bluuebunny/crossref_metadata_2025_split huggingface dataset:
Qualitative analysis of HIV and AIDS disease transmission: impact of awareness, testing and effective follow up
Authors: Abiodun Oluwakemi E. , Adebimpe Olukayode , Ndako James , Oludoun Olajumoke , Aladeitan Benedicta , Adeniyi Michael 
Published: October 2022

Background: Since the early 1980s, human immunodeficiency virus (HIV) and its accompanying acquired immunodeficiency syndrome (AIDS) have spread worldwide, becoming one of the world's major global health issues. From the beginning of the epidemic until 2020, about 79.3 million people became infected, with 36.3 million deaths due to AIDS illnesses. This huge figure is a result of those unaware of their status due to stigmatization and invariably spreading the virus unknowingly. Methods: Qualitative analysis through a mathematical model that will address HIV unaware individuals and the effect of an increasing defaulter on the dynamics of HIV/AIDS was investigated. The impact of treatment and the effect of inefficient follow-up on the transmission of HIV/AIDS were examined. The threshold for the effective reduction of the unaware status of HIV through testing, in response to awareness, and the significance of effective non-defaulting in treatment commonly called defaulters loss to follow-up as these individuals contribute immensely to the spread of the virus due to their increase in CD4+ count was determined in this study. Stability analysis of equilibrium points is performed using the basic reproduction number $R_0$, an epidemiological threshold that determines disease eradication or persistence in viral populations. We tested the most sensitive parameters in the basic reproduction numbers. The model of consideration in this study is based on the assumption that information (awareness) and non-stigmatization can stimulate change in the behaviours of infected individuals, and can lead to an increase in testing and adherence to treatment. This will in turn reduce the basic reproduction number, and consequently, the spread of the virus. Results: The results portray that the early identification and treatment are inadequate for the illness to be eradicated. Conclusions: Other control techniques, such as treatment adherence and effective condom usage, should be investigated in order to lessen the disease's burden.
Viewing the global health system as a complex adaptive system – implications for research and practice
Authors: Borghi Josephine , Ismail Sharif , Hollway James , Kim Rakhyun E. , Sturmberg Joachim , Brown Garrett , Mechler Reinhard , Volmink Heinrich , Spicer Neil , Chalabi Zaid , Cassidy Rachel , Johnson Jeff , Foss Anna , Koduah Augustina , Searle Christa , Komendantova Nadejda , Semwanga Agnes , Moon Suerie 
Published: October 2022

The global health system (GHS) is ill-equipped to deal with the increasing number of transnational challenges. The GHS needs reform to enhance global resilience to future risks to health. In this article we argue that the starting point for any reform must be conceptualizing and studying the GHS as a complex adaptive system (CAS) with a large and escalating number of interconnected global health actors that learn and adapt their behaviours in response to each other and changes in their environment. The GHS can be viewed as a multi-scalar, nested health system comprising all national health systems together with the global health architecture, in which behaviours are influenced by cross-scale interactions. However, current methods cannot adequately capture the dynamism or complexity of the GHS or quantify the effects of challenges or potential reform options. We provide an overview of a selection of systems thinking and complexity science methods available to researchers and highlight the numerous policy insights their application could yield. We also discuss the challenges for researchers of applying these methods and for policy makers of digesting and acting upon them. We encourage application of a CAS approach to GHS research and policy making to help bolster resilience to future risks that transcend national boundaries and system scales.
Paradigm shift in medical education due to the COVID-19 pandemic: guidelines for developing a blended learning curriculum in medical education
Authors: Rafi Aisha , Anwar Muhammad Idrees , Younas Ayesha , Manzoor Shamaila 
Published: October 2022

Background: The coronavirus disease 2019 (COVID-19) pandemic has transformed the world’s economy, health and education in a blink of an eye. Almost 1 billion learners have been affected across the globe. This has resulted in a paradigm shift to blended learning. Therefore, it was felt necessary to provide practical guidelines for the development of blended curriculum in medical education. It would help to overcome the challenges faced due to unprecedented transformation of medical education on account of pandemic. Methods: Guidelines based on personal experience of the authors and literature search were developed using the complex adapted blended learning system (CALBS) framework. Seven experts developed these guidelines using the nominal group technique. The consent form and literature for CABLS framework was shared with experts. The experts developed the guidelines independently during phase one of the technique. After a given time, phase 2 started with moderator mediated discussion about the individual guidelines developed by the experts. After discussion and mutual consensus four types of guideline ideas were developed. During the third phase the experts ranked the guideline ideas on a scale of 1 to 5. The guideline idea that ranked highest was selected as a final guideline for developing a blended learning curriculum. Results: The group consensus resulted in developing seven guidelines for a blended course or curriculum in medical education. These guidelines are based on a conceptual framework supplemented by expert’s own personal experience and current evidence from literature. Conclusions: These guidelines would provide a comprehensive and systematic approach to develop a blended learning curriculum in medical education.
Research Software vs. Research Data II: Protocols for Research Data dissemination and evaluation in the Open Science context
Authors: Gomez-Diaz Teresa , Recio Tomas 
Published: October 2022

