bluuebunny/crossref_metadata_2025_split huggingface dataset:
Using clinical cascades to measure health facilities’ obstetric emergency readiness: testing the cascade model using cross-sectional facility data in East Africa
Authors: Whaley Bridget , Butrick Elizabeth , Sales Jessica M , Wanyoro Anthony , Waiswa Peter , Walker Dilys , Cranmer John N 
Published: April 2022

ObjectivesGlobally, hundreds of women die daily from preventable pregnancy-related causes, with the greatest burden in sub-Saharan Africa. Five key emergencies—bleeding, infections, high blood pressure, delivery complications and unsafe abortions—account for nearly 75% of these obstetric deaths. Skilled clinicians with strategic supplies could prevent most deaths. In this study, we (1) measured facility readiness to manage common obstetric emergencies using the clinical cascades and signal function tracers; (2) compared these readiness estimates by facility characteristics; and (3) measured cascading drop-offs in resources.DesignA facility-based cross-sectional analysis of resources for common obstetric emergencies.SettingData were collected in 2016 from 23 hospitals (10 designated comprehensive emergency obstetric care (CEmOC) facilities) in Migori County, western Kenya, and Busoga Region, eastern Uganda, in the Preterm Birth Initiative study in East Africa. Baseline data were used to estimate a facility’s readiness to manage common obstetric emergencies using signal function tracers and the clinical cascade model. We compared emergency readiness using the proportion of facilities with tracers (signal functions) and the proportion with resources for identifying and treating the emergency (cascade stages 1 and 2).ResultsThe signal functions overestimated practical emergency readiness by 23 percentage points across five emergencies. Only 42% of CEmOC-designated facilities could perform basic emergency obstetric care. Across the three stages of care (identify, treat and monitor-modify) for five emergencies, there was a 28% pooled mean drop-off in readiness. Across emergencies, the largest drop-off occurred in the treatment stage. Patterns of drop-off remained largely consistent across facility characteristics.ConclusionsAccurate measurement of obstetric emergency readiness is a prerequisite for strengthening facilities’ capacity to manage common emergencies. The cascades offer stepwise, emergency-specific readiness estimates designed to guide targeted maternal survival policies and programmes.Trial registration numberNCT03112018.
A feasibility study evaluating the uptake, effectiveness and acceptability of routine screening of pregnant migrants for latent tuberculosis infection in antenatal care: a research protocol
Authors: Rahman A , Thangaratinam Shakila , Copas Andrew , Zenner D , White Peter J , Griffiths Chris , Abubakar Ibrahim , McCourt Christine , Kunst Heinke 
Published: April 2022

IntroductionGlobally, tuberculosis (TB) is a leading cause of death in women of reproductive age and there is high risk of reactivation of latent tuberculosis infection (LTBI) in pregnancy. The uptake of routine screening of migrants for LTBI in the UK in primary care is low. Antenatal care is a novel setting which could improve uptake and can lend insight into the feasibility and acceptability of offering opt-out screening for LTBI.Methods and analysisThis is an observational feasibility study with a nested qualitative component. The setting will be the antenatal clinics in three hospitals in East London, UK . Inclusion criteria are pregnant migrant women aged 16–35 years attending antenatal clinics who are from countries with a TB incidence of greater than 150/100 000 including sub-Saharan Africa, and who have been in the UK for less than 5 years. Participants will be offered LTBI screening with an opt-out interferon gamma release assay blood test, and be invited to complete a questionnaire. Both participants and healthcare providers will be invited to participate in semistructured interviews or focus groups to evaluate understanding, feasibility and acceptability of routine opt-out LTBI screening. The primary analysis will focus on estimating the uptake of the screening programme along with the corresponding 95% CI. Secondary analysis will focus on estimating the test positivity. Qualitative analysis will evaluate the acceptability of offering routine opt-out LTBI screening to participants and healthcare providers.Ethics and disseminationThe study has received the following approvals: Health Research Authority (IRAS 247388) and National Health Service Ethics Committee (19/LO/0557). The results will be made available locally to antenatal clinics and primary care physicians, nationally to NHS England and Public Health England and internationally through conferences and journals.Trial registration numberNCT04098341.
Downstream activities after laboratory testing in primary care: an exploratory outcome of the ELMO cluster randomised trial (Electronic Laboratory Medicine Ordering with evidence-based order sets in primary care)
Authors: Piessens Veerle , Delvaux Nicolas , Heytens Stefan , Aertgeerts Bert , De Sutter An 
Published: April 2022

