The state of international collaboration for health systems research: what do publications tell?

AIM: International collaboration for health system development has been identified as a critical input to meet pressing global health needs. North-South collaboration has the potential to benefit both parties, while South-South collaboration offers promise to strengthen capacity rapidly and efficiently across developing countries. There is an emerging trend to analyze the fruits of such collaboration. This paper builds on this trend by applying an innovative concept-based bibliometric method to identify the international scope of collaboration within the field of health policy and systems research. Two key questions are addressed: to what extent are papers comparing developing countries as against reporting on single country studies? To what extent are papers in either case being produced by researchers within their respective countries or through North-South or South-South collaboration? METHODS: A total of 8,751 papers published in Medline between 1999 and 2003 with data on health systems and policies in developing countries were identified and content-analyzed using an innovative concept-based search technology. A sample of 13% of papers was used to identify the corresponding institution and countries covered. The sampled data was then analyzed by income group. RESULTS: Papers with an international, cross-country focus account for only 10% of the total. Just over a third of all papers are led by upper middle income country authors, closely followed by authors from high income countries. Just under half of all papers target low income countries. Cross-country papers are led mostly by institutions in high income countries, with 74% of the total. Only seven countries concentrate 60% of the papers led by developing country institutions. Institutions in the United States and the United Kingdom concentrate between them as many as 68% of the papers led by high income countries. Only 11% of all single-country papers and 21% of multi-country studies are the product of South-South collaboration. Health Financing is the topic with the greatest international scope, with 26% of all papers in the topic. Topics such as Costing and Cost Effectiveness, Finance, Sector Analysis and Insurance, regardless of their national or international scope, are led in 38% to 54% of cases by high income authors. CONCLUSION: While there is modest health systems research capacity in many developing countries for single country studies, capacity is severely limited for multi-country studies. While North-South collaboration is important, the number of international studies is still very limited to produce the kind of knowledge required to learn from experiences across countries. The fact that lead institutions as well as study countries are concentrated in a handful of mostly middle income countries attests to great disparities in research capacity. However, disparities in research capacity and interest are also evident in the North. It is urgent to build cross-country research capacity including appropriate forms of South-South and North-South collaboration

Gender-differences of in vitro colonic motility after chemo- and radiotherapy in humans.

Background: The aim of the present in vitro study was to investigate, in different genders, motor responses in surgical colonic specimens from patients with rectal cancer undergoing and not undergoing chemotherapy with capecitabine and radiotherapy. Methods: This in vitro study was conducted from October 2015 to August 2017 at the Experimental Pharmacology Laboratory at the National Institute “S. de Bellis” after collecting samples at the Department of Surgery. Segments of sigmoid colon were obtained from 15 patients (Male (M)/Female (F) = 8/7; control group, CG) operated on for elective colorectal resection for rectal cancer without obstruction and 14 patients (M/F = 7/7; study group, SG) operated on for elective colorectal resection for rectal cancer who also received chemotherapy, based on capecitabine twice daily, and radiotherapy. Isometric tension was measured on colonic circular muscle strips exposed to increasing carbachol or histamine concentrations to obtain concentration-response curves. The motor responses to electrically evoked stimulation were also investigated. Results: In males, carbachol and histamine caused concentration-dependent contractions in the CG and SG. An increased sensitivity and a higher response to carbachol and histamine were observed in SG than CG (P < 0.01). On the contrary, in females, the response to carbachol was not significantly different in CG from the SG and the maximal responses to carbachol were greater in CG than in SG (P < 0.001). The same applied to histamine for half-maximal effective concentrations and maximal response in that they were not significantly different in CG from the SG. Electrically evoked contractions were significantly more pronounced in males, especially in the SG (P < 0.05). Conclusions: This preliminary in vitro study has shown gender differences in motor responses of colonic circular muscle strips in patients who had received chemotherapy with capecitabine and radiotherapy

The 'not-so-strange' body in the mirror: : A principal components analysis of direct and mirror self-observation

