bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness and cost-effectiveness of dynamic bracing versus standard care alone in patients suffering from osteoporotic vertebral compression fractures: protocol for a multicentre, two-armed, parallel-group randomised controlled trial with 12 months of follow-up
Authors: Weber Annemarijn , Huysmans Stephanie M D , van Kuijk Sander M J , Evers Silvia M A A , Jutten Elisabeth M C , Senden Rachel , Paulus Aggie T G , van den Bergh Joop P W , de Bie Rob A , Merk Johannes M R , Bours Sandrine P G , Hulsbosch Mark , Janssen Esther R C , Curfs Inez , van Hemert Wouter L W , Schotanus Martijn G M , de Baat Paul , Schepel Niek C , den Boer Willem A , Hendriks Johannes G E , Liu Wai-Yan , Kleuver Marinus de , Pouw Martin H , van Hooff Miranda L , Jacobs Eva , Willems Paul C P H 
Published: May 2022

IntroductionPatients with osteoporosis may suffer from a fracture after minimal trauma. Osteoporotic vertebral compression fractures (OVCFs) are among the most common fractures, often leading to substantial pain. There is a need for evidence-based conservative treatment to aid in the management of OVCFs. The objective of this randomised controlled trial (RCT) is to evaluate the effectiveness and cost-effectiveness of dynamic bracing in addition to standard care for improving quality of life (QoL) in patients suffering from an OVCF.Methods and analysisNinety-eight postmenopausal women from two academic and four community hospitals with a recent symptomatic thoracolumbar OVCF will be randomised into either the standard care or dynamic bracing group. In the dynamic bracing group, the Spinova Osteo orthosis will be used in addition to standard care. Standard care comprises pain control with analgesics, physical therapy and osteoporosis medication. The primary outcome parameter is QoL 1 year after inclusion, as measured by the Quality of Life Questionnaire of the European Foundation for Osteoporosis (QUALEFFO-41). Secondary outcome parameters are pain, pain medication used, functional disability, sagittal spinal alignment, recurrence rate of OVCFs and physical activity in daily life. A trial-based economic evaluation consisting of both cost-effectiveness analysis and cost-utility analysis will be performed based on empirical data obtained in the RCT. A process evaluation will assess the feasibility of dynamic bracing. All outcomes will be assessed at baseline, 6 weeks, 3 months, 6 months, 9 months and 12 months.Ethics and disseminationEthical approval has been granted by the Medical Ethics Committee, University Hospital Maastricht and Maastricht University (METC azM/UM) (NL74552.068.20/METC 20-055). Patients will be included only after verification of eligibility and obtaining written informed consent. Results will be disseminated via the Dutch National Osteoporosis Patient Society and via publications and conferences.Trial registration numberNL8746.
Factors associated with accessing and utilisation of healthcare and provision of health services for residents of slums in low and middle-income countries: a scoping review of recent literature
Authors: Park Ji-Eun , Kibe Peter , Yeboah Godwin , Oyebode Oyinlola , Harris Bronwyn , Ajisola Motunrayo M , Griffiths Frances , Aujla Navneet , Gill Paramjit , Lilford Richard J , Chen Yen-Fu 
Published: May 2022

ObjectiveTo identify factors associated with accessing and utilisation of healthcare and provision of health services in slums.DesignA scoping review incorporating a conceptual framework for configuring reported factors.Data sourcesMEDLINE, Embase, CINAHL, Web of Science and the Cochrane Library were searched from their inception to December 2021 using slum-related terms.Eligibility criteriaEmpirical studies of all designs reporting relevant factors in slums in low and middle-income countries.Data extraction and synthesisStudies were categorised and data were charted according to a preliminary conceptual framework refined by emerging findings. Results were tabulated and narratively summarised.ResultsOf the 15 469 records retrieved from all years, 4368 records dated between 2016 and 2021 were screened by two independent reviewers and 111 studies were included. The majority (63 studies, 57%) were conducted in Asia, predominantly in India. In total, 104 studies examined healthcare access and utilisation from slum residents’ perspective while only 10 studies explored provision of health services from providers/planners’ perspective (three studies included both). A multitude of factors are associated with accessing, using and providing healthcare in slums, including recent migration to slums; knowledge, perception and past experience of illness, healthcare needs and health services; financial constraint and competing priorities between health and making a living; lacking social support; unfavourable physical environment and locality; sociocultural expectations and stigma; lack of official recognition; and existing problems in the health system.ConclusionThe scoping review identified a significant body of recent literature reporting factors associated with accessing, utilisation and provision of healthcare services in slums. We classified the diverse factors under seven broad categories. The findings can inform a holistic approach to improving health services in slums by tackling barriers at different levels, taking into account local context and geospatial features of individual slums.Systematic review registration numberhttps://osf.io/694t2.
Patient preferences and attitudes towards first choice medical services in Shenzhen, China: a cross-sectional study
Authors: Zhao Xinyu , Xiao Junhui , Chen Huida , Lin Kena , Li Xiaoman , Zeng Zhiwen , Huang Shuyun , Xie Zhikui , Du Jinlin 
Published: May 2022

