective studies
Authors: Dai Zhi-Wei , Cai Ke-Dan , Li Fu-Rong , Wu Xian-Bo , Chen Guo-Chong 
Published: September 2019

Abstract

Background
Current evidence remains equivocal as to whether and how consumption of coffee may be associated with risk of bladder cancer, and potential influence of confounding by smoking on this association is yet to be elucidated. We conducted an updated meta-analysis of prospective studies to address these issues.

Methods
Relevant studies were identified by searching PubMed and EMBASE databases from inception to April 2019. A random-effects model was used to estimate summary relative risk (RR) with corresponding 95% confidence interval (CI) of bladder cancer associated with coffee consumption.

Results
The final analysis included 16 prospective studies comprising 2,122,816 participants and 11,848 bladder cancer cases. Overall, coffee consumption was not associated with risk of bladder cancer (RR high-vs-low = 1.07, 95% CI: 0.96–1.20). The lack of association persisted in the strata defined by sex or participants’ smoking status. Meta-regression analyses identified the number cases (Pdifference = 0.06) and the degree of adjustment for smoking (Pdifference = 0.04) as potential sources of heterogeneity. There was an increased risk of bladder cancer related to higher coffee consumption among studies with fewer cases (RR high-vs-low = 1.38, 95% CI: 1.05–1.81) and among those with poorer adjustment for smoking (RR high-vs-low = 1.48, 95% CI: 1.14–1.93). Results were similar in the dose-response analyses (RR 1 cup/d = 1.01, 95% CI: 0.98–1.03).

Conclusion
Best evidence available to date does not support an independent association between coffee consumption and bladder cancer risk. Some direct associations observed in individual studies may be a result of residual confounding by smoking.
Sensory processing of women diagnosed with genito-pelvic pain/penetration disorder: a research proposal
Authors: Labuschagne Elsie , van Niekerk Matty 
Published: September 2019

Abstract

Objectives
The study objectives are to describe the sensory processing patterns of women diagnosed with genito-pelvic pain/penetration disorder (GPPPD), to explore the level of anxiety when both GPPPD and sensory processing disorder (SPD) are present and to investigate participants’ experience of participating in a sensory-based home programme.

Methods
A descriptive two-phased study design will be used. Phase one is a quantitative, cross sectional non-experimental descriptive study, using the Adolescent/Adult Sensory History (ASH) and Hospital Anxiety and Depression Scales (HADS) to obtain data from purposive sampling. Phase two is an exploratory qualitative study involving participants who were identified with SPD in phase one. They will participate in a sensory-based home programme and their experience thereof will be established during semi-structured interviews.

Outcomes
Descriptive studies are known to be useful in planning health services and to develop hypotheses for future testing. This study could improve practitioners’ understanding of GPPPD and SPD and make alternative, non-invasive, non-pharmacological treatment options available to better assist these patients. The study could further clarify the role of the occupational therapist in sexuality. Exploring participants’ anxiety has important implications for treatment protocols in occupational therapy and assisting in describing the signs and symptoms of GPPPD.
Legal and policy requirements of basic health insurance package to achieve universal health coverage in a developing country
Authors: Hayati Ramin , Kabir Mohammad Javad , Kavosi Zahra , Bastani Peivand , Sobhani Ghasem , Javadinasab Hamideh 
Published: September 2019

Abstract

Objectives
This study has analyzed the policy-making requirements related to basic health insurance package at the national level with a systematic view.

Results
All the documents presented since the enactment of universal health insurance in Iran from 1994 to 2017 were included applying Scott method for assuring meaningfulness, authenticity, credibility and representativeness. Then, content analysis was conducted applying MAXQDA10. The legal and policy requirements related to basic health insurance package were summarized into three main themes and 11 subthemes. The main themes include three kinds of requirements at three level of third party insurer, health care provider and citizen/population that contains 5 (financing insurance package, organizational structure, tariffing and purchasing the benefit packages and integration of policies and precedents), 4 (determining the necessities, provision of services, rules relating to implementation and covered services) and 2 (expanded coverage of population and insurance premiums) sub themes respectively. According to the results, Iranian policy makers should notice three axes of third party insurers, health providers and population of the country to prepare an appropriate basic benefit package based on local needs for all the people that can access with no financial barriers in order to be sure of achieving UHC.
The prevalence and the reasons of issuing permission for therapeutic abortion in department of forensic medicine, Kermanshah, Iran, during 2005 to 2010
Authors: Sharifi Azam , Janatolmakan Maryam , Khatony Alireza 
Published: September 2019