This document is the Accepted Manuscript version of the following article: Paul M. Jenkinson, and Catherine Preston, ‘The “not-so-strange” body in the mirror: A principal components analysis of direct and mirror self-observation’, Consciousness and Cognition, Vol. 48, pp. 262-272, first published online 4 January 2017, doi: http://dx.doi.org/10.1016/j.concog.2016.12.007 This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/.In this study we adopted a psychometric approach to examine how the body is subjectively experienced in a mirror. One hundred and twenty-four healthy participants viewed their body for five minutes directly or via a mirror, and then completed a 20-item questionnaire designed to capture subjective experiences of the body. PCA revealed a two-component structure for both direct and mirror conditions, comprising body evaluations (and alienation) and unusual feelings and perceptions. The relationship between these components and pre-existing tendencies for appearance anxiety, body dysmorphic-type beliefs, dissociative symptomatology, self-objectification and delusion ideation further supported the similarity between direct and mirror conditions; however, the occurrence of strange experiences like those reported to occur during prolonged face viewing was not confirmed. These results suggest that, despite obvious differences in visual feedback, observing the body via a mirror (as an outside observer) is subjectively equivalent to observing the body directly (from our own viewpoint).Peer reviewedFinal Accepted Versio

The onset time of the ownership sensation in the moving rubber hand illusion

The rubber hand illusion (RHI) is a perceptual illusion whereby a model hand is perceived as part of one’s own body. This illusion has been extensively studied, but little is known about the temporal evolution of this perceptual phenomenon, i.e., how long it takes until participants start to experience ownership over the model hand. In the present study, we investigated a version of the rubber hand experiment based on finger movements and measured the average onset time in active and passive movement conditions. This comparison enabled us to further explore the possible role of intentions and motor control processes that are only present in the active movement condition. The results from a large group of healthy participants (n D 117) showed that the illusion of ownership took approximately 23 s to emerge (active: 22.8; passive: 23.2). The 90th percentile occurs in both conditions within approximately 50 s (active: 50; passive: 50.6); therefore, most participants experience the illusion within the first minute. We found indirect evidence of a facilitatory effect of active movements compared to passive movements, and we discuss these results in the context of our current understanding of the processes underlying the moving RHI

Cosmology at Low Frequencies: The 21 cm Transition and the High-Redshift Universe

Observations of the high-redshift Universe with the 21 cm hyperfine line of neutral hydrogen promise to open an entirely new window onto the early phases of cosmic structure formation. Here we review the physics of the 21 cm transition, focusing on processes relevant at high redshifts, and describe the insights to be gained from such observations. These include measuring the matter power spectrum at z~50, observing the formation of the cosmic web and the first luminous sources, and mapping the reionization of the intergalactic medium. The epoch of reionization is of particular interest, because large HII regions will seed substantial fluctuations in the 21 cm background. We also discuss the experimental challenges involved in detecting this signal, with an emphasis on the Galactic and extragalactic foregrounds. These increase rapidly toward low frequencies and are especially severe for the highest redshift applications. Assuming that these difficulties can be overcome, the redshifted 21 cm line will offer unique insight into the high-redshift Universe, complementing other probes but providing the only direct, three-dimensional view of structure formation from z~200 to z~6.Comment: extended review accepted by Physics Reports, 207 pages, 44 figures (some low resolution); version with high resolution figures available at http://pantheon.yale.edu/~srf28/21cm/index.htm; minor changes to match published versio

Embodiment and Presence in Virtual Reality After Stroke. A Comparative Study With Healthy Subjects

