bluuebunny/crossref_metadata_2025_split huggingface dataset:
Country readiness and prerequisites for successful design and transition to implementation of essential packages of health services: experience from six countries
Authors: Alwan Ala , Majdzadeh Reza , Yamey Gavin , Blanchet Karl , Hailu Alemayehu , Jama Mohamed , Johansson Kjell Arne , Musa Mohammed Yusuf Ahmed , Mwalim Omar , Norheim Ole Frithjof , Safi Najibullah , Siddiqi Sameen , Zaidi Raza 
Published: January 2023

This paper reviews the experience of six low-income and lower middle-income countries in setting their own essential packages of health services (EPHS), with the purpose of identifying the key requirements for the successful design and transition to implementation of the packages in the context of accelerating progress towards universal health coverage (UHC). The analysis is based on input from three meetings of a knowledge network established by the Disease Control Priorities 3 Country Translation Project and working groups, supplemented by a survey of participating countries.All countries endorsed the Sustainable Development Goals target 3.8 on UHC for achievement by 2030. The assessment of country experiences found that health system strengthening and mobilising and sustaining health financing are major challenges. EPHS implementation is more likely when health system gaps are addressed and when there are realistic and sustainable financing prospects. However, health system assessments were inadequate and the government planning and finance sectors were not consistently engaged in setting the EPHS in most of the countries studied. There was also a need for greater engagement with community and civil society representatives, academia and the private sector in package design. Leadership and reinforcement of technical and managerial capacity are critical in the transition from EPHS design to sustained implementation, as are strong human resources and country ownership of the process. Political commitment beyond the health sector is key, particularly commitment from parliamentarians and policymakers in the planning and finance sectors. National ownership, institutionalisation of technical and managerial capacity and reinforcing human resources are critical for success.The review concludes that four prerequisites are crucial for a successful EPHS: (1) sustained high-level commitment, (2) sustainable financing, (3) health system readiness, and (4) institutionalisation.
Risk and timing of venous thromboembolism in patients with gastrointestinal cancer: a nationwide Danish cohort study
Authors: Tønnesen Jacob , Pallisgaard Jannik , Rasmussen Peter Vibe , Ruwald Martin H , Lamberts Morten , Nouhravesh Nina , Strange Jarl , Gislason Gunnar Hilmar , Hansen Morten Lock 
Published: January 2023

AimsCancer is a well-known risk factor of venous thromboembolism (VTE). Some cancers are believed to be more thrombogenic. The purpose of this study was to investigate the characteristics of patients with incident gastrointestinal cancers (GI) and their associated 1-year risk and timing of venous thromboembolic events and the 1-year mortality.MethodsThis study was a retrospective cohort study. Through Danish nationwide registries, all patients with first-time GI cancer diagnosis from 2008 to 2018 were identified. Incident VTE events were identified within a 1-year follow-up after GI cancer diagnosis using the Aalen-Johansen estimator. Cox proportional-hazard models were applied to investigate risk factors for VTE events and the impact of VTE on mortality.ResultsA total of 87 069 patients were included and stratified by cancer types: liver (5.8%), pancreatic (12.0%), gastric (6.9%), small intestinal (1.9%), colorectal (61.8%), oesophageal (7.3%) and gallbladder (3%). Most VTE events happened close to onset of the cancer diagnosis with declining events by time. The 1-year cumulative incidence of VTE differed according to cancer type with pancreatic cancer being most thrombogenic (7.8%), and colorectal and liver cancer being the least (3.6%). Prior VTE, heart failure, chronic obstructive pulmonary disease (COPD), liver disease, chronic kidney disease (CKD) and diabetes increased the VTE risk. Overall, the patients with GI cancer had high 1-year mortality of 33.3% with patients with pancreatic cancer having the highest mortality (70.3%).ConclusionWe found that most VTE events happen close to onset of the GI cancer diagnosis and thrombogenicity differed by type of GI cancer, ranging from 7.8% in patients with pancreatic cancer to 3.6% in colorectal and patients with liver cancer. Prior VTE, heart failure, COPD, liver disease, CKD and DM were associated with increased risk of VTE.
Comparison of the prevalence of SARS-CoV-2 nucleoprotein antibodies in healthcare workers and an unselected adult and paediatric all-comer patient population: insights from a longitudinal study of healthcare workers and concurrent serial cross-sectional studies of patients at an academic medical centre in Austria
Authors: Riesenhuber Martin , Nitsche Christian , Binder Christoph J , Schernhammer Eva S , Stamm Tanja , Jakse Friedrich , Anwari Elaaha , Hamidi Fardin , Haslacher Helmuth , Perkmann Thomas , Hengstenberg Christian , Zelniker Thomas A 
Published: January 2023

