bluuebunny/crossref_metadata_2025_split huggingface dataset:
Women's health for a primary care workforce
Authors: McClintock Adelaide H. , Starks Helene , Williams Meagan 
Published: March 2022

AbstractBackgroundPrimary care training should include competencies to provide reproductive health services. In the United Sates, primary care is often provided by general internal medicine physicians. Longitudinal training experiences for internal medicine residents in women's health increase knowledge, skills and retention in careers in women's health, but very little literature describes their implementation. The purpose of this paper is to describe the implementation and evaluation of a 2‐year women's health training pathway in Internal Medicine.ApproachUsing the Context, Input, Process, Product (CIPP) model, we describe the salient features of a complex, longitudinal educational intervention at the development, planning and evaluation stages within a large academic medical centre.EvaluationIn 2019, we conducted interviews with the pathway participants (N = 6) in the first 3 years of the programme and used the CIPP framework and Kirkpatrick's Model as an a priori codebook for analysis. Participants reported high fidelity and that the training was relevant and appropriate to meet their needs. Practicing clinicians similarly reported that training was relevant and useful and met desired goals for knowledge and integrated approaches to care. Trainees reported unexpected benefits of identity formation and a community of practice.ImplicationsThese results suggest that longitudinal training pathways are an effective way to train Internal Medicine residents to provide comprehensive care to women. This study has broader applications for health professions education, providing a model for implementation and evaluation of complex educational interventions in large organisations. Future research should focus on dissemination to train a workforce prepared to offer evidence‐based care to women throughout their lifespan.
Geography of Participation: Deepening the Understanding of the Participation Process in Time and Space
Authors: Awuh Harrison Esam 
Published: March 2022

AbstractRecent studies explain how participatory mechanisms create opportunities for the inclusion. However, sufficient attention has not been paid to how participation can be transformed into inclusive practice within a sound methodological approach. In response, this paper advances a framework for more inclusive participation based on: theory (time‐space geography), experimentation with different methods (rapid appraisal, online surveys, photovoice and public deliberation), and empirical findings. These converging trajectories provide an opportunity for advancing dialogue on inclusion in participation. The research was conducted in the Dutch city of Almere in the reclaimed province of Flevoland (The Netherlands). The findings reveal how time and space (from the time‐space geography framework) enable and constrain participation. By stimulating reflections on the ‘making’ of participation (through different combinations of time and space in research methodology), this approach contributes to deeper understandings on when and how participation can have the capacity to be more inclusive.
Values and preferences of the general population in Indonesia in relation to rapid COVID‐19 antigen self‐tests: A cross‐sectional survey
Authors: Thomas Caroline , Shilton Sonjelle , Thomas Catherine , Batheja Deepshikha , Goel Srishti , Mone Iye Claudius , Ivanova Elena , Martínez‐Pérez Guillermo Z. 
Published: March 2022

AbstractObjectivesHome diagnostics are essential to assist members of the general population become active agents of case detection. In Indonesia, a country with an over‐burdened healthcare system, individuals could use rapid SARS‐CoV‐2 antigen tests to self‐detect COVID‐19. To assess the general population's values and attitudes towards SARS‐CoV‐2 self‐testing, a survey was conducted in mid‐2021 in Jakarta and the provinces of Banten and North Sulawesi.MethodsThis was a quantitative survey that approached respondents in >600 randomly selected street‐points in the three study geographies in July–August 2021. A 35‐item questionnaire was used to collect data on key variables, such as likelihood to use a SARS‐CoV‐2 self‐test, willingness to pay for a self‐test device, and likely actions following a positive self‐test result. Bivariate and multivariate regression analyses were performed.ResultsOf 630 respondents (318 were female), 15.53% knew about COVID‐19 self‐testing, while 62.70% agreed with the idea of people being able to self‐test at home, unassisted, for COVID‐19. If self‐tests were available in Indonesia, >60% of respondents would use them if they felt it necessary and would undertake regular self‐testing for example weekly if recommended. Upon receiving a positive self‐test result, most respondents would communicate it (86.03%), request post‐test counselling (80.79%), self‐isolate (97.46%), and/or warn their close contacts (90.48%).ConclusionsThe use of rapid SARS‐CoV‐2 antigen detection tests for self‐testing appears acceptable to a majority of the Indonesian public, to learn whether they have COVID‐19. Self‐testing should be prioritised to complement to an over‐burdened healthcare system by helping the public, asymptomatic individuals included, become agents of change in epidemiological surveillance of SARS‐CoV‐2 in their communities.
Impact of restrictive red blood cell transfusion strategy on thrombosis‐related events: A meta‐analysis and systematic review
Authors: Maimaitiming Mairehaba , Zhang Chenxiao , Xie Jingui , Zheng Zhichao , Luo Haidong , Ooi Oon Cheong 
Published: March 2022