[EN] The ability of virtual reality (VR) to recreate controlled, immersive, and interactive environments that provide intensive and customized exercises has motivated its therapeutic use after stroke. Interaction and bodily presence in VR-based interventions is usually mediated through virtual selves, which synchronously represent body movements or responses to events on external input devices. Embodied self-representations in the virtual world not only provide an anchor for visuomotor tasks, but their morphologies can have behavioral implications. While research has focused on the underlying subjective mechanisms of exposure to VR on healthy individuals, the transference of these findings to individuals with stroke is not evident and remains unexplored, which could affect the experience and, ultimately, the clinical effectiveness of neurorehabilitation interventions. This study determined and compared the sense of embodiment and presence elicited by a virtual environment under different perspectives and levels of immersion in healthy subjects and individuals with stroke. Forty-six healthy subjects and 32 individuals with stroke embodied a gender-matched neutral avatar in a virtual environment that was displayed in a first-person perspective with a head-mounted display and in a third-person perspective with a screen, and the participants were asked to interact in a virtual task for 10 min under each condition in counterbalanced order, and to complete two questionnaires about the sense of embodiment and presence experienced during the interaction. The sense of body-ownership, self-location, and presence were more vividly experienced in a first-person than in a third-person perspective by both healthy subjects (p < 0.001, eta(2)(p) = 0.212; p = 0.005, eta(2)(p) = 0.101; p = 0.001, eta(2)(p) = 0.401, respectively) and individuals with stroke (p = 0.019, eta(2)(p) = 0.070; p = 0.001, eta(2)(p) = 0.135; p = 0.014, eta(2)(p) = 0.077, respectively). In contrast, no agency perspective-related differences were found in any group. All measures were consistently higher for healthy controls than for individuals with stroke, but differences between groups only reached statistical significance in presence under the first-person condition (p < 0.010, eta(2)(p) = 0.084). In spite of these differences, the participants experienced a vivid sense of embodiment and presence in almost all conditions. These results provide first evidence that, although less intensively, embodiment and presence are similarly experienced by individuals who have suffered a stroke and by healthy individuals, which could support the vividness of their experience and, consequently, the effectiveness of VR-based interventions.This study was funded by Ministerio de Economía y Competitividad of Spain (Project RTC-2017-6051-7 and Grant BES-2014-068218), Fundació la Marató de la TV3 (Grant 201701-10), and Universitat Politècnica de València (Grant PAID-10-18). We acknowledge the support of NVIDIA Corporation with the donation of the Titan Xp GPU used for this research.Borrego, A.; Latorre, J.; Alcañiz Raya, ML.; Llorens Rodríguez, R. (2019). Embodiment and Presence in Virtual Reality After Stroke. A Comparative Study With Healthy Subjects. Frontiers in Neurology. 10:1-8. https://doi.org/10.3389/fneur.2019.01061S1810Berlucchi, G., & Aglioti, S. (1997). The body in the brain: neural bases of corporeal awareness. Trends in Neurosciences, 20(12), 560-564. doi:10.1016/s0166-2236(97)01136-3Legrand, D. (2006). The Bodily Self: The Sensori-Motor Roots of Pre-Reflective Self-Consciousness. Phenomenology and the Cognitive Sciences, 5(1), 89-118. doi:10.1007/s11097-005-9015-6Arzy, S., Overney, L. S., Landis, T., & Blanke, O. (2006). Neural Mechanisms of Embodiment. Archives of Neurology, 63(7), 1022. doi:10.1001/archneur.63.7.1022De Vignemont, F. (2011). Embodiment, ownership and disownership. Consciousness and Cognition, 20(1), 82-93. doi:10.1016/j.concog.2010.09.004Giummarra, M. J., Gibson, S. J., Georgiou-Karistianis, N., & Bradshaw, J. L. (2008). Mechanisms underlying embodiment, disembodiment and loss of embodiment. Neuroscience & Biobehavioral Reviews, 32(1), 143-160. doi:10.1016/j.neubiorev.2007.07.001Ma, K., & Hommel, B. (2015). The role of agency for perceived ownership in the virtual hand illusion. Consciousness and Cognition, 36, 277-288. doi:10.1016/j.concog.2015.07.008Kilteni, K., Maselli, A., Kording, K. P., & Slater, M. (2015). Over my fake body: body ownership illusions for studying the multisensory basis of own-body perception. Frontiers in Human Neuroscience, 9. doi:10.3389/fnhum.2015.00141Clark, A., Kiverstein, J., & Vierkant, T. (Eds.). (2013). Decomposing the Will. doi:10.1093/acprof:oso/9780199746996.001.0001Frith, C. D., Blakemore, S.