ObjectivesThis study aimed to estimate and compare the prevalence of the virus-specific antibodies against the SARS-CoV-2 nucleoprotein antigen (anti-SARS-CoV-2 N) in healthcare workers and an all-comer paediatric and adult patient population.Design, setting and participantsA longitudinal study enrolling healthcare professionals and concurrent serial cross-sectional studies of unselected all-comer patients were conducted at an Austrian academic medical centre. Healthcare workers were tested at enrolment and after 1, 2, 3, 6 and 12 months. The cross-sectional studies in patients were conducted at three time periods, which roughly coincided with the times after the first, second and third wave of SARS-CoV-2 in Austria (ie, 24 August–7 September 2020; 8–22 February 2021 and 9–23 November 2021). Anti-SARS-CoV-2 N antibodies were measured using a sandwich electrochemiluminescence assay (Roche).ResultsIn total, 2735 and 9275 samples were measured in 812 healthcare workers (median age: 40 years, 78% female) and 8451 patients (median age: 55 years, 52% female), respectively. Over the entire study period, anti-SARS-CoV-2 N antibodies were detected in 98 of 812 healthcare workers, resulting in a seroprevalence of 12.1% (95% CI 10.0% to 14.5%), which did not differ significantly (p=0.63) from that of the all-comer patient population at the end of the study period (407/3184; 12.8%, 95% CI 11.7% to 14.0%). The seroprevalence between healthcare workers and patients did not differ significantly at any time and was 1.5-fold to 2-fold higher than the number of confirmed cases in Austria throughout the pandemic. In particular, there was no significant difference in the seroprevalence between paediatric and adult patients at any of the tested time periods.ConclusionThroughout the pandemic, healthcare staff and an adult and paediatric all-comer patient population had similar exposure to SARS-CoV-2.Trial registration numberClinicalTrials.gov Identifier:NCT04407429.
At the edge of chaos: a prospective multiple case study in Australian general practices adapting to COVID-19
Authors: Russell Grant , Lane Riki , Neil Jennifer , Advocat Jenny , Sturgiss Elizabeth Ann , Staunton Smith Timothy , Alexander Karyn , Hattle Simon , Crabtree Benjamin F , Miller William L 
Published: January 2023

ObjectivesThe rapid onset and progressive course of the COVID-19 pandemic challenged primary care practices to generate rapid solutions to unique circumstances, creating a natural experiment of effectiveness, resilience, financial stability and governance across primary care models. We aimed to characterise how practices in Melbourne, Australia modified clinical and organisational routines in response to the pandemic in 2020–2021 and identify factors that influenced these changes.DesignProspective, qualitative, participatory case study design using constant comparative data analysis, conducted between April 2020 and February 2021. Participant general practitioner (GP) investigators were involved in study design, recruitment of other participants, data collection and analysis. Data analysis included investigator diaries, structured practice observation, documents and interviews.SettingThe cases were six Melbourne practices of varying size and organisational model.ParticipantsGP investigators approached potential participants. Practice healthcare workers were interviewed by social scientists on three occasions, and provided feedback on presentations of preliminary findings.ResultsWe conducted 58 interviews with 26 practice healthcare workers including practice owners, practice managers, GPs, receptionists and nurses; and six interviews with GP investigators. Data saturation was achieved within each practice and across the sample. The pandemic generated changes to triage, clinical care, infection control and organisational routines, particularly around telehealth. While collaboration and trust increased within several practices, others fragmented, leaving staff isolated and demoralised. Financial and organisational stability, collaborative problem solving, creative leadership and communication (internally and within the broader healthcare sector) were major influences on practice ability to negotiate the pandemic.ConclusionsThis study demonstrates the complex influences on primary care practices, and reinforces the strengths of clinician participation in research design, conduct and analysis. Two implications are: telehealth, triage and infection management innovations are likely to continue; the existing payment system provides inadequate support to primary care in a global pandemic.
Quality of maternal healthcare and travel time influence birthing service utilisation in Ghanaian health facilities: a geographical analysis of routine health data
Authors: Dotse-Gborgbortsi Winfred , Tatem Andrew J , Matthews Zoe , Alegana Victor A , Ofosu Anthony , Wright Jim A 
Published: January 2023

