bluuebunny/crossref_metadata_2025_split huggingface dataset:
Towards a cervical cancer-free future: women’s healthcare decision making and cervical cancer screening uptake in sub-Saharan Africa
Authors: Okyere Joshua , Aboagye Richard Gyan , Seidu Abdul-Aziz , Asare Bernard Yeboah-Asiamah , Mwamba Bupe , Ahinkorah Bright Opoku 
Published: July 2022

ObjectiveWe investigated the association between women’s healthcare decision making and cervical cancer screening uptake in sub-Saharan Africa.DesignSecondary data from the Demographic and Health Surveys of six countries in sub-Saharan Africa were used. We employed multilevel binary logistic regression modelling.SettingSub-Saharan Africa.ParticipantsWomen aged 15–49 years in Benin (n=5282), Côte d’Ivoire (n=1925), Cameroon (n=7558), Kenya (n=6696), Namibia (n=1990) and Zimbabwe (n=5006).Primary outcome measuresCervical cancer screening uptake.ResultsThe overall prevalence of cervical cancer screening across the six sub-Saharan African countries was 13.4%. Compared with women whose healthcare decisions were made solely by husbands/partners/someone else, the likelihood of cervical cancer screening uptake was significantly higher among women who took healthcare decisions in consultation with their husbands/partners (aOR=1.38; 95% CI 1.19 to 1.59), but highest among those who made healthcare decisions alone (aOR=1.66; 95% CI 1.44 to 1.91). Women aged between 40 and 45 years (aOR=5.18; 95% CI 3.15 to 8.52), those with higher education (aOR=2.13; 95% CI 1.57 to 2.88), those who had ever heard of cervical cancer (aOR=32.74; 95% CI 20.02 to 53.55), read newspaper or magazine at least once a week (aOR=2.11; 95% CI 1.83 to 2.44), listened to the radio at least once a week (aOR=1.35; 95% CI1.18 to 1.52) and those in households with richest wealth index (aOR=1.55; 95% CI 1.20 to 2.00) had significantly higher odds of screening for cervical cancer compared to their counterparts.ConclusionWomen who are able to make autonomous healthcare decisions and those who practice shared decision making are more likely to uptake cervical cancer screening. Therefore, policy interventions should focus on empowering women to be able to take autonomous healthcare decisions or shared decision making while targeting subpopulations (ie, multiparous and rural-dwelling women, as well as those in other religious affiliations aside from Christianity) that are less likely to uptake cervical cancer screening. Also, the radio and print media could be leveraged in raising awareness about cervical cancer screening to accelerate cervical cancer screening uptake in sub-Saharan Africa.
Exploratory analyses of clinical trial data used for health technology assessments: a retrospective evaluation
Authors: Oddens Björn J , Agaku Israel T , Snyder Ellen S , Malbecq William , Wang William WB , Kaplan Karen M , Koch Gary G , Rockhold Frank W 
Published: July 2022

ObjectivesTo examine the validity and statistical limitations of exploratory analyses of clinical trial data commonly requested by agencies responsible for determining which medical products may be financed or reimbursed by a healthcare system.DesignThis was a retrospective review of efficacy and safety analyses conducted for German Health Technology Assessment (HTA) evaluations with a decision date between 2015 and 2020, and an illustrative safety-related exploratory analysis of data from two phase III clinical trials of verubecestat (an anti-amyloid drug whose development was stopped for lack of efficacy) as would be mandated by the German HTA agency.ResultsWe identified 422 HTA evaluations of 404 randomised controlled clinical trials. For 140 trials (34.7%), the evaluation was based on subpopulations of participants in the originating confirmatory trial (175 subpopulations were assessed). In 57% (100 of 175), the subpopulation sample size was 50% or less of the original study population. Detailed analysis of five evaluations based on subpopulations of the original trial is presented. The safety-related exploratory analysis of verubecestat led to 206 statistical analyses for treatments and 812 treatment-by-subgroup interaction tests. Of 31 safety endpoints with an elevated HR (suggesting association with drug treatment), the HR for 81% of these (25 of 31) was not elevated in both trials. Of the 812 treatment-by-subgroup interactions evaluated, 26 had an elevated HR for a subgroup in one trial, but only 1 was elevated in both trials.ConclusionsMany HTA evaluations rely on subpopulation analyses and numerous post hoc statistical hypothesis tests. Subpopulation analysis may lead to loss of statistical power and uncontrolled influences of random imbalances. Multiple testing may introduce spurious findings. Decisions about benefits of medical products should therefore not rely on exploratory analyses of clinical trial data but rather on prospective clinical studies and careful synthesis of all available evidence based on prespecified criteria.
Tobacco prevention and control interventions in humanitarian settings: a scoping review protocol
Authors: Gudi Nachiket , Swain Ansuman , Kulkarni Muralidhar M , Pattanshetty Sanjay , Zodpey Sanjay 
Published: July 2022