-J., & Wolpert, D. M. (2000). Abnormalities in the awareness and control of action. Philosophical Transactions of the Royal Society of London. Series B: Biological Sciences, 355(1404), 1771-1788. doi:10.1098/rstb.2000.0734Bermúdez i Badia, S., Fluet, G. G., Llorens, R., & Deutsch, J. E. (2016). Virtual Reality for Sensorimotor Rehabilitation Post Stroke: Design Principles and Evidence. Neurorehabilitation Technology, 573-603. doi:10.1007/978-3-319-28603-7_28Perez-Marcos, D., Sanchez-Vives, M. V., & Slater, M. (2011). Is my hand connected to my body? The impact of body continuity and arm alignment on the virtual hand illusion. Cognitive Neurodynamics, 6(4), 295-305. doi:10.1007/s11571-011-9178-5IJsselsteijn, W. A., de Kort, Y. A. W., & Haans, A. (2006). Is This My Hand I See Before Me? The Rubber Hand Illusion in Reality, Virtual Reality, and Mixed Reality. Presence: Teleoperators and Virtual Environments, 15(4), 455-464. doi:10.1162/pres.15.4.455Banakou, D., Groten, R., & Slater, M. (2013). Illusory ownership of a virtual child body causes overestimation of object sizes and implicit attitude changes. Proceedings of the National Academy of Sciences, 110(31), 12846-12851. doi:10.1073/pnas.1306779110Yee, N., & Bailenson, J. (2007). The Proteus Effect: The Effect of Transformed Self-Representation on Behavior. Human Communication Research, 33(3), 271-290. doi:10.1111/j.1468-2958.2007.00299.xSteed, A., Frlston, S., Lopez, M. M., Drummond, J., Pan, Y., & Swapp, D. (2016). An ‘In the Wild’ Experiment on Presence and Embodiment using Consumer Virtual Reality Equipment. IEEE Transactions on Visualization and Computer Graphics, 22(4), 1406-1414. doi:10.1109/tvcg.2016.2518135Colomer, C., Llorens, R., Noé, E., & Alcañiz, M. (2016). Effect of a mixed reality-based intervention on arm, hand, and finger function on chronic stroke. Journal of NeuroEngineering and Rehabilitation, 13(1). doi:10.1186/s12984-016-0153-6Laver, K. E., Lange, B., George, S., Deutsch, J. E., Saposnik, G., & Crotty, M. (2017). Virtual reality for stroke rehabilitation. Cochrane Database of Systematic Reviews. doi:10.1002/14651858.cd008349.pub4Llorens, R., Borrego, A., Palomo, P., Cebolla, A., Noé, E., i Badia, S. B., & Baños, R. (2017). Body schema plasticity after stroke: Subjective and neurophysiological correlates of the rubber hand illusion. Neuropsychologia, 96, 61-69. doi:10.1016/j.neuropsychologia.2017.01.007Zeller, D., Gross, C., Bartsch, A., Johansen-Berg, H., & Classen, J. (2011). Ventral Premotor Cortex May Be Required for Dynamic Changes in the Feeling of Limb Ownership: A Lesion Study. Journal of Neuroscience, 31(13), 4852-4857. doi:10.1523/jneurosci.5154-10.2011Folstein, M. F., Folstein, S. E., & McHugh, P. R. (1975). «Mini-mental state». Journal of Psychiatric Research, 12(3), 189-198. doi:10.1016/0022-3956(75)90026-6Romero, M., Sánchez, A., Marín, C., Navarro, M. D., Ferri, J., & Noé, E. (2012). Clinical usefulness of the Spanish version of the Mississippi Aphasia Screening Test (MASTsp): validation in stroke patients. Neurología (English Edition), 27(4), 216-224. doi:10.1016/j.nrleng.2011.06.001Latorre, J., Llorens, R., Colomer, C., & Alcañiz, M. (2018). Reliability and comparison of Kinect-based methods for estimating spatiotemporal gait parameters of healthy and post-stroke individuals. Journal of Biomechanics, 72, 268-273. doi:10.1016/j.jbiomech.2018.03.008Lloréns, R., Noé, E., Naranjo, V., Borrego, A., Latorre, J., & Alcañiz, M. (2015). Tracking Systems for Virtual Rehabilitation: Objective Performance vs. Subjective Experience. A Practical Scenario. Sensors, 15(3), 6586-6606. doi:10.3390/s150306586Slater, M., & Steed, A. (2000). A Virtual Presence Counter. Presence: Teleoperators and Virtual Environments, 9(5), 413-434. doi:10.1162/105474600566925Slater, M., Spanlang, B., Sanchez-Vives, M. V., & Blanke, O. (2010). First Person Experience of Body Transfer in Virtual Reality. PLoS ONE, 5(5), e10564. doi:10.1371/journal.pone.0010564Petkova, V. I., Khoshnevis, M., & Ehrsson, H. H. (2011). The Perspective Matters! Multisensory Integration in Ego-Centric Reference Frames Determines Full-Body Ownership. Frontiers in Psychology, 2. doi:10.3389/fpsyg.2011.00035Maselli, A., & Slater, M. (2013). The building blocks of the full body ownership illusion. Frontiers in Human Neuroscience, 7. doi:10.3389/fnhum.2013.00083Debarba, H. G., Molla, E., Herbelin, B., & Boulic, R. (2015). 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Angular and Current-Target Correlations in Deep Inelastic Scattering at HERA