ObjectivesTo investigate how the quality of maternal health services and travel times to health facilities affect birthing service utilisation in Eastern Region, Ghana.DesignThe study is a cross-sectional spatial interaction analysis of birth service utilisation patterns. Routine birth data were spatially linked to quality care, service demand and travel time data.Setting131 Health facilities (public, private and faith-based) in 33 districts in Eastern Region, Ghana.ParticipantsWomen who gave birth in health facilities in the Eastern Region, Ghana in 2017.Outcome measuresThe count of women giving birth, the quality of birthing care services and the geographic coverage of birthing care services.ResultsAs travel time from women’s place of residence to the health facility increased up to two2 hours, the utilisation rate markedly decreased. Higher quality of maternal health services haves a larger, positive effect on utilisation rates than service proximity. The quality of maternal health services was higher in hospitals than in primary care facilities. Most women (88.6%) travelling via mechanised transport were within two2 hours of any birthing service. The majority (56.2%) of women were beyond the two2 -hour threshold of critical comprehensive emergency obstetric and newborn care (CEmONC) services. Few CEmONC services were in urban centres, disadvantaging rural populations.ConclusionsTo increase birthing service utilisation in Ghana, higher quality health facilities should be located closer to women, particularly in rural areas. Beyond Ghana, routinely collected birth records could be used to understand the interaction of service proximity and quality.
Longitudinal patient-reported outcomes 1 year after thoracoscopic segmentectomy versus lobectomy for early-stage lung cancer: a multicentre, prospective cohort study protocol
Authors: Gao Xin , Dai Wei , Zhang Qi , Liu Wenwu , Liu Yangjun , Yang Lingjia , Wei Xing , Shi Qiuling , Pompili Cecilia , Pu Yang , Xie Shaohua , Xiang Run , Tian Bo , Hu Bin , Yang Xiaozun , Wang Xiang , Yang Xiaojun , Xie Tianpeng , Tang Yong , Qiao Guibin , Sun Nan , Gao Shan , Zhang Guangjian , Chen Dan , Cui Yue , Chen Xiaobo , He Yu , Zhang Rong , Li Qiang , Zhuang Xiang 
Published: January 2023

IntroductionSegmentectomy and lobectomy are the main surgical procedures for early-stage lung cancer. However, few studies have analysed patient-reported outcomes after segmentectomy versus lobectomy. This study aims to compare patient-reported outcomes—such as symptoms, daily functioning and quality of life—between thoracoscopic segmentectomy and lobectomy for early-stage lung cancer during the 1 year after surgery.Methods and analysisOverall, 788 newly diagnosed patients with early-stage lung cancer (tumour size ≤2 cm), who are scheduled to undergo thoracoscopic segmentectomy or lobectomy, will be recruited in this multicentre, prospective cohort study. The patients will receive standardised care after surgery. The Perioperative Symptom Assessment for Lung Surgery—a validated lung cancer surgery-specific scale—will be used to assess the symptoms and functions at baseline, at discharge and monthly after discharge for 1 year. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 and Lung Cancer module 29 will be used to assess the patients’ quality of life at the same time points. The primary outcome will be the shortness of breath scores during the first year after thoracoscopic segmentectomy and lobectomy and will be compared using mixed-effects models. The secondary outcomes will include other symptoms, indicators of daily functioning, quality of life scores and traditional clinical outcomes. These will be compared using mixed-effects models and the Student’s t-test, non-parametric test or Χ2test. Propensity score matching will be used to ensure an even distribution of known confounders between the groups.Ethics and disseminationThe Ethics Committee for Medical Research and New Medical Technology of Sichuan Cancer Hospital approved this study (approval number: SCCHEC-02-2022-002). All participants will be instructed to provide informed consent. The manuscript is based on protocol version 3.0. The study results will be presented at medical conferences and published in peer-reviewed journals.Trial registration numberChiCTR2200060753.
Computer-assisted simulated workplace-based assessment in surgery: application of the universal framework of intraoperative performance within a mixed-reality simulation
Authors: Stefan Philipp , Pfandler Michael , Kullmann Aljoscha , Eck Ulrich , Koch Amelie , Mehren Christoph , von der Heide Anna , Weidert Simon , Fürmetz Julian , Euler Ekkehard , Lazarovici Marc , Navab Nassir , Weigl Matthias 
Published: January 2023