IntroductionTobacco has been a complex global problem that has adversely affected almost all the sectors of society. However, the ill-effects are often most reflected in humanitarian settings, which inadvertently are surmounted by fragile systems. We aim to map tobacco prevention and control intervention in humanitarian settings.Methods and analysisThis scoping review will follow the guidelines of the Joanna Briggs Institute. A comprehensive search strategy was designed using Medical Subject Heading terms, subject experts and pertinent reviews. The search was conducted on Medline (through PubMed and Ovid), EMBASE (through OVID), ProQuest Health and Medical Complete, EBSCO (through CINAHL Complete), Scopus and Web of Science databases. Two reviewers will independently screen the identified studies on removing duplicates, which shall be followed by data extraction using a pretested data extraction form. A narrative synthesis approach will be employed to collate the findings from the studies and tabular formats would be used to aid the representation.Ethics and disseminationThis review will identify, map and synthesise the interventions for tobacco prevention and control in the humanitarian settings. An ethics committee approval was not sought for this body of work as it does not include human subjects. Results from the study will be disseminated through conference presentations and peer-reviewed publications.
Neuromuscular and structural tendon adaptations after 6 weeks of either concentric or eccentric exercise in individuals with non-insertional Achilles tendinopathy: protocol for a randomised controlled trial
Authors: Contreras-Hernandez Ignacio , Falla Deborah , Martinez-Valdes Eduardo 
Published: July 2022

IntroductionThere is limited evidence on the neural strategies employed by the central nervous system to control muscle force in the presence of non-insertional Achilles tendinopathy (NIAT). Additionally, the neuromuscular mechanisms by which exercise may help to resolve tendon pain remain unclear.ObjectiveThis study aims to first establish changes in the gastrocnemius-soleus motor unit firing properties after applying a training protocol of 6 weeks based on either controlled eccentric or concentric contractions in individuals with NIAT. Second, we want to determine changes in the level of pain and function and mechanical and structural properties of the Achilles tendon after applying the same training protocol. Additionally, we want to compare these variables at baseline between individuals with NIAT and asymptomatic controls.Methods and analysisA total of 26 individuals with chronic (>3 months) NIAT and 13 healthy controls will participate in the study. Individuals with NIAT will be randomised to perform eccentric or concentric training for 6 weeks. Motor unit firing properties of the medial gastrocnemius, lateral gastrocnemius and soleus muscles will be assessed using high-density surface electromyography, as well as Achilles tendon length, cross-sectional area, thickness and stiffness using B-mode ultrasonography and shear wave elastography. Moreover, participants will complete a battery of questionnaires to document their level of pain and function.Ethics and disseminationEthical approval (ERN-20-0604A) for the study was obtained from the Science, Technology, Engineering and Mathematics Ethical Review Committee of the University of Birmingham. The results of the study will be published in peer-review journals.Trial registration numberISRCTN46462385.
Improving routine prenatal penicillin allergy testing for reported penicillin allergy
Authors: Gill Margaret M , Gasner Sara , Banken Alisha , Park Miguel , Weaver Amy , Sharpe Emily , Theiler Regan 
Published: July 2022