ObjectiveTo estimate the rate and type of downstream activities (DAs) after laboratory testing in primary care, with a specific focus on check-up laboratory panels, and to explore the effect of a clinical decision support system (CDSS) for laboratory ordering on these DAs.DesignCluster randomised clinical trial.Setting72 primary care practices in Belgium, with 272 general practitioners (GPs), randomly assigned to the intervention arm or the control arm.ParticipantsThe study included 10 270 lab panels from 9683 primary care patients (women 55.1%, mean age 56.5). All adult patients who consulted one of the participating GPs during the trial period and needed a laboratory exam were eligible for participation.InterventionsGPs in the intervention group used a CDSS integrated into their online laboratory ordering system, while GPs in the control arm used their lab ordering system as usual. The trial duration was 6 months, with another 6 months follow-up.Main outcome measuresThis publication reports on the exploratory outcome of DAs after an initial laboratory exam and the effect of the CDSS on these DAs.Results19.7% of all laboratory panels resulted in further diagnostic procedures (95% CI 18.9% to 20.5%) and 19% (95% CI 18.2% to 19.7%) in treatment changes. Check-up laboratory exams showed similar rates of DAs, with 17.5% (95% CI 13.8% to 21.2%) diagnostic DAs and 18.9% (95% CI 13.9% to 23.9%) treatment changes. Using the CDSS resulted in a significant reduction in downstream referrals (−2.4%; 95% CI −4.2% to −0.6%; p=0008), imaging and endoscopies (−0.9%; 95% CI −1.6% to −0.1%; p=0026) and treatment changes (−5.4%; 95% CI −9.5% to −1.2%; p=0.01).ConclusionThis is the largest study so far to examine DAs after laboratory testing. It shows that almost one in three laboratory exams leads to further DAs, even in check-up panels. Using a CDSS for laboratory orders may reduce the rate of some DAs.Trial registration numberNCT02950142.
Time-limited trials in the ICU: a mixed-methods sequential explanatory study of intensivists at two academic centres
Authors: Viglianti Elizabeth M , Ervin Jennifer N , Newton Chad A , Kruser Jacqueline M , Iwashyna Theodore J , Valley Thomas S 
Published: April 2022

ObjectiveTo understand intensivist perceptions of the appropriateness of time-limited trials (TLTs)—a strategy to align life-sustaining care with patient goals and values in the midst of clinical uncertainty.DesignWe conducted a mixed-methods sequential explanatory study of intensive care unit (ICU) intensivists regarding appropriateness of utilising TLTs in three vignettes centred on invasive mechanical ventilation (IMV); continuous renal replacement therapy (CRRT); and heated high-flow nasal cannula (HHFNC). Semistructured interviews were conducted using the Tailored Implementation of Chronic Diseases framework. Data were analysed using thematic and matrix analysis.SettingTwo academic medical centres in the USA participated in the randomised surveys and one centre participated in the semistructured interviews.ParticipantsPulmonary and critical care intensivists and fellows.Primary and secondary outcomesTo understand intensivists perceptions of the appropriateness in using TLTs.ResultsOf 115 physicians surveyed, 71 initiated the survey and 44 completed the entire survey with a response rate of 38% (N=44/115) and a completion rate of 62% (N=44/71). While 35% (N=23/66) of intensivists had never heard of a TLT, of the intensivists who had heard of a TLT, 77% (N=33/43) had participated in one. In response to the vignettes, appropriateness of using a TLT varied (IMV: 74% (N=46/62); CRRT 78% (N=49/63); HHFNC 92% (N=56/61) as did the durations of the TLT. Semistructured interviews with 11 intensivists revealed having clarity about patient goals and clinical endpoints facilitated successful TLTs while lack of an evidenced-based framework was a barrier.ConclusionMore than half of the physicians who responded had conducted or participated in a TLT. To increase the use of TLTs in the ICU, clinicians desire a more robust, evidence-based framework on how to conduct TLTs.
Assessing the impact of predatory journals on policy and guidance documents: a cross-sectional study protocol
Authors: Brandts-Longtin Olivier , Lalu Manoj M , Adie Euan A , Albert Marc A , Almoli Elham , Almoli Faris , Bryson Gregory L , Dony Christophe , Dunleavy Daniel , Grudniewicz Agnes , Lehmann Christian , Lhoest Rémy , Moher David , Montroy Joshua , Pitts Mallory , Ricketts Alicia , Thirion Paul , Cobey Kelly D 
Published: April 2022