ObjectivesWorkplace-based assessment (WBA) is a key requirement of competency-based medical education in postgraduate surgical education. Although simulated workplace-based assessment (SWBA) has been proposed to complement WBA, it is insufficiently adopted in surgical education. In particular, approaches to criterion-referenced and automated assessment of intraoperative surgical competency in contextualized SWBA settings are missing.Main objectives were (1) application of the universal framework of intraoperative performance and exemplary adaptation to spine surgery (vertebroplasty); (2) development of computer-assisted assessment based on criterion-referenced metrics; and (3) implementation in contextualized, team-based operating room (OR) simulation, and evaluation of validity.DesignMultistage development and assessment study: (1) expert-based definition of performance indicators based on framework’s performance domains; (2) development of respective assessment metrics based on preoperative planning and intraoperative performance data; (3) implementation in mixed-reality OR simulation and assessment of surgeons operating in a confederate team. Statistical analyses included internal consistency and interdomain associations, correlations with experience, and technical and non-technical performances.SettingSurgical simulation center. Full surgical team set-up within mixed-reality OR simulation.ParticipantsEleven surgeons were recruited from two teaching hospitals. Eligibility criteria included surgical specialists in orthopedic, trauma, or neurosurgery with prior VP or kyphoplasty experience.Main outcome measuresComputer-assisted assessment of surgeons’ intraoperative performance.ResultsPerformance scores were associated with surgeons’ experience, observational assessment (Objective Structured Assessment of Technical Skill) scores and overall pass/fail ratings. Results provide strong evidence for validity of our computer-assisted SWBA approach. Diverse indicators of surgeons’ technical and non-technical performances could be quantified and captured.ConclusionsThis study is the first to investigate computer-assisted assessment based on a competency framework in authentic, contextualized team-based OR simulation. Our approach discriminates surgical competency across the domains of intraoperative performance. It advances previous automated assessment based on the use of current surgical simulators in decontextualized settings. Our findings inform future use of computer-assisted multidomain competency assessments of surgeons using SWBA approaches.
Using CT scans to determine the optimal sizes of hard armour plates to protect the torso for UK female Armed Forces personnel
Authors: Breeze John , Fryer RN , Bowley D , Gibb I , Lewis E 
Published: January 2023

IntroductionHard armour plates provide coverage to essential anatomical structures in the torso that, if injured, would likely be responsible for death before damage control surgery can be undertaken. Existing front and rear OSPREY plates in conjunction with Mark 2 plates used at the sides in current UK Armed Forces personal armour systems are provided in a single size, used by both female and male users.MethodsCT scans of 45 female UK military personnel were analysed. Distances between anatomical structures representing threshold (absolute minimum) and objective (the maximum level of coverage beyond which there is limited further benefit) coverage of the torso were determined and compared with OSPREY and Mark 2 plate dimensions. Sample characteristics were compared with the 2006/2007 UK Armed Forces Anthropometric Survey.ResultsNo statistical difference was found between sample means for stature (p=0.131) and mass (p=0.853) from those of the anthropometric survey in this sample. The height of both the front OSPREY plates exceeded the threshold coverage (suprasternal notch to lower border of the 10th rib) for all women studied. The height of the Mark 2 plate exceeds the objective coverage from the side for all women studied.ConclusionsBased on a plate height providing threshold coverage of all women up to the 50th percentile, the height of the front and rear OSPREY plates could be reduced by 36mm and 31mm respectively. Based on a presumption that a side plate should cover up to the 95th percentile, the Mark 2 plate achieves the objective height and width for the female population studied. Strong evidence was found to support the UK Ministry of Defence requirement for procurement of new front and rear plates of multiple heights for both female and male users.
Soft gluon–quark–antiquark emission in QCD hard scattering
Authors: Catani Stefano , Cieri Leandro , Colferai Dimitri , Coradeschi Francesco 
Published: January 2023