BackgroundPatients with self-reported antibiotic allergies have a higher cost of care, more frequent infections with resistant bacteria and worse health outcomes than patients without antibiotic allergies. Ultimately, less than 5% of patients who report a penicillin allergy have a clinically significant immune-mediated hypersensitivity reaction when tested. As 10%–30% of the population of pregnant patients are colonised for group BStreptococcus(GBS) and guidelines recommend penicillin as the treatment of choice for GBS, current recommendations support penicillin allergy testing in pregnant patients who report an allergy.Methods and interventionIn this quality improvement project, nursing staff used an algorithm outlining inclusion and exclusion criteria to determine which patients were eligible to have penicillin allergy testing completed. Penicillin allergy testing consisted of a skin test using benzylpenicilloyl polylysine (Pre-Pen), penicillin G potassium, amoxicillin and alkaline hydrolysis mix (penicilloate) as a prick skin test, followed by intradermal skin test and finally an oral challenge with either amoxicillin or penicillin. Patient outcomes were analysed to evaluate the impact of the intervention.ResultsOf the 1266 patients receiving prenatal care during the intervention, 236 (19%) reported a history of penicillin allergy, and 212 if these were eligible for testing. 150 of the eligible patients were offered penicillin allergy testing. 101 patients (67%) completed testing and 49 (33%) declined testing. Seven patients (7%) had positive penicillin allergy testing, while 94 patients (93%) had negative penicillin allergy testing and were immediately de-labelled as penicillin allergic. Seventeen of the de-labelled patients subsequently tested positive for GBS colonisation, and all received intrapartum penicillin without adverse events.ConclusionsPursuing penicillin allergy testing for pregnant patients with reported penicillin allergy is a safe and feasible approach, allowing for allergy de-labelling and safe, guideline-driven antimicrobial therapy during subsequent labour and delivery hospitalisations. Cost-effectiveness of the allergy testing and impact on later episodes of care should be further investigated.
Use of real-world data and clinical registries to identify new uses of existing vascular endografts: combined use of GORE EXCLUDER Iliac Branch Endoprosthesis and GORE VIABAHN VBX Balloon Expandable Endoprosthesis
Authors: Barnes Jonathan Aaron , Eid Mark A , Moore Kayla , Aryal Suvekshya , Gebre Eden , Woodard Jennifer Nicole , Kitpanit Napong , Mao Jialin , Kuwayama David P , Suckow Bjoern D , Schneider Darren , Abushaikha Tiffany , Zusterzeel Robbert , Vemulapalli Sreekanth , Shenkman Elizabeth A , Williams James , Sedrakyan Art , Goodney Philip 
Published: July 2022

ObjectiveTo assess the feasibility of collecting, examining and reporting observational, real-world evidence regarding the novel use of the GORE EXCLUDER Iliac Branch Endoprosthesis (IBE) in conjunction with the GORE VIABAHN VBX Balloon Expandable Endoprosthesis (IBE+VBX stent graft).DesignMulticentre retrospective cohort study.SettingFour real-world data sources were used: a national quality improvement registry, a statewide clinical research network, a regional quaternary health system and two tertiary academic medical centres.ParticipantsIn total, 30 patients with 37 IBE+VBX stent graft were identified. Of those, the mean age was 72±10.2 years and 90% were male. The cohort was 77% white, 10% black, 3% Hispanic and 10% other.Main outcome measuresOutcome measures included: proportion of percutaneous vs open surgical access, intensive care admission, intensive care unit (ICU) length-of-stay (LOS), total LOS, postoperative complications, discharge disposition and 30-day mortality.ResultsThe majority (89%) of cases were performed percutaneously, 5% required surgical exposure following failed percutaneous access and 6% required open surgical exposure outright. Nearly half (43%) required intensive care admission with a median ICU LOS of 1 day (range: 1–2). Median total LOS was 1 day (IQR: 1–2). There were zero postoperative myocardial infarctions, zero reported leg embolisations and no reported reinterventions. Access site complications were described in 1 of 28 patients, manifesting as a haematoma or pseudoaneurysm. Ultimately, 97% were discharged to home and one patient was discharged to a nursing home or rehabilitation facility. There were no 30-day perioperative deaths.ConclusionsThis project demonstrates the feasibility of identifying and integrating real-world evidence, as it pertains to an unapproved combination of endovascular devices (IBE+VBX stent graft), for short-term outcomes analysis. This new paradigm of evidence has potential to be used for device monitoring, submission to regulatory agencies, or consideration in indication expansions and approvals with further efforts to systematise data collection and transmission mechanisms.
The safety value of driver education an training
Authors: Mayhew D R , Simpson H M 
Published: July 2022