IntroductionMany predatory journals fail to follow best publication practices. Studies assessing the impact of predatory journals have focused on how these articles are cited in reputable academic journals. However, it is possible that research from predatory journals is cited beyond the academic literature in policy documents and guidelines. Given that research used to inform public policy or government guidelines has the potential for widespread impact, we will examine whether predatory journals have penetrated public policy.Methods and analysisThis is a descriptive study with no hypothesis testing. Policy documents that cite work from the known predatory publisher OMICS will be downloaded from the Overton database. Overton collects policy documents from over 1200 sources worldwide. Policy documents will be evaluated to determine how the predatory journal article is used. We will also extract epidemiological details of the policy documents, including: who funded their development, the discipline the work is relevant to and the name of the organisations producing the policy. The record of scholarly citations of the identified predatory articles will also be examined. Findings will be reported with descriptive statistics using counts and percentages.Ethics and disseminationNo ethical approval was required for this study since it does not involve human or animal research. Study findings will be discussed at workshops on journalology and predatory publishing and will be disseminated through preprint, peer-reviewed literature and conference presentations.
Estimating the gap between demand and supply of medical appointments by physicians for hypertension care: a pooled analysis in 191 countries
Authors: Carrillo-Larco Rodrigo M , Guzman-Vilca Wilmer Cristobal , Neupane Dinesh 
Published: April 2022

IntroductionWith a growing number of people with hypertension, the limited number of physicians could not provide treatment to all patients. We quantified the gap between medical appointments available and needed for hypertension care, overall and in relation to hypertension treatment cascade metrics.MethodsEcological descriptive analysis. We combined country-year-specific data on hypertension prevalence, awareness, treatment and control (from Non-Communicable Disease Risk Factor Collaboration) and number of physicians (from WHO). We estimated from 1 to 12 medical appointments per year for patients with hypertension. We assumed that physicians could see 25 patients per day, work 200 days/year and dedicate 10% of their time to hypertension care.ResultsWe studied 191 countries. Forty-one countries would not have enough physicians to provide at least one medical appointment per year to all the population with hypertension; these countries were low/lower middle income and in sub-Saharan Africa or East Asia and Pacific. Regardless of the world region, ≥50% of countries would not have enough physicians to provide ≥8 medical appointments to their population with hypertension. Countries where the demand exceeded the offer of medical appointments for hypertension care had worse hypertension diagnosis, treatment and control rates than countries where the demand did not exceed the offer. There were positive correlations between the physician density and hypertension diagnosis (r=0.70, p<0.001), treatment (r=0.70, p<0.001) and control (r=0.59, p<0.001).ConclusionsWhere physicians are the only healthcare professionals allowed to prescribe antihypertensive medications, particularly in low and middle-income countries, the healthcare system may struggle to deliver antihypertensive treatment to patients with hypertension.
Economic change and population health: lessons learnt from an umbrella review on the Great Recession
Authors: Backhaus Insa , Hoven Hanno , Di Tecco Cristina , Iavicoli Sergio , Conte Arne , Dragano Nico 
Published: April 2022