ObjectiveThis study aimed to explore the characteristics of Shenzhen residents’ preferences and influencing factors regarding their first choice of medical institution at various medical levels, and to understand their attitudes towards community health services.DesignCross-sectional survey.ParticipantsA total of 1612 participants at least 18 years of age were randomly sampled with stratification among 10 districts in Shenzhen. Data were gathered through a self-designed questionnaire. The effective questionnaire response rate was 93.05%. All patients participated in the study voluntarily, provided written informed consent and were able to complete the questionnaire.Main outcome measuresWe measured and compared the participants’ expected and actual preferences and influencing factors regarding their first choice of medical service at various medical levels.ResultsMore than 50% of the participants preferred municipal and district hospitals as their first choice, and 27.5% chose medical institutions according to specific circumstances. Univariate analysis indicated that age, education, income, medical insurance, housing conditions and registered permanent residence were significantly associated with the actual and expected preferred first medical institution. The main factors influencing participants' actual and expected preferred medical institution differed. With the actual preferred first medical institution as the dependent variable, education, monthly income, medical technology, convenience and providers’ service attitude and medical ethics were the main factors (χ2=212.63, p<0.001), whereas with the expected preferred first medical institution as the dependent variable, occupation, Shenzhen registered permanent residence, education and medical technology were the main factors (χ2=78.101, p<0.001).ConclusionThe main factors influencing participants’ preferred medical institution and their actual first visit differed. Patients with high education or income or registered permanent residence preferred high-level medical institutions for the first visit.
Multi-disciplinary Evaluation of Sexual Assault Referral Centres (SARCs) for better Health (MESARCH): protocol for a 1-year cohort study examining health, well-being and cost outcomes in adult survivors of sexual assault attending SARCs in England
Authors: O'Doherty Lorna , Carter Grace , Lutman-White Eleanor , Caswell Rachel , Jackson Louise J , Feder Gene , Heron Jon , Morris Richard , Brown Katherine 
Published: May 2022

IntroductionSexual violence is commonplace and has serious adverse consequences for physical and mental health. Sexual Assault Referral Centres (SARCs) are viewed as a best practice response. Little is known about their effectiveness and cost-effectiveness. Long-term data on the health and well-being of those who have experienced rape and sexual assault are also lacking.Methods and analysisThis is a mixed-methods protocol for a 1-year cohort study aiming to examine the health and well-being in survivors of sexual violence after attending a SARC in England. Quantitative measures are being taken at baseline, 6 and 12 months. Post-traumatic stress (PTS) is the primary outcome (target N=270 at 12-month follow-up). Secondary measures include anxiety, depression, substance use and sexual health and well-being. Using mixed-effects regression, our main analysis will examine whether variation in SARC service delivery and subsequent mental healthcare is associated with improvement in trauma symptoms after 12 months. An economic analysis will compare costs and outcomes associated with different organisational aspects of SARC service delivery and levels of satisfaction with care. A nested qualitative study will employ narrative analysis of transcribed interviews with 30 cohort participants and 20 survivors who have not experienced SARC services.Ethics and disseminationThe research is supported by an independent study steering committee, data monitoring and ethics committee and patient and public involvement (PPI) group. A central guiding principle of the research is that being involved should feel diametrically opposed to being a victim of sexual violence, and be experienced as empowering and supportive. Our PPI representatives are instrumental in this, and our wider stakeholders encourage us to consider the health and well-being of all involved. We will disseminate widely through peer-reviewed articles and non-academic channels to maximise the impact of findings on commissioning of services and support for survivors.Trial registration numberISRCTN30846825.
Leveraging breast cancer screening to promote timely detection, diagnosis and treatment among women in sub-Saharan Africa: a scoping review protocol
Authors: Yakong Vida Nyagre , Afaya Agani , Alhassan Robert Kaba , Sang Somin , Salia Solomon Mohammed , Afaya Richard Adongo , Karim Jebuni Fuseini , Kuug Anthony , Selorm Daniels-Donkor Silas , Atakro Confidence Alorse , Akokre Renna , Adatara Peter , Ayanore Martin Amogre 
Published: May 2022