AbstractObjectiveThe present study aimed to investigate the prevalence and the reasons of issuing permission for therapeutic abortion in department of forensic medicine, Kermanshah-Iran.ResultsThere were a total number of 428 applications for issuing permits. The most common reasons of issuing permit for therapeutic abortion were fetal and maternal problems, specifically cerebral abnormalities (70.8%), and anencephaly (30.3%). Furthermore, 354 (82/7%) out of 428 applications were able to get the legal permit and 17.3% of the applications did not receive permission, which was mainly due to “the lack of maternal indication”. Increased knowledge of physicians and clinical personnel on indications of therapeutic abortions and related regulations would lead to the implementation of strategies which prevent void referrals to the department of forensic medicine and a better execution of therapeutic abortion law. By improving the health condition of pregnant women who seek pregnancy termination, informing them about indications of therapeutic abortions, and developing proper strategies to make pregnant women more acquainted with legal cases of abortion, we can take a significant step towards helping pregnant women and promoting their health.
An innovative approach of incorporating a humanoid robot into teaching EFL learners with intellectual disabilities
Authors: Alemi Minoo , Bahramipour Shirin 
Published: September 2019

AbstractThe present case study investigated the probable effect of applying a humanoid robot as a teacher-assistant for learning and retention of English vocabulary among 10 Iranian foreign language learners with intellectual disabilities, more specifically Down syndrome. This method is a new trend in using technology to teach classes called Robot Assisted Language Learning (RALL). To this end, participants were divided into 2 groups of five, one with the help of the robot (RALL) and one without (non-RALL). Both groups received the same lessons to learn 40 English vocabulary in 8 sessions. To measure the results, three English tests were run at different times during the teaching sessions (a pre-test, post-test, and a delayed post-test). The independent sample t-test on gain scores from pre-test to post-test revealed that there was a significant difference between the gains of the RALL group (M = 12.40) and the non-RALL group (M = 8.40), which indicates that RALL instruction had a large effect on the participants’ English vocabulary improvement. Moreover, while both RALL and non-RALL groups retained the taught vocabulary, the RALL group showed a more satisfying result. The findings of this study demonstrate the positive effects of using a humanoid robot to facilitate vocabulary learning and retention among people with Down syndrome who have issues with both language learning and verbal short-term memory and need to learn through visual activities, gestures, and games. This study could be a starting point for a new line of research in second or foreign language instruction specific to people with Down syndrome.
Cost distribution and equity of climate policy in Switzerland
Authors: Landis Florian 
Published: September 2019

AbstractSwiss targets for climate policy require significant reductions of emissions by 2050. While such reductions can be achieved in a cost-efficient manner by employing taxes on greenhouse gas emissions, such taxes tend to lead to a regressive distribution of policy cost among households. To counteract such a regressive outcome, tax revenue may be recycled in a progressive way. This paper uses a computable general equilibrium model coupled with a microsimulation of household income and expenditure to examine the policy cost of different carbon tax policies and their distribution across households. I find that in the absence of revenue recycling, emission taxation leads to a regressive distribution of policy cost. I analyze different revenue recycling schemes (per-capita lump-sum transfers, reductions in labor taxation, and reductions in VAT taxation of necessary commodities) and their ability to avoid regressive outcomes.
Multi-model comparison of Swiss decarbonization scenarios
Authors: Landis Florian , Marcucci Adriana , Rausch Sebastian , Kannan Ramachandran , Bretschger Lucas 
Published: September 2019

Abstract
Collaborating under the Swiss Energy Modeling Platform (SEMP), five modeling teams (employing an energy systems model and four macroeconomic models with a focus on energy) have carried out a multi-model comparison to assess the economic and technological consequences of reaching emission reduction targets for 2050 in the context of Switzerland. We consider different designs of carbon taxes to compare their economic cost: economy-wide or sector-specific carbon taxes with or without an emission trading system (ETS) in place. All models find that the climate targets can be reached at modest welfare reductions of 0.15–0.37% (if targeting 1.5 tonnes of CO 2 per capita) or 0.24–0.48% (if targeting 1.0 tonnes per capita) compared to a business-as-usual scenario in which the emission level of 1.5 tonnes per capita is exceeded by 83–137%. In contradiction to the additional target of reducing Swiss electricity use, most models find it cost-effective to replace some of the energy supplied by fossil fuels by electricity and thus do not recommend a decrease in electricity use.Most models find that a uniform carbon tax is the most efficient instrument to achieve the emission reduction targets. Those models with a detailed representation of pre-existing mineral oil taxes find that in early periods of climate policy, taxing emission from transport fuels at lower rates than other emissions may be cost-efficient. This effect vanishes as the stringency of targets and thus CO 2 taxes increase over time.
Growth impacts of Swiss steering-based climate policies
Authors: Marcucci Adriana , Zhang Lin 
Published: September 2019