AbstractBackground and ObjectivesThere is an ongoing controversy regarding the risks of restrictive and liberal red blood cell (RBC) transfusion strategies. This meta‐analysis assessed whether transfusion at a lower threshold was superior to transfusion at a higher threshold, with regard to thrombosis‐related events, that is, whether these outcomes can benefit from a restrictive transfusion strategy is debated.Materials and MethodsWe searched PubMed, Cochrane Central Register of Controlled Trials and Scopus from inception up to 31 July 2021. We included randomized controlled trials (RCTs) in any clinical setting that evaluated the effects of restrictive versus liberal RBC transfusion in adults. We used random‐effects models to calculate the risk ratios (RRs) and 95% confidence intervals (CIs) based on pooled data.ResultsThirty RCTs involving 17,334 participants were included. The pooled RR for thromboembolic events was 0.65 (95% CI 0.44–0.94; p = 0.020; I2 = 0.0%, very low‐quality evidence), favouring the restrictive strategy. There were no significant differences in cerebrovascular accidents (RR = 0.83; 95% CI 0.64–1.09; p = 0.180; I2 = 0.0%, very low‐quality evidence) or myocardial infarction (RR = 1.05; 95% CI 0.87–1.26; p = 0.620; I2 = 0.0%, low‐quality evidence). Subgroup analyses showed that a restrictive (relative to liberal) strategy reduced (1) thromboembolic events in RCTs conducted in North America and (2) myocardial infarctions in the subgroup of RCTs where the restrictive transfusion threshold was 7 g/dl but not in the 8 g/dl subgroup (with a liberal transfusion threshold of 10 g/dl in both subgroups).ConclusionsA restrictive (relative to liberal) transfusion strategy may be effective in reducing venous thrombosis but not arterial thrombosis.
Conventional and Advanced Exergy and Exergoeconomic Assessment of an Optimized System Consisting of Kalina and Organic Rankine Cycles for Waste Heat Recovery
Authors: Sohrabi Arvin , Behbahaninia Ali 
Published: March 2022

Abstract
The use of different technologies to recover the waste heat from various sources is receiving a wide currency worldwide. The current study proposes a Kalina-organic Rankine cycle (ORC)-based system in order to make use of the exhaust gas and the jacket cooling water of an existing diesel engine. First, the system is optimized to generate maximum power. Then, the optimum system is subjected to both conventional and advanced analyses investigating its exergy and exergoeconomic aspects. Hence, the real sources of inefficiency and chances of enhancement are revealed. The system can produce 69.7 kW power with energy and exergy efficiencies of 22.3% and 59.2%, respectively. The Kalina steam generator has the most irreversibility share in the system; however, when it comes to the real potential of improvement, the Kalina turbine ranks the first that can benefit the entire system. Moreover, the results of both conventional and advanced exergoeconomic analyses indicate the Kalina turbine is the most highlighted component that both needs and can be improved in terms of cost rates. In the end, a comparison between the different results and approaches is made to summarize the results.
Electrical Reliability of Flexible Silicon Package Integrated on Polymer Substrate During Repeated Bending Deformations
Authors: Kim Tae-Wook , Kim Jae-Min , Yun Hyeon-Ji , Lee Jong-Sung , Lee Jae-Hak , Song Jun-Yeob , Joo Young-Chang , Lee Won-Jun , Kim Byoung-Joon 
Published: March 2022