AbstractWe consider the radiation of a soft gluon (g) and a soft quark–antiquark ($$q{{\bar{q}}}$$

q

q

¯

) pair in QCD hard scattering. In the soft limit the scattering amplitude has a singular behaviour that is factorized and controlled by a soft current, which has a process-independent structure in colour space. We evaluate the soft $$gq{{\bar{q}}}$$

g
q

q

¯

current at the tree level for an arbitrary multiparton scattering process. The irreducible correlation component of the current includes strictly non-abelian terms and also terms with an abelian character. Analogous abelian correlations appear for soft photon–lepton–antilepton emission in QED. The squared current for soft $$gq{{\bar{q}}}$$

g
q

q

¯

emission produces colour dipole and colour tripole interactions between the hard-scattering partons. The colour tripole interactions are odd under charge conjugation and lead to charge asymmetry effects. We consider the specific applications to processes with two and three hard partons, and we discuss the structure of the corresponding charge asymmetry contributions. We also generalize our QCD results to the cases of QED and mixed QCD $$\times $$
×
QED radiative corrections.
A $$\nu $$ approach to analyzing neutrino data in the $${\textbf{R}}$$-parity-violating MSSM
Authors: Dreiner Herbi K. , Köhler Dominik , Nangia Saurabh 
Published: January 2023

AbstractThe R-parity-violating Minimal Supersymmetric Standard Model (RPV-MSSM) can naturally accommodate massive neutrinos as required by the oscillation data. However, studying the phenomenology is complicated due to the large number of undetermined parameters involved. Thus, studies are usually restricted to specific submodels. In this work, we develop an approach that allows us to be less restrictive. Working in (almost) the completely general RPV-MSSM setting, we analyze the structure of the neutrino mass matrix, and identify – for the case of two massive neutrinos – only four minimal classes of structures that can solve the neutrino data; we call these Minimal Oscillation Models (MOMs). We study the general features of each MOM class, and present numerical fits to the oscillation data. Our approach allows us to study all RPV models satisfying the neutrino data in a unified manner, as long as they satisfy the MOM criteria. Through several examples, we show that this indeed holds for many interesting scenarios.
Exotic states with triple charm
Authors: Bayar M. , Martínez Torres A. , Khemchandani K. P. , Molina R. , Oset E. 
Published: January 2023

AbstractIn this work we investigate the possibility of the formation of states from the dynamics involved in the $$D^*D^*D^*$$

D
∗

D
∗

D
∗

system by considering that two $$D^*$$

D
∗

’s generate a $$J^P=1^+$$

J
P

=

1
+

bound state, with isospin 0, which has been predicted in an earlier theoretical work. We solve the Faddeev equations for this system within the fixed center approximation and find the existence of $$J^P=0^-$$

J
P

=

0
-

, $$1^-$$

1
-

and $$2^-$$

2
-

states with charm 3, isospin 1/2, masses $$\sim 6000$$

∼
6000

MeV, which are manifestly exotic hadrons, i.e., with a multiquark inner structure.
The fundamental group of the complement of the Hesse configuration
Authors: Kaneko Jyoichi 
Published: January 2023

This note is of supplementary nature to our previous paper [J. Kaneko, K. Matsumoto and K. Ohara, The structure of a local system associated with a hypergeometric system of rank 9, Int. J. Math. 31 (2020) 2050021]. Let [Formula: see text] be the union of the nodal cubic curve and its three inflectional tangents in the complex projective plane [Formula: see text]. Such [Formula: see text] has appeared as the singular locus of certain hypergeometric system introduced in [J. Kaneko, K. Matsumoto and K. Ohara, A system of hypergeometric differential system in two variables of rank 9,Int. J. Math. 28 (2017) 1750015], and we have given generators and defining relations of the fundamental group of [Formula: see text] [J. Kaneko, K. Matsumoto and K. Ohara, The structure of a local system associated with a hypergeometric system of rank 9, Int. J. Math. 31 (2020) 2050021]. [Formula: see text] has a 9-fold Galois covering space [Formula: see text] given by the complement of the Hesse configuration of 12 lines in [Formula: see text]. Hence one can apply the method of Reidemeister–Schreier to derive a finite presentation of [Formula: see text], which we carry out in this note.