Abstract
This paper studies the growth impacts of realizing two long-term carbon targets in Switzerland (reducing CO2 emissions in 2050 by 72% and 80% relative to 1990 levels) with alternative steering-based climate policies that include a uniform tax on the whole economy and differentiated tax schemes. For this analysis, we use the Computable Induced Technical change and Energy (CITE) model, a computable general equilibrium (CGE) model with endogenous growth. We find that achieving the climate targets could lead to a slight decrease in utility and an increase in investments through the shift of labor from manufacturing to research. Higher investments coming from higher innovation could compensate the reduction in output due to the carbon policies, leading to relatively unaffected economic output. The economic structure adjusts following three drivers: energy intensity, substitutability from energy in the production of the intermediate varieties, and the relative attractiveness of research. Moreover, the results from the CITE model show that the economy-wide carbon tax is the most effective option when we consider the effects on utility. Differentiating the sectors regulated by the emission trading system (ETS) has relatively low impact while applying lower taxes on transport fuels results in lower utility driven by inefficiencies in the sectoral mitigation efforts. Finally, we find that the effects of increasing the stringency of the target (in terms of foregone utility) are independent from the policy instrument.
Tox4 modulates cell fate reprogramming
Authors: Vanheer Lotte , Song Juan , De Geest Natalie , Janiszewski Adrian , Talon Irene , Provenzano Caterina , Oh Taeho , Chappell Joel , Pasque Vincent 
Published: September 2019

ABSTRACT
Reprogramming to induced pluripotency induces the switch of somatic cell identity to induced pluripotent stem cells (iPSCs). However, the mediators and mechanisms of reprogramming remain largely unclear. To elucidate the mediators and mechanisms of reprogramming, we used a siRNA-mediated knockdown approach for selected candidate genes during the conversion of somatic cells into iPSCs. We identified Tox4 as a novel factor that modulates cell fate through an assay that determined the efficiency of iPSC reprogramming. We found that Tox4 is needed early in reprogramming to efficiently generate early reprogramming intermediates, irrespective of the reprogramming conditions used. Tox4 enables proper exogenous reprogramming factor expression, and the closing and opening of putative somatic and pluripotency enhancers early during reprogramming, respectively. We show that the TOX4 protein assembles into a high molecular form. Moreover, Tox4 is also required for the efficient conversion of fibroblasts towards the neuronal fate, suggesting a broader role of Tox4 in modulating cell fate. Our study reveals Tox4 as a novel transcriptional modulator of cell fate that mediates reprogramming from the somatic state to the pluripotent and neuronal fate.
This article has an associated First Person interview with the first author of the paper.
Prognostic Relevance of a Complete Pathologic Response in Liver Transplantation for Hepatocellular Carcinoma
Authors: Grąt Michał , Krawczyk Marek , Stypułkowski Jan , Morawski Marcin , Krasnodębski Maciej , Wasilewicz Michał , Lewandowski Zbigniew , Grąt Karolina , Patkowski Waldemar , Zieniewicz Krzysztof 
Published: September 2019

Abstract

Background
A complete pathologic response (CPR) after neoadjuvant treatment is reported to be associated with an exceptionally low risk of recurrence after liver transplantation for hepatocellular carcinoma (HCC). This study aimed to evaluate the prognostic role of CPR in liver transplantation for HCC.

Methods
This retrospective cohort study was based on 222 HCC transplant recipients. Incidence of recurrence and survival at 5 years were the primary and secondary outcome measures, respectively. Competing risk analyses were applied to evaluate recurrence incidence and its predictors. Propensity score matching was performed to compare the outcomes for patients after neoadjuvant treatment with and without CPR.

Results
Neoadjuvant treatment was performed for 127 patients, 32 of whom achieved CPR (25.2%). Comparison of baseline characteristics showed that the patients with CPR were at lowest baseline recurrence risk, followed by treatment-naïve patients and patients without CPR. Adjusted for potential confounders, CPR did not have any significant effects on tumor recurrence. No significant net reclassification improvement was noted after addition of CPR to existing criteria. Neoadjuvant treatment without CPR was associated with increased risk of recurrence in subgroups within the Milan criteria (p = 0.016), with alpha-fetoprotein concentration (AFP) model not exceeding 2 points (p = 0.021) and within the Warsaw criteria (p = 0.007) compared with treatment-naïve patients who were at risk similar to those with CPR. The 5-year incidences of recurrence in propensity score-matched patients with and without CPR were respectively 14.0% and 15.9% (p = 0.661), with corresponding survival rates of 73.2% and 67.4%, respectively (p = 0.329).