Background: Open Science seeks to render research outputs visible, accessible and reusable. In this context, Research Data and Research Software sharing and dissemination issues provide real challenges to the scientific community, as consequence of recent progress in political, legal and funding requirements. Methods: We take advantage from the approach we have developed in a precedent publication, in which we have highlighted the similarities between the Research Data and Research Software definitions. Results: The similarities between Research Data and Research Software definitions can be extended to propose protocols for Research Data dissemination and evaluation derived from those already proposed for Research Software dissemination and evaluation. We also analyze FAIR principles for these outputs. Conclusions: Our proposals here provide concrete instructions for Research Data and Research Software producers to make them more findable and accessible, as well as arguments to choose suitable dissemination platforms to complete the FAIR framework. Future work could analyze the potential extension of this parallelism to other kinds of research outputs that are disseminated under similar conditions to those of Research Data and Research Software, that is, without widely accepted publication procedures involving editors or other external actors and where the dissemination is usually restricted through the hands of the production team.
Accelerability vs. Scalability: R&D Investment Under Financial Constraints and Competition
Authors: Lin Danmo 
Published: October 2022

I develop a continuous-time model to examine how the interaction between competition and financial constraints affects firms’ research and development (R&D) strategies. The model integrates two key characteristics of R&D investment: accelerability (i.e., higher R&D intensity leads to faster discovery) and scalability (i.e., higher R&D intensity leads to higher project payoff). I find that firms react strategically to their rivals’ financial constraints when making investment decisions in a duopoly R&D race. In particular, firms respond positively to the R&D intensity of an unconstrained rival, while they respond in a hump-shaped fashion to the R&D intensity of a constrained rival. As a result, a constrained firm can pre-empt an unconstrained competitor in market equilibrium. Accelerability is necessary for such pre-emption to occur, and scalability generally reduces its likelihood. Comparison with a monopoly benchmark shows that the economic mechanism differs from over-investment induced by financial constraints alone. The model also generates new implications regarding how project characteristics and cash flow risks impact R&D decisions. This paper was accepted by Gustavo Manso, finance. Supplemental Material: The online appendix is available at https://doi.org/10.1287/mnsc.2022.4503 .
Early discontinuation of Implanon and associated factors among women in public health facilities of the Hawassa administration, south Ethiopia
Authors: Reda Mulu , Abebe Belay Amare 
Published: October 2022

Background/Aims Despite improving availability and use of the contraceptive Implanon, early discontinuation is a public health concern. A significant proportion of women discontinue using Implanon before it is due to be removed, which poses a health concern and may lead to contraceptive failure. Only 8% of married women in Ethiopia use contraceptive implants. There is a paucity of information on factors associated with early discontinuation of Implanon. This study's aims were to assess early discontinuation of Implanon and associated factors among women using public health facilities of Hawassa, south Ethiopia. Methods An institution-based cross-sectional study was conducted in six randomly selected public health facilities in Hawassa. All women using Implanon who visited the selected institutions during the data collection period were invited to participate in the study. Data were collected through face-to-face interviews using a pretested questionnaire. A multivariate logistic regression model was used to identify predictors of early Implanon removal. Results Of the 250 study participants, 54.0% discontinued using Implanon early. A woman having primary level education (adjusted odds ratio=2.332, P=0.048), lack of counselling about the possible benefits of Implanon (adjusted odds ratio=2.496, P=0.019), side effects (adjusted odds ratio=2.092, P=0.002) and the desire to be pregnant in the near future (adjusted odds ratio=2.222, P<0.0001) were associated with early discontinuation. Conclusions Over half of women using Implanon discontinued early, which was related to lower education, a lack of counselling, side effects of the implant and the desire to become pregnant. Pre-insertion counselling for women should include information on the possible side effects and benefits of Implanon, to decrease the proportion of women who discontinue its use early.
Compassionate and respectful maternity care for mothers who gave birth in public health facilities in North Gondar, Ethiopia: a cross-sectional study
Authors: Zeleke Agerie Mengistie , Bayeh Gashaw Melkie 
Published: October 2022