Abstract
Although the reliability of flexible electronics during bending deformation is of great interest nowadays, the mechanical reliability that has mainly been investigated is of single electronic components or simple devices, such as metal interconnect, transparent conductive electrode, or thin-film devices, rather than that of the real package sample having complex structure and various materials. This study systematically investigated the mechanical reliability of flexible Si package sample consisting of Si die, polymer bump, and polymer substrate, by using individual resistance monitoring of the metal line, bump array, and total interconnect. For the bending test, the sample consisting of only Si die and polymer substrate shows abrupt electrical resistance increase below a bending radius of 3 mm, due to cracking of the Si die. For the bending fatigue test, the electrical resistance increases after 2000 cycles in 5 mm bending radius, due to fatigue failure of the metal line and bump array. Both the maximum bendability and fatigue lifetime can be significantly improved by covering with the molding layer. Finite element method simulation is conducted to analyze the mechanical stress distribution of the flexible package with and without molding layer during bending deformation. This study based on experimental results and simulation analysis can provide helpful guidelines for the design of highly reliable flexible packages.
Computational Study of the Effects of Ignition Parameters Changes on a Spark Ignition Engine Fueled With Syngas
Authors: Pérez Gordillo David Sebastian , Mantilla González Juan Miguel 
Published: March 2022

Abstract
This article presents the development of a geometric model for the full-cycle simulation of a spark ignition engine fueled with a biomass-derived syngas. The engine simulations are carried out in KIVA 4, using a global reaction mechanism. This model aims to predict the parameters that stipulate the engine performance and NO emissions. The domain undergoes a convergence process to select the appropriate mesh size for the simulations. Then, in order to assess the veracity of the results obtained in the simulations, a comparison is made with experimental data reported in the literature. In this way, it was concluded that the developed model successfully predicts the mixing process, the combustion of the gas, the indicated parameters, and the NO emissions of the real engine, presenting admissible differences regarding the experimental results. Finally, with the validated model, simulations are carried out, modifying different ignition parameters, seeking to evidence the engine operation as a function of these variables. The results demonstrate that it is possible to obtain improvements in the engine performance and its polluting emissions, altering the ignition energy, ignition timing, or spark location.
Swiss-Ski Power Test Results in Youth Competitive Alpine Skiers Are Associated With Biological Maturation and Skiing Performance
Authors: Javet Marie , Fröhlich Stefan , Bruhin Björn , Frey Walter O. , Romann Michael , Spörri Jörg 
Published: March 2022

Purpose: To explore reasonable application purposes and potential confounders of the Swiss-Ski Power Test (SSPT) that is, since 2004, annually performed by all youth competitive alpine skiers of the under-16-years age category in Switzerland. Methods: Preseason SSPT results (8 individual tests on anaerobic and aerobic capacity, muscle strength, and speed and coordination) of 144 skiers (57 female and 87 male) age 14.5 (0.7) years were analyzed along with anthropometry and biological age. Skiing performance was quantified as the actual performance points according to the Swiss national ranking. After the SSPT tests, skiers were prospectively monitored over 12 months using the Oslo Trauma Research Center questionnaire. Data were analyzed using multivariate analysis of variance, Pearson correlations, and multiple linear/binary logistic regression models. Results: Biological maturation and SSPT results differed between sexes and age (P < .05). For males, SSPT results in the subdisciplines Swiss Cross, 1-leg 5-hop, and standing long jump were correlated to maturity offset, while for females only the obstacle run was related. High box jump and Swiss Cross scores were associated with skiing performance (P < .05). However, none of the SSPT subdisciplines was related to traumatic and overuse injuries (P < .05). Conclusions: The SSPT is a broadly implementable and cost-effective field test providing a general fitness profile of youth skiers. Around the growth spurt, differences in biological maturation should be considered. While SSPT results showed association with skiing performance, the test in its current form is limited for identifying injury-relevant physical deficiencies. Consequently, more specific tests may be required.
Active Relative to Passive Ischemic Preconditioning Enhances Intense Endurance Performance in Well-Trained Men
Authors: Christiansen Danny , Olsen Casper B.L. , Kehler Frederik , Hansen Anders P. , Jessen Søren , Christensen Peter M. , Bangsbo Jens 
Published: March 2022