IntroductionFemale breast cancer is now the most often diagnosed cancer in the world. Breast cancer screening aims to reduce mortalities related to cancer, and morbidity associated with advanced stages of the disease, through timely detection in asymptomatic women. This study aims to conduct a comprehensive assessment and evaluation of the evidence on the factors that influence the provision and uptake of breast cancer screening among women in sub-Saharan Africa (SSA).Methods and analysisPubMed, Web of Science, EMBASE and the Cumulative Index to Nursing and Allied Health Literature including Google Scholar will be searched to identify published studies on barriers and facilitators to breast cancer screening from January 2010 to 2021. Two reviewers will independently assess the quality of all the included studies using the Mixed Methods Appraisal Tool version 2018. We envisage that this review will adduce evidence on common barriers and facilitators to breast cancer screening in SSA. Identifying these barriers and facilitators will help guide the initialisation of effective interventions that will improve breast cancer screening uptake among women in SSA. This review will also guide future research in developing, implementing and evaluating appropriate interventions tailored toward increasing breast cancer screening uptake.Ethics and disseminationEthics approval for this protocol is not required since it does not involve collecting data from human participants. The outcomes of this study will be published in a peer-reviewed journal.
How can the healthcare system deliver sustainable performance? A scoping review
Authors: Zurynski Yvonne , Herkes-Deane Jessica , Holt Joanna , McPherson Elise , Lamprell Gina , Dammery Genevieve , Meulenbroeks Isabelle , Halim Nicole , Braithwaite Jeffrey 
Published: May 2022

BackgroundIncreasing health costs, demand and patient multimorbidity challenge the sustainability of healthcare systems. These challenges persist and have been amplified by the global pandemic.ObjectivesWe aimed to develop an understanding of how the sustainable performance of healthcare systems (SPHS) has been conceptualised, defined and measured.DesignScoping review of peer-reviewed articles and editorials published from database inception to February 2021.Data sourcesPubMed and Ovid Medline, and snowballing techniques.Eligibility criteriaWe included articles that discussed key focus concepts of SPHS: (1) definitions, (2) measurement, (3) identified challenges, (4) identified solutions for improvement and (5) scaling successful solutions to maintain SPHS.Data extraction and synthesisAfter title/abstract screening, full-text articles were reviewed, and relevant information extracted and synthesised under the five focus concepts.ResultsOf 142 included articles, 38 (27%) provided a definition of SPHS. Definitions were based mainly on financial sustainability, however, SPHS was also more broadly conceptualised and included acceptability to patients and workforce, resilience through adaptation, and rapid absorption of evidence and innovations. Measures of SPHS were also predominantly financial, but recent articles proposed composite measures that accounted for financial, social and health outcomes. Challenges to achieving SPHS included the increasingly complex patient populations, limited integration because of entrenched fragmented systems and siloed professional groups, and the ongoing translational gaps in evidence-to-practice and policy-to-practice. Improvement strategies for SPHS included developing appropriate workplace cultures, direct community and consumer involvement, and adoption of evidence-based practice and technologies. There was also a strong identified need for long-term monitoring and evaluations to support adaptation of healthcare systems and to anticipate changing needs where possible.ConclusionsTo implement lasting change and to respond to new challenges, we need context-relevant definitions and frameworks, and robust, flexible, and feasible measures to support the long-term sustainability and performance of healthcare systems.
Importance of ideal cardiovascular health metrics in the risk of colorectal cancer among people aged 50 years or older: a UK Biobank cohort study
Authors: Zhang Jijuan , Yu Hancheng , Huang Tao , Huang Ninghao , Liang Hailun 
Published: May 2022