Background Improving the prevalence of compassionate and respectful maternity care is a critical agenda and an important component of healthcare provider quality assurance. Making compassionate and respectful maternity care available is an important way to increase facility-based childbirth use in Ethiopia. However, evidence on compassionate and respectful maternal care during labour delivery services is limited. Therefore, this study aimed to assess compassionate and respectful maternity care, and its predictors, among those who gave birth in health facilities in North Gondar. Methods An institution-based cross-sectional study was conducted from May to July 2020 in a public health facility in North Gondar, Ethiopia. Systematic random sampling was used to select 398 study participants. Data were collected from participants using a pretested structured questionnaire. Bivariate and multivariate logistic regression model analyses with 95% confidence intervals were carried out to identify predictors of compassionate and respectful maternity care. Results A total of 398 respondents participated in the study. The overall prevalence of compassionate, respectful maternal care was 52.5%. Having primary school level education (adjusted odds ratio: 1.96), having attended antenatal care (adjusted odds ratio: 2.92), labour lasting for less than 6 hours (adjusted odds ratio: 2.22), and the intention to give birth in a health facility (adjusted odds ratio: 3.06) were significant predictors of compassionate and respectful maternity care. Conclusions The prevalence of compassionate and respectful maternity care was low and violations of women's rights are an important barrier to women seeking to give birth in a health facility. Hence, to promote high-quality maternal health services, health professionals must practice women-friendly approaches to improve the relationship between health workers and mothers during their stay at health facilities. Enforcing respectful maternity care is vital to strengthen maternal services and improve the rate of institution-based birth.
Parallel optimization of tridimensional deformation measurement based on correlation function constraints of a multi-camera network
Authors: Zhang Guiyang , Wei Liang , Zhang Bin , Zhou Xing , Huo Ju 
Published: October 2022

This study primarily investigates the low accuracy and redundant time-consuming problem of speckle registration in the full-field deformation measurement of slender and biggish specimens. To solve these problems, a parallel optimization of the tridimensional deformation measurement method is proposed based on what we believe is a novel correlation function constraints of a multi-camera network. First, a neotype correlation function is built based on the joint constraint relationship among the multiple cameras, which is capable of accurately restricting the search for homologous points in image pairs to the epipolar line, instead of the entire image, while significantly narrowing the search space and accelerating the search. The multiple cameras are bundled as a whole, thus reducing the dimension of the Jacobian matrix and the normalized matrix to a certain extent. Subsequently, more speckle images can be calculated in one iteration. Furthermore, the decomposition of the derived correlation function and the scheme of the parallel algorithm are decomposed via the kernel function based on the GPU parallel mechanism of the compute unified device architecture source program, thus increasing the subpixel search speed of speckle matching and ensuring the calculation performance of the stereo deformation measurement method to reach a higher level. Lastly, the experimental results revealed that the proposed strategy could allow the calculation speed-up ratio of speckle sequence and stereo registration to reach 20.390 times and 17.873 times, respectively, while ensuring the out-of-plane displacement average measuring accuracy to be higher than 0.179 mm within the spatial range of [2 m, 2 m, 3 m]. As a result, the proposed approach has crucial applications in rapid and stable tridimensional deformation measurement.
Sine-limiting microcell solar concentrators for space
Authors: Ruud Christian J. , Gordon Jeffrey M. , McCarthy Robert F. , Giebink Noel C. 
Published: October 2022

Microcell concentrating photovoltaics (µCPV) have the potential to improve performance and reduce the cost of solar power in space. Here, we introduce an ultracompact V-cone tailored edge ray (V-TERC) concentrator, rooted in nonimaging optics, which enables operation near the sine limit. Relative to previous space µCPV implementations, this concentrator design enables an approximate four-fold increase in concentration ratio for a given acceptance angle and specific power. We validate the design through ray tracing simulations and construction of a proof-of-concept system that consists of a 650 × 650 µm2 triple-junction microcell bonded to a 3.1 mm-thick prototype V-TERC optic. In outdoor testing on a sunny day, the system achieves a power conversion efficiency of 30% at a geometric gain of 137× with a specific power of 90 W kg-1 and an acceptance angle of ±4.5°. This is a record combination for µCPV to date and represents an important step toward increasing efficiency and lowering the cost of solar power in space.
Health system opportunities and challenges for PrEP implementation in Kenya: A qualitative framework analysis
Authors: Atkins Kaitlyn , Musau Abednego , Mugambi Mary , Odhyambo Geoffrey , Tengah Soud Ali , Kamau Mercy , Kumau Ruth , Reed Jason , Were Daniel 
Published: October 2022

Background
As pre-exposure prophylaxis (PrEP) scales up in sub-Saharan Africa, governments and implementers need to understand how to best manage national programs. Kenya’s national PrEP program offers an opportunity to review elements of program success within the health system and evaluate the utility of a national implementation framework. We explored health system considerations for PrEP implementation to understand how Kenya’s national PrEP implementation priorities align with those of PrEP service providers, peer educators, and program or county managers.