Purpose: This study tested the hypothesis of whether ischemic exercise preconditioning (IPC-Ex) elicits a better intense endurance exercise performance than traditional ischemic preconditioning at rest (IPC-rest) and a SHAM procedure. Methods: Twelve men (average ∼61 mL·kg−1·min−1) performed 3 trials on separate days, each consisting of either IPC-Ex (3 × 2-min cycling at ∼40 W with a bilateral-leg cuff pressure of ∼180 mm Hg), IPC-rest (4 × 5-min supine rest at 220 mm Hg), or SHAM (4 × 5-min supine rest at <10 mm Hg) followed by a standardized warm-up and a 4-minute maximal cycling performance test. Power output, blood lactate, potassium, pH, rating of perceived exertion, oxygen uptake, and gross efficiency were assessed. Results: Mean power during the performance test was higher in IPC-Ex versus IPC-rest (+4%; P = .002; 95% CI, +5 to 18 W). No difference was found between IPC-rest and SHAM (−2%; P = .10; 95% CI, −12 to 1 W) or between IPC-Ex and SHAM (+2%; P = .09; 95% CI, −1 to 13 W). The rating of perceived exertion increased following the IPC-procedure in IPC-Ex versus IPC-rest and SHAM (P < .001). During warm-up, IPC-Ex elevated blood pH versus IPC-rest and SHAM (P ≤ .027), with no trial differences for blood potassium (P > .09) or cycling efficiency (P ≥ .24). Eight subjects anticipated IPC-Ex to be best for their performance. Four subjects favored SHAM. Conclusions: Performance in a 4-minute maximal test was better following IPC-Ex than IPC-rest and tended to be better than SHAM. The IPC procedures did not affect blood potassium, while pH was transiently elevated only by IPC-Ex. The performance-enhancing effect of IPC-Ex versus IPC-rest may be attributed to a placebo effect, improved pH regulation, and/or a change in the perception of effort.
Early versus delayed lengthening exercises for acute hamstring injury in male athletes: a randomised controlled clinical trial
Authors: Vermeulen Robin , Whiteley Rod , van der Made Anne D , van Dyk Nicol , Almusa Emad , Geertsema Celeste , Targett Stephen , Farooq Abdulaziz , Bahr Roald , Tol Johannes L , Wangensteen Arnlaug 
Published: March 2022

BackgroundTo evaluate the efficacy of early versus delayed introduction of lengthening (ie, eccentric strengthening) exercises in addition to an established rehabilitation programme on return to sport duration for acute hamstring injuries in a randomised controlled superiority trial.Methods90 male participants (age: 18–36 years, median 26 years) with an MRI-confirmed acute hamstring injury were randomised into an early lengthening (at day 1 of rehabilitation) group or a delayed lengthening (after being able to run at 70% of maximal speed) group. Both groups received an established rehabilitation programme. The primary outcome was time to return to sport (ie, time from injury to full unrestricted training and/or match play). The secondary outcome was reinjury rate within 12 months after return to sport. Other outcomes at return to sport included the Askling H-test, hamstring strength, clinical examination and readiness questions.ResultsThe return to sport in the early lengthening group was 23 (IQR 16–35) days and 33 (IQR 23–40) days in the delayed lengthening group. For return to sport (in days), the adjusted HR for the early lengthening group compared with the delayed lengthening group was 0.95 (95% CI 0.56 to 1.60, p=0.84). There was no significant difference between groups for reinjury rates within 2 months (OR=0.94, 95% CI 0.18 to 5.0, p=0.94), from 2 to 6 months (OR=2.00, 95% CI 0.17 to 23.3, p=0.58), and 6 to 12 months (OR=0.57, 95% CI 0.05 to 6.6, p=0.66).ConclusionAccelerating the introduction of lengthening exercises in the rehabilitation of hamstring injury in male athletes did not improve the time to return to sport nor the risk of reinjury.
Identifying key influences on antibiotic use in China: a systematic scoping review and narrative synthesis
Authors: Coope Caroline , Schneider Annegret , Zhang Tingting , Kadetz Paul , Feng Rui , Lambert Helen , Wang DeBin , Oliver Isabel , Michie Susan , Cabral Christie 
Published: March 2022