ObjectiveTo explore the correlation between the ideal cardiovascular health metrics (ICVHMs) and the incidence of colorectal cancer (CRC) among people aged 50 years or older.DesignProspective cohort study.SettingThe UK Biobank, a prospective cohort of middle-aged participants recruited between 2006 and 2010.ParticipantsThe study included 342 226 participants from the UK Biobank aged 50 years or older without prevalent cancer.ExposureThe ICVHMs consist of four behavioural factors (abstinence from smoking, ideal body mass index (BMI), physical activity at goal and consumption of healthy diet) and three cardiometabolic factors (untreated total cholesterol <200 mg/dL, untreated blood pressure <120/80 mm Hg and untreated fasting plasma glucose <100 mg/dL).Main outcomesThe outcome was ascertained by linkage to cancer and death registries using the International Classification of Diseases, Tenth codes C18–C20.ResultsDuring a median follow-up time of 8.72 years, 3060 CRC cases were identified. Compared with the reference (participants with ICVHMs ≤2), the multivariable-adjusted HRs for subgroups with 3, 4, 5 and ≥6 ICVHM factors were 0.98 (95% CI 0.85 to 1.12), 0.90 (95% CI 0.77 to 1.02), 0.85 (95% CI 0.71 to 0.98) and 0.69 (95% CI 0.48 to 0.90), respectively. Among the seven ICVHM factors, lower BMI, healthier diet and ideal fasting plasma glucose were significantly associated with lower risk of CRC (HR: 0.86, 95% CI 0.78 to 0.95; HR: 0.92, 95% CI 0.84 to 0.99; HR: 0.90, 95% CI 0.80 to 0.99).ConclusionsAdherence to the ICVHMs was associated with a lower risk of CRC among people aged 50 years or older. Among the seven ICVHM factors, BMI, diet and fasting plasma glucose played a more critical role in the prevention of CRC. These findings imply that adherence to ICVHMs should be encouraged to reduce the burden of cardiovascular disease as well as CRC.
Impact of out-of-pocket expenses for surgical care on households in rural Haiti: a mixed-methods study
Authors: Padovany Michelson MN , Patterson Rolvix H , Bowder Alexis N , O'Brien Eva , Alkire Blake C , Katz Arlene M , Mitnick Carole D , Lu Chunling 
Published: May 2022

ObjectivesThis study aimed to report household catastrophic spending on surgery and the experiences of patients and families seeking surgical care in rural Haiti.DesignThe study used an explanatory, sequential mixed-methods approach. We collected both quantitative and qualitative data from the participants through interviews.SettingA rural tertiary hospital (St. Boniface Hospital) in southern Haiti.ParticipantsThere were 200 adult Haitian surgical patients who entered the study. Of these, 41 were excluded due to missing variables or health expenditure outliers. The final sample included 159 participants.Primary and secondary outcome measuresThe primary outcomes were (1) direct and indirect payments for surgical care; (2) the rate of catastrophic health expenditure (CHE) (as defined by the Sustainable Development Goals (10% of total household expenditure) and WHO (10%, 20%, 30% and 40% of household capacity to pay)) due to surgical care; and (3) common themes across the lived experiences of households of surgical patients seeking care.ResultsThe median household expenditure on surgery-related expenses was US$385.6, slightly more than half of per capita gross domestic product in Haiti (US$729.3). Up to 86% of households experienced CHE, as defined by the Sustainable Development Goals, due to receiving surgical care. Patients commonly paid for surgical costs through loans and donations (69.8%). The qualitative analysis revealed prominent themes related to barriers to care including the burden of initiating care-seeking, care-seeking journeys and social suffering.ConclusionsCHE is common for Haitian surgical patients, and the associated care-seeking experiences are often arduous. These findings suggest that low, flat fees in non-profit hospital settings may not be sufficient to mitigate the costs of surgical care or the resulting challenges that patients experience.
Improving the uptake of cervical screening in pregnant and recently postnatal women: a quality improvement project
Authors: Coleridge Sarah Louise , Wiggans Alison , Nelissen Ellen , Bethune Rob , Blackwell Richard , Bryant Andrew , Morrison Jo 
Published: May 2022