ObjectivesWorldwide, the COVID-19 pandemic triggered the sharpest economic downturn since the Great Recession. To prepare for future crises and to preserve public health, we conduct an overview of systematic reviews to examine the evidence on the effect of the Great Recession on population health.MethodsWe searched PubMed and Scopus for systematic reviews and/or meta-analyses focusing specifically on the impact of the Great Recession on population health (eg, mental health). Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines were followed throughout this review and critical appraisal of included systematic reviews was performed using Assessing the Methodological Quality of Systematic Reviews.ResultsTwenty-one studies were identified and consistently showed that the Great Recession was most risky to health, the more a country’s economy was affected and the longer strict austerity policies were in place. Consequently, a deterioration of health was highest in countries that had implemented strict austerity measures (eg, Greece), but not in countries that rejected austerity measures (eg, Germany). Moreover, the impact of the Great Recession fell disproportionately on the most vulnerable groups such as people in unemployment, at risk of unemployment and those living in poverty.ConclusionsThe experiences of the last economic crisis show that it is possible to limit the consequences for health. Prioritising mental healthcare and prevention, foregoing austerity measures in the healthcare system and protecting vulnerable groups are the most important lessons learnt. Moreover, given the further aggravating social inequalities, a health in all policies approach, based on a comprehensive Health Impact Assessment, is advised.
Climate emergency, young people and mental health: time for justice and health professional action
Authors: Singh Guddi , Xue Siqi , Poukhovski-Sheremetyev Feodor 
Published: April 2022

Climate change is driving a public mental health crisis that disproportionately, and unjustly, affects the world’s young people. Despite the growing evidence for harm to the next generation, the medical community has largely been hesitant to take the next step and act on the evidence. We propose that the medical community has a responsibility to do more.Drawing from our interdisciplinary experience in paediatrics and psychiatry, we call for our profession to take the ‘leap’ beyond the walls of our clinics and laboratories, and take a courageous stance on the topic of climate change. We argue that the medical profession must adopt a broader conception of health and its determinants—or a ‘social lens’—if it is to move beyond rhetoric to action.Viewing climate change as a clear determinant of mental health opens up potential avenues of action, both as individual clinicians and as a profession as a whole. We offer the beginnings of a framework for action in the context of climate change and youth mental health, before calling for our profession to re-examine its role - and its very purpose - to better address the climate crisis.
Reconciling individual-based forest growth models with landscape-level studies through a meta-modelling approach
Authors: Fortin Mathieu , Lavoie Jean-François 
Published: April 2022

Landscape-level studies such as those on forest management planning and carbon accounting rely on large-area growth projections provided by forest growth models. Nowadays, most of these models are individual tree-based models. The detailed input they require and their complexity are a challenge for the integration into a landscape-level study. A possible alternative consists of approximating the complex model through a meta-model. A meta-model mimics the behaviour of the original model, while being simpler in terms of input and computation. In this study, we developed a Bayesian meta-modelling approach that can be used to obtain a simplified growth model from an individual tree-based model. The approach was exemplified through a real-world case study, namely a forest management unit in the province of Quebec, Canada. Using a Markov chain Monte Carlo method, we managed to fit meta-models based on the Chapman–Richards equation or its derivative for the main potential vegetation types. This meta-modelling approach has the advantages of ( i) being an effective method of upscaling, ( ii) providing simple meta-models suitable for landscape-level studies, and ( iii) ensuring a proper error propagation from the original individual tree-based model into the meta-model.
Rational non-linear electrodynamics of AdS black holes and extended phase space thermodynamics
Authors: Kruglov S. I. 
Published: April 2022

AbstractThe critical behaviour of magnetically charged AdS black holes based on rational non-linear electrodynamics (RNED) in an extended phase space is investigated herein. The cosmological constant is considered as thermodynamic pressure, and the black hole mass is identified with the chemical enthalpy. An analogy with the van der Walls liquid–gas system is found, and the critical exponents coincide with those of the van der Waals system. The thermodynamics of RNED-AdS black holes and phase transitions are studied, and new thermodynamic quantities conjugated to the non-linear parameter of RNED and magnetic charge are defined. The consistency of the first law of black hole thermodynamics and the Smarr formula is demonstrated.
The $$\mu \rightarrow e\gamma $$ decay in an EW-scale non-sterile RH neutrino model
Authors: Dinh D. N. 
Published: April 2022

AbstractWe investigate herein the phenomenology of $$\mu \rightarrow e\gamma $$

μ
→
e
γ

decay in a scenario of the class of extended models with non-sterile right-handed (RH) neutrinos at electroweak (EW) scale proposed by P. Q. Hung. The field content of the standard model (SM) is increased by introducing for each SM fermion a corresponding mirror partner with the same quantum numbers along with opposite chirality. Light neutrino masses are generated via the type I seesaw mechanism, and it is also proved to be relevant to low energy within the EW scale of RH neutrino masses. We introduce the model and derive the branching ratio of the $$\mu \rightarrow e\gamma $$