Correlations between charged particles in deep inelastic ep scattering have been studied in the Breit frame with the ZEUS detector at HERA using an integrated luminosity of 6.4 pb-1. Short-range correlations are analysed in terms of the angular separation between current-region particles within a cone centred around the virtual photon axis. Long-range correlations between the current and target regions have also been measured. The data support predictions for the scaling behaviour of the angular correlations at high Q2 and for anti-correlations between the current and target regions over a large range in Q2 and in the Bjorken scaling variable x. Analytic QCD calculations and Monte Carlo models correctly describe the trends of the data at high Q2, but show quantitative discrepancies. The data show differences between the correlations in deep inelastic scattering and e+e- annihilation.Comment: 26 pages including 10 figures (submitted to Eur. J. Phys. C

Dissociation of virtual photons in events with a leading proton at HERA

The ZEUS detector has been used to study dissociation of virtual photons in events with a leading proton, gamma^* p -> X p, in e^+p collisions at HERA. The data cover photon virtualities in two ranges, 0.03<Q^2<0.60 GeV^2 and 2<Q^2<100 GeV^2, with M_X>1.5 GeV, where M_X is the mass of the hadronic final state, X. Events were required to have a leading proton, detected in the ZEUS leading proton spectrometer, carrying at least 90% of the incoming proton energy. The cross section is presented as a function of t, the squared four-momentum transfer at the proton vertex, Phi, the azimuthal angle between the positron scattering plane and the proton scattering plane, and Q^2. The data are presented in terms of the diffractive structure function, F_2^D(3). A next-to-leading-order QCD fit to the higher-Q^2 data set and to previously published diffractive charm production data is presented

Performance of CMS muon reconstruction in pp collision events at sqrt(s) = 7 TeV

The performance of muon reconstruction, identification, and triggering in CMS has been studied using 40 inverse picobarns of data collected in pp collisions at sqrt(s) = 7 TeV at the LHC in 2010. A few benchmark sets of selection criteria covering a wide range of physics analysis needs have been examined. For all considered selections, the efficiency to reconstruct and identify a muon with a transverse momentum pT larger than a few GeV is above 95% over the whole region of pseudorapidity covered by the CMS muon system, abs(eta) < 2.4, while the probability to misidentify a hadron as a muon is well below 1%. The efficiency to trigger on single muons with pT above a few GeV is higher than 90% over the full eta range, and typically substantially better. The overall momentum scale is measured to a precision of 0.2% with muons from Z decays. The transverse momentum resolution varies from 1% to 6% depending on pseudorapidity for muons with pT below 100 GeV and, using cosmic rays, it is shown to be better than 10% in the central region up to pT = 1 TeV. Observed distributions of all quantities are well reproduced by the Monte Carlo simulation.Comment: Replaced with published version. Added journal reference and DO

Performance of CMS muon reconstruction in pp collision events at sqrt(s) = 7 TeV

The performance of muon reconstruction, identification, and triggering in CMS has been studied using 40 inverse picobarns of data collected in pp collisions at sqrt(s) = 7 TeV at the LHC in 2010. A few benchmark sets of selection criteria covering a wide range of physics analysis needs have been examined. For all considered selections, the efficiency to reconstruct and identify a muon with a transverse momentum pT larger than a few GeV is above 95% over the whole region of pseudorapidity covered by the CMS muon system, abs(eta) < 2.4, while the probability to misidentify a hadron as a muon is well below 1%. The efficiency to trigger on single muons with pT above a few GeV is higher than 90% over the full eta range, and typically substantially better. The overall momentum scale is measured to a precision of 0.2% with muons from Z decays. The transverse momentum resolution varies from 1% to 6% depending on pseudorapidity for muons with pT below 100 GeV and, using cosmic rays, it is shown to be better than 10% in the central region up to pT = 1 TeV. Observed distributions of all quantities are well reproduced by the Monte Carlo simulation.Comment: Replaced with published version. Added journal reference and DO