Background:New drivers, especially young ones, have extremely high crash rates. Formal instruction, which includes in-class education and in-vehicle training, has been used as a means to address this problem.Objectives:To summarize the evidence on the safety value of such programs and suggest improvements in program delivery and content that may produce safety benefits.Methods:The empirical evidence was reviewed and summarized to determine if formal instruction has been shown to produce reductions in collisions, and to identify ways it might achieve this objective.Results:The international literature provides little support for the hypothesis that formal driver instruction is an effective safety measure. It is argued that such an outcome is not entirely unexpected given that traditional programs fail to address adequately the age and experience related factors that render young drivers at increased risk of collision.Conclusions:Education/training programs might prove to be effective in reducing collisions if they are more empirically based, addressing critical age and experience related factors. At the same time, more research into the behaviors and crash experiences of novice drivers is needed to refine our understanding of the problem.
Impact of the transition to digital pathology in a clinical setting on histopathologists in training: experiences and perceived challenges within a UK training region
Authors: Browning Lisa , Winter Lucinda , Cooper Rosalin A , Ghosh Abhisek , Dytor Thomas , Colling Richard , Fryer Eve , Rittscher Jens , Verrill Clare 
Published: July 2022

AimsWith increasing utility of digital pathology (DP), it is important to consider the experiences of histopathologists in training, particularly in view of the varied access to DP across a training region and the consequent need to remain competent in reporting on glass slides (GS), which is also relevant for the Fellowship of the Royal College of Pathologists part 2 examination. Understanding the impact of DP on training is limited but could aid development of guidance to support the transition. We sought to investigate the perceptions of histopathologists in training around the introduction of DP for clinical diagnosis within a training region, and the potential training benefits and challenges.MethodsAn anonymous online survey was circulated to 24 histopathologists in training within a UK training region, including a hospital which has been fully digitised since summer 2020.Results19 of 24 histopathologists in training responded (79%). The results indicate that DP offers many benefits to training, including ease of access to cases to enhance individual learning and teaching in general. Utilisation of DP for diagnosis appears variable; almost half of the (10 of 19) respondents with DP experience using it only for ancillary purposes such as measurements, reporting varying levels of confidence in using DP clinically. For those yet to undergo the transition, there was a perceived anxiety regarding digital reporting despite experience with DP in other contexts.ConclusionsThe survey evidences the need for provision of training and support for histopathologists in training during the transition to DP, and for consideration of their need to maintain competence and confidence with GS reporting.
Hand osteoarthritis is associated with limitations in paid and unpaid work participation and related societal costs: the HOSTAS cohort
Authors: Terpstra Sietse E S , van de Stadt Lotte A , Boonen Annelies , Damman Wendy , Rosendaal Frits R , Kloppenburg Margreet 
Published: July 2022

ObjectivesData on work participation impairment and related societal costs for patients with hand osteoarthritis (OA) are scarce. Therefore, we aimed to investigate the association of hand OA with work limitations and costs of productivity loss in paid and unpaid work.MethodsWe used data from the Hand Osteoarthritis in Secondary Care cohort, including patients with hand OA diagnosed by their treating rheumatologist. Using the validated Health and Labour Questionnaire, we assessed experienced unpaid and paid work restrictions, unpaid work replacement by others and inefficiency and absence during paid work related to hand OA over the last 2 weeks. Societal costs (€) per hour of paid and unpaid work were estimated using Dutch salary data in 2019.Results381 patients were included (mean age 61 years, 84% women, 26% high education level, 55% having any comorbidity). Replacement of unpaid work by others due to hand OA was necessary for 171 out of 381 patients (45%). Paid work was reported by 181/381 patients (47%), of whom 13/181 (7%) reported absenteeism, 28/181 (15%) unproductive hours at work and 120/181 (66%) paid work restrictions due to hand OA.Total estimated work-related societal costs per patient with hand OA (381 patients) were €94 (95% CI 59 to 130) per 2 weeks (€2452, 95% CI 1528 to 3377 per year).ConclusionsHand OA is associated with impairment in paid and unpaid work participation, which translates into substantial societal costs of lost productivity. These results highlight the importance of adequate hand OA treatment.
Sensory methods to evaluate perception of flavours in tobacco and other nicotine-containing products: a review
Authors: Bernat Jennifer K , Jackson Kia J , Krüsemann Erna J Z , Boesveldt Sanne , Rudy Susan F , Talhout Reinskje 
Published: July 2022