IntroductionThe inappropriate use of antibiotics is a key driver of antimicrobial resistance. In China, antibiotic prescribing and consumption exceed recommended levels and are relatively high internationally. Understanding the influences on antibiotic use is essential to informing effective evidence-based interventions. We conducted a scoping review to obtain an overview of empirical research about key behavioural, cultural, economic and social influences on antibiotic use in China.MethodsSearches were conducted in Econlit, Medline, PsycINFO, Social Science citation index and the Cochrane Database of Systematic Reviews for the period 2003 to early 2018. All study types were eligible including observational and intervention, qualitative and quantitative designs based in community and clinical settings. Two authors independently screened studies for inclusion. A data extraction form was developed incorporating details on study design, behaviour related to antibiotic use, influences on behaviour and information on effect (intervention studies only).ResultsIntervention studies increased markedly from 2014, and largely focused on the impact of national policy and practice directives on antibiotic use in secondary and tertiary healthcare contexts in China. Most studies used pragmatic designs, such as before and after comparisons. Influences on antibiotic use clustered under four themes: antibiotic prescribing; adherence to antibiotics; self-medicating behaviour and over-the-counter sale of antibiotics. Many studies highlighted the use of antibiotics without a prescription for common infections, which was facilitated by availability of left-over medicines and procurement from local pharmacies.ConclusionsInterventions aimed at modifying antibiotic prescribing behaviour show evidence of positive impact, but further research using more robust research designs, such as randomised trials, and incorporating process evaluations is required to better assess outcomes. The effect of national policy at the primary healthcare level needs to be evaluated and further exploration of the influences on antibiotic self-medicating is required to develop interventions that tackle this behaviour.
What, how, when and who of trial results summaries for trial participants: stakeholder-informed guidance from the RECAP project
Authors: Bruhn Hanne , Campbell Marion , Entwistle Vikki , Humphreys Rosemary , Jayacodi Sandra , Knapp Peter , Tizzard Juliet , Gillies Katie 
Published: March 2022

ObjectiveTo generate stakeholder informed evidence to support recommendations for trialists to implement the dissemination of results summaries to participants.DesignA multiphase mixed-methods triangulation design involving Q-methodology, content analysis, focus groups and a coproduction workshop (the REporting Clinical trial results Appropriately to Participants project).SettingPhase III effectiveness trials.ParticipantsA range of participants were included from ongoing and recently completed trials, public contributors, trialists, sponsors, research funders, regulators, ethics committee members.ResultsFewer than half of the existing trial result summaries contained information on the clinical implications of the study results, an item deemed to be of high importance to participants in the Q-methodology study. Priority of inclusion of a thank you message varied depending on whether considering results for individuals or populations. The need for personally responsive modes of sharing trial result summaries was highlighted as important. Ideally, participants should be the first to know of the results with regard to the timing of sharing results summaries but given this can be challenging it is therefore important to manage expectations. In addition to patients, it was identified that it is important to engage with a range of stakeholders when developing trial results summaries.ConclusionsResults summaries for trial participants should cover four core questions: (1) What question the trial set out to answer?; (2) What did the trial find?; (3) What effect have the trial results had and how will they change National Health Service/treatment?; and (4) How can I find out more? Trial teams should develop appropriately resourced plans and consult patient partners and trial participants on how ‘best’ to share key messages with regard to content, mode, and timing. The study findings provide trial teams with clear guidance on the core considerations of the ‘what, how, when and who’ with regard to sharing results summaries.