BackgroundIn 2018, cervical screening uptake was at its lowest level since screening began, particularly in those aged 25–35, coinciding with the peak incidence of cervical cancer and average age at first delivery.ProblemRetrospective baseline data of pregnant women found 47.3% (n=123/260) were overdue for screening by delivery, of whom 74% (n=91/123) remained overdue by 6 months postnatal.MethodsWe undertook a quality improvement project from April 2018 to April 2019 to improve cervical screening uptake in pregnant and postnatal women. We mapped out the screening process and canvassed stakeholders. The main theme was inconsistency of advice received by women. From February 2018 to May 2020, we undertook a prospective audit of 10 women per week who gave birth in our maternity department, recording screening status at delivery and 6 months postnatal.Interventions included introducing evidence-based guidelines about cervical screening in pregnancy and the postnatal period, flow charts for maternity staff, multiprofessional teaching for all maternity staff and information dissemination to women (via the HANDiApp platform, a social media campaign and adapting results letters following colposcopy, highlighting dates when screening would be due). Primary care opening hours were extended for screening and women received a letter from their midwives, if they required cervical screening in pregnancy.ResultsLocally, the percentage of women overdue for cervical screening by 6 months postnatal improved by 8.0% during this project, compared with a 1.6% change in national screening rates in women aged 25–49.ConclusionsWe increased the percentage of local pregnant and postnatal women attending cervical screening by introduction of a package of information, targeted education and widening access to screening appointments.
Baseline platelet count in percutaneous coronary intervention: a dose–response meta-analysis
Authors: Galimzhanov Akhmetzhan , Sabitov Yersyn , Tenekecioglu Erhan , Tun Han Naung , Alasnag Mirvat , Mamas Mamas A 
Published: May 2022

ObjectivesThe nature of the relationship between baseline platelet count and clinical outcomes following percutaneous coronary intervention (PCI) is unclear. We undertook dose–response and pairwise meta-analyses to better describe the prognostic value of the initial platelet count and clinical endpoints in patients after PCI.MethodsA search of PubMed, Scopus and Web of Science (up to 9 October 2021) was performed to identify studies that evaluated the association between platelet count and clinical outcomes following PCI. The primary outcomes of interest were all-cause mortality, major adverse cardiovascular events (MACE) and major bleeding. We performed random-effects pairwise and one-stage dose–response meta-analyses by calculating HRs and 95% CIs.ResultsThe meta-analysis included 19 studies with 217 459 patients. We report a J-shaped relationship between baseline thrombocyte counts and all-cause death, MACE and major bleeding at follow-up. The risk of haemorrhagic events exceeded the risk of thrombotic events at low platelet counts (<175×109/L), while a predominant ischaemic risk was observed at high platelet counts (>250×109/L). Pairwise meta-analyses revealed a robust link between initial platelet counts and the risk of postdischarge all-cause mortality, major bleeding (for thrombocytopenia: HR 1.39, 95% CI 1.30 to 1.49; HR 1.51, 95% CI 1.15 to 2.00, respectively) and future death from any cause and MACE (thrombocytosis: HR 1.60, 95% CI 1.29 to 1.98; HR 1.47, 95% CI 1.22 to 1.78, respectively).ConclusionLow platelet counts were associated with the predominant bleeding risk, while high platelet counts were only associated with the ischaemic events.PROSPERO registration numberCRD42021283270.
A generalized Frenkel–Kontorova model for a propagating austenite–martensite phase boundary: revisited numerically
Authors: Quapp W. , Bofill J. M. 
Published: May 2022

Abstract
We explain the propagating austenite–martensite phase boundary by a Frenkel–Kontorova model for a chain of meshes along a ledge of the phase transitions. We demonstrate such steps for example chains of 16 and 47 meshes. We can represent a Langevin solution which describes possible cases of a consecutive excitation of a higher phase under a low external force.

Graphic abstract