Methods
We conducted twelve key informant interviews (KII) and nine focus group discussions (FGDs) with PrEP program and county managers (n = 12), peer educators (n = 44), and PrEP service providers (n = 48). We recruited participants across a variety of cadres and experiences with PrEP programs. KIIs and FGDs focused on PrEP service delivery and program implementation. Data were collected by trained study staff, audio recorded, translated into English, and transcribed. We used framework analysis methods to systematically apply Kenya’s 2017 National PrEP Implementation Framework to the data and summarized findings according to the seven Implementation Framework domains.

Results
All respondents emphasized the important role of communication, coordination, training, and leadership in PrEP implementation. PrEP service providers and program and county managers highlighted the importance of efficient data collection and utilization, and improved resource allocation. Commodity security and research, while key elements of the PrEP Implementation Framework, were less commonly discussed, and research was less prioritized by respondents. Respondents highlighted the importance of coordinated PrEP service delivery across sites and programs to improve overall client experiences.

Conclusion
In the context of a nationally-scaled PrEP program, PrEP service providers, peer educators, and program and county managers value strong leadership, close coordination of services across sites, and expedient use of data to improve strategies and services. Kenya’s PrEP Implementation Framework aligns closely with the priorities of individuals involved in PrEP service delivery and management, and provides a comprehensive overview of health system considerations for effective implementation of a PrEP program at scale.
Aggressive antipyretics in central nervous system malaria: Study protocol of a randomized-controlled trial assessing antipyretic efficacy and parasite clearance effects (Malaria FEVER study)
Authors: Chilombe Moses B. , McDermott Michael P. , Seydel Karl B. , Mathews Manoj , Mwenechanya Musaku , Birbeck Gretchen L. 
Published: October 2022

Background
Malaria remains a major public health challenge in Africa where annually, ~250,000 children with malaria experience a neurologic injury with subsequent neuro-disability. Evidence indicates that a higher temperature during the acute illness is a risk factor for post-infectious neurologic sequelae. As such, aggressive antipyretic therapy may be warranted among children with complicated malaria at substantial risk of brain injury. Previous clinical trials conducted primarily in children with uncomplicated malaria and using only a single antipyretic medication have shown limited benefits in terms of fever reduction; however, no studies to date have examined malaria fever management using dual therapies. In this clinical trial of aggressive antipyretic therapy, children hospitalized with central nervous system (CNS) malaria will be randomized to usual care (acetaminophen every 6 hours for a temperature ≥ 38.5°C) vs. prophylactic acetaminophen and ibuprofen every 6 hours for 72 hours.

Methods
In this double-blinded, placebo controlled, two-armed clinical trial, we will enroll 284 participants from three settings at Queen Elizabeth Central Hospital in Blantyre, Malawi; at the University Teaching Hospitals Children’s Hospital in Lusaka, Zambia and at Chipata Central Hospital, Chipata, Zambia. Parents or guardians must provide written informed consent. Eligible participants are 2–11 years with evidence of P. falciparum malaria infection by peripheral blood smear or rapid diagnostic test with CNS symptoms associated with malaria. Eligible children will receive treatment allocation randomization either to standard of care for fever management or to prophylactic, scheduled treatment every 6 hours for 72 hours with dual antipyretic therapies using acetaminophen and ibuprofen. Assignment to treatment groups will be with 1:1 allocation using blocked randomization. The primary outcome will be maximum temperature in the 72 hours after enrolment. Secondary outcomes include parasite clearance as determined by quantitative Histidine Rich Protein II and seizures through 72 hours after enrolment.

Discussion
This clinical trial seeks to challenge the practice paradigm of limited fever treatment based upon hyperpyrexia by evaluating the fever-reduction efficacy of more aggressive antipyretic using two antipyretics and prophylactic administration and will elucidate the impact of antipyretics on parasite clearance and acute symptomatic seizures. If aggressive antipyretic therapy is shown to safely reduce the maximum temperature, a clinical trial evaluating the neuroprotective effects of temperature reduction in CNS malaria is warranted.