μ
→
e
γ

decay at one-loop approximation with the participation of W gauge boson and neutral and singly charged Higgs scalars. We then set constraints on relevant parameters and predict the sensitivity of the decay channel under the present and future experiments.
Motion of spinning particles around electrically charged black hole in Eddington-inspired Born–Infeld gravity
Authors: Yang Ke , Gu Bao-Min , Zhang Yu-Peng 
Published: April 2022

AbstractA test particle possessing spin angular momentum moves along a non-geodesic path due to an additional spin-curvature force. We study the spinning test particle moving in the vicinity of the electrically charged black hole formation in Eddington-inspired Born–Infeld (EiBI) gravity. Through the numerical analysis of its effective potential and orbits, it is found that the orbital eccentricity reduces as the deviation parameter $$\kappa $$
κ
increases. By comparing the orbits for the observed stars around Sagittarius A*, we conclude that the observed orbits with too large radii can not give a stringent constraint with acceptable magnitude. To dig out the potential observation effects of the relations between the orbits and parameter $$\kappa $$
κ
, we mainly focus on the orbits in the vicinity of black hole in this paper. The parameters of inner most stable circular orbit (ISCO) decrease monotonously with $$\kappa $$
κ
when the spin angular momentum is small, however they change non-monotonously with $$\kappa $$
κ
when the spin is large enough. Moreover, the spin dependences of ISCO parameters have similar behavior to that of Reissner–Nordström (RN) black hole. We analyze the causality of the circular orbits by using the superluminal constraint condition as well. As a result, two new parameter regions may emerge in case of large $$\kappa $$
κ
, where the particle has two stable circular orbits with one subluminal and the other superluminal.
Neutrino spin operator and dispersion in moving matter
Authors: Grigoriev Alexander , Studenikin Alexander , Ternov Alexei 
Published: April 2022

AbstractWe found the spin integral of motion for neutrinos propagating in moving and polarized matter. Contrary to all previous studies this is the exact spin operator commuting with the Hamiltonian for a neutrino in matter which moves in an arbitrary direction relative to the direction of neutrino propagation. The operator obtained opens up the possibility of consistent classification of neutrino states in such a medium and, as a consequence, a systematic description of the related physical phenomena. Using the operator, we obtain a dispersion relation for neutrinos in arbitrary moving matter and consider its particular cases.
Patient-Derived Triple-Negative Breast Cancer Organoids Provide Robust Model Systems That Recapitulate Tumor Intrinsic Characteristics
Authors: Bhatia Sonam , Kramer Melissa , Russo Suzanne , Naik Payal , Arun Gayatri , Brophy Kyle , Andrews Peter , Fan Cheng , Perou Charles M. , Preall Jonathan , Ha Taehoon , Plenker Dennis , Tuveson David A. , Rishi Arvind , Wilkinson John E. , McCombie W. Richard , Kostroff Karen , Spector David L. 
Published: April 2022

Abstract

Triple-negative breast cancer (TNBC) is an aggressive form of breast cancer with poor patient outcomes, highlighting the unmet clinical need for targeted therapies and better model systems. Here, we developed and comprehensively characterized a diverse biobank of normal and breast cancer patient-derived organoids (PDO) with a focus on TNBCs. PDOs recapitulated patient tumor intrinsic properties and a subset of PDOs can be propagated for long-term culture (LT-TNBC). Single cell profiling of PDOs identified cell types and gene candidates affiliated with different aspects of cancer progression. The LT-TNBC organoids exhibit signatures of aggressive MYC-driven, basal-like breast cancers and are largely comprised of luminal progenitor (LP)-like cells. The TNBC LP-like cells are distinct from normal LPs and exhibit hyperactivation of NOTCH and MYC signaling. Overall, this study validates TNBC PDOs as robust models for understanding breast cancer biology and progression, paving the way for personalized medicine and tailored treatment options.

Significance:
A comprehensive analysis of patient-derived organoids of TNBC provides insights into cellular heterogeneity and mechanisms of tumorigenesis at the single-cell level.