ObjectivesSensory methods use human senses to evaluate product attributes. This review provides an overview of the types of sensory methods used to evaluate the perception of flavour in tobacco and other nicotine-containing (ToNic) products and to discuss how sensory data could inform flavoured ToNic product policy.Data sourcesPubMed, Embase and Web of Science.Study selectionAll peer-reviewed studies evaluating ToNic products using a sensory method published before 23 May 2020.Data extractionTwo independent coders completed title/abstract and full-text screening to choose articles for inclusion (Cohen’s kappa=0.85, strong agreement). Each coder completed data extraction on half the articles, recording relevant information (eg, sensory methods used, results). The coders categorised sensory methods and generated overarching themes.Data synthesisOf 110 articles identified, we included 29 articles containing 35 studies that used sensory methods to investigate ToNic products. The sensory methods included analytic methods such as discrimination and descriptive tests and hedonic methods such as liking tests. Six themes emerged regarding how sensory methods can be used to understand consumer perception and liking of ToNic products and to inform ToNic product policy.ConclusionsThe identified studies highlight that sensory data can inform ToNic product policy. Analytic and sensory hedonic ratings can be used to assess a ToNic product’s ability to promote addiction in the user (ie, abuse liability). Lastly, hedonic ratings can provide information to assess potential use behaviours.
High-field magnetoresistance of microcrystalline and nanocrystalline Ni metal at 3 K and 300 K
Authors: Bakonyi I. , Czeschka F. D. , Kiss L. F. , Isnaini V. A. , Krupp A. T. , Palotás K. , Zsurzsa S. , Péter L. 
Published: July 2022

AbstractThe longitudinal and transverse magnetoresistance curves MR(H) and the magnetization isotherms M(H) were measured at T = 3 K and 300 K up to high magnetic fields for a microcrystalline (µc) Ni foil with grain sizes above 1 µm (corresponding to bulk Ni) and for a nanocrystalline (nc) Ni foil with an average grain size of about 100 nm. At T = 3 K, the field-induced resistivity change was quite different for the two microstructural states of Ni and the evolution of resistivity with magnetic field was also different which could be explained as arising from their very different electron mean free paths. At T = 300 K, the MR(H) curves of both the μc-Ni and nc-Ni samples were very similar to those known for bulk Ni. The MR(H) data were analyzed at both temperatures with the help of Kohler plots from which the resistivity anisotropy splitting (ΔρAMR) and the anisotropic magnetoresistance (AMR) ratio were derived, the latter values being very similar at both temperatures and for both microstructural states of Ni metal. The present high-precision MR(H) data revealed that the available theoretical models do not accurately describe the suppression of thermally induced magnetic disorder at around room temperature in high magnetic fields.
Boosting Antitumor Immunity with an Expanded Neoepitope Landscape
Authors: Nagel Remco , Pataskar Abhijeet , Champagne Julien , Agami Reuven 
Published: July 2022

AbstractImmune-checkpoint blockade therapy has been successfully applied to many cancers, particularly tumors that harbor a high mutational burden and consequently express a high abundance of neoantigens. However, novel approaches are needed to improve the efficacy of immunotherapy for treating tumors that lack a high load of classic genetically derived neoantigens. Recent discoveries of broad classes of nongenetically encoded and inducible neoepitopes open up new avenues for therapeutic development to enhance sensitivity to immunotherapies. In this review, we discuss recent work on neoantigen discovery, with an emphasis on novel classes of noncanonical neoepitopes.