Conclusions
The findings showed that CPR is not independently associated with long-term outcomes after liver transplantation for HCC.
Percepción de los maestros sobre el derecho al juego libre en educación infantil y educación primaria. Estudio desarrollado en Barcelona (España)
Authors: Vendrell Mañós Roser , Geis Balagué Àngels , Anglès Virgili Núria , Dalmau Montalá Mariona 
Published: September 2019

INTRODUCCIÓN. El juego libre infantil se valora, desde un marco constructivista y ecológico, como un derecho y una necesidad en el desarrollo integral del niño. El estudio pretende conocer la percepción de los maestros e identificar el cumplimiento de este derecho en la escuela. MÉTODO. Es un estudio descriptivo en el que se aplica una metodología mixta. En la investigación se diseña un cuestionario ad hoc a partir del análisis cualitativo de los resultados obtenidos en diferentes Focus Groups (FG). Posteriormente se realiza la validación del mismo, y finalmente se administra a maestros de educación infantil y primaria de Barcelona. RESULTADOS. El proceso de análisis de los resultados finales pone de manifiesto cuáles son las creencias de los maestros sobre la incorporación del juego libre en la intervención educativa y las influencias que ejerce el contexto educativo y social en su implementación. Las dificultades que se dan en la escuela para favorecer la incorporación del juego libre se evidencian en algunos de los datos que atañen a las propias creencias de los maestros, a la rigidez de los horarios escolares, a la presión curricular y a la dirección y/o titularidad. DISCUSIÓN. Se concluye el informe subrayando que si se pretende mejorar la calidad de las experiencias educativas, es preciso reivindicar, a través de la formación de los maestros, el valor del juego en la escuela.
Intimate Relationship Dynamics and Changing Desire for Pregnancy Among Young Women
Authors: Barber Jennifer S. , Miller Warren , Kusunoki Yasamin , Hayford Sarah R. , Guzzo Karen Benjamin 
Published: September 2019

CONTEXTAlthough substantial research has focused on unintended pregnancy among young women, less is known about the circumstances under which pregnancy is desired. Whether a young woman's pregnancy desire changes across her different relationships, or over time within a relationship, has not been directly assessed.METHODSData on intimate relationships and pregnancy desire were assessed weekly for 895 women aged 18–22 who participated in the Relationship Dynamics and Social Life study in a county in Michigan (2008–2012). Within‐between logistic regression models were used to examine within‐cluster and between‐cluster differences—comparisons of a woman's pregnancy desire within a relationship over time as well as across a woman's different relationships.RESULTSYoung women were more likely to desire pregnancy if they were in any relationship more intimate and committed than a casual relationship (odds ratios, 1.6–9.2); the odds of desiring pregnancy were also higher in long‐term relationships rather than in short‐term ones (2.1). In general, pregnancy desire increased over time as a relationship endured and became more serious. The odds of desiring pregnancy were lower among women with less educated, rather than equally educated, partners (0.7), while the odds were higher in nonmonogamous or violent relationships than in monogamous or nonviolent relationships (1.6 and 1.9, respectively).CONCLUSIONSYoung women's pregnancy desire changes depending on their intimate relationship context, across the range of relationships they experience during the transition to adulthood.
Tolerance of Baked Cheese in Cow's Milk-Mediated Eosinophilic Esophagitis
Authors: Brown Teresa M. , Leung John 
Published: September 2019

ABSTRACT
Eosinophilic esophagitis (EoE) is a chronic antigen-driven disease of the esophagus diagnosed by both clinical and pathological features. Current treatments include proton pump inhibitors, elimination diets, and swallowed steroids. This study discusses a young boy with cow's milk-mediated EoE who remained in remission after a 6-week baked cheese challenge following the successful completion of a 6-week baked milk challenge. To our knowledge, there are currently no reported cases of successful remission of milk-triggered EoE after a baked cheese challenge.
Hepatic Actinomycosis in a Patient With Retained Common Bile Duct Stent
Authors: Grossen Alyssa , Magguilli Michael , Thai Theresa C. , Salem George 
Published: September 2019

ABSTRACT
Primary hepatic actinomycosis is rare, with less than 100 cases reported in English literature. Most of these cases are cryptogenic. We describe a 35-year-old woman who presented with a retained common bile duct stent for 6 years and found to have a hepatic mass with altered perfusion and enhancement, and minimal degree of washout on enhanced cross-sectional imaging. Fine-needle aspiration revealed presence of filamentous bacteria morphologically consistent with Actinomyces species. This report is a demonstration of a rare instance in which a retained biliary stent led to primary hepatic actinomycosis.