bluuebunny/crossref_metadata_2025_split huggingface dataset:
Scoping exercise to develop a storybook to support children’s education during the COVID-19 pandemic
Authors: Syeda Rowshonara , Hann Magdalena , Allison Rosalie , Demirjian Alicia 
Published: March 2021

ObjectiveIn June 2020, as COVID-19 lockdown measures were eased in the UK, this scoping exercise aimed to rapidly identify topics to cover within a children’s online storybook ‘My Back to School Bubble’, designed to support the return to school.MethodsAn email invitation was sent to 71 known contacts within networks across Public Health England, local authorities, health protection teams and contacts within the Department for Education. Following online publication of ‘My Back to School Bubble’, users were asked to provide informal feedback via an online survey to ask about their impressions of the story.ResultsFindings from the 31 responses highlighted that children are likely to hold differing feelings regarding COVID-19, depending on their own temperament and lockdown experiences, including changes in relationships with family and friends. Following the launch of ‘My Back to School Bubble’ e-storybook, 21 users provided feedback via survey. Fourteen respondents (67%) indicated that the storybook was a useful tool for providing support to children, and twelve (57%) reported that the resource helped children understand their own feelings.RecommendationsClear, accurate information about the new school environment should be provided in the context of COVID-19. It is especially important to support children with special educational needs and disabilities, including those with autism. Encouraging children to take ownership of their health and hygiene behaviours, such as handwashing, will help to normalise this and prevent the spread of infection. Lessons learnt from the development of ‘My Back to School Bubble’ online storybook suggest the clarity of imagery could be improved to better support children with autism. Future work should focus on longitudinal and qualitative research. This should include the long-term effects of the pandemic on children’s development and education, effects on mental health and resilience, peer socialisation, and ability to cope with life-changing events.
Abortion provision in Northern Ireland: the views of health professionals working in obstetrics and gynaecology units
Authors: Bloomer Fiona , Kavanagh Jayne , Morgan Leanne , McLaughlin Laura , Roberts Ralph , Savage Wendy , Francome Colin 
Published: March 2021

IntroductionAbortion became decriminalised in Northern Ireland in October 2019. Until that point there existed no evidence concerning the views of health professionals on decriminalisation or on their willingness to be involved in abortion care. The purpose of this study was to address this lack of evidence, including all categories of health professionals working in obstetrics and gynaecology units in Northern Ireland.MethodsThe online survey was targeted at medical, nursing and midwifery staff working in the obstetrics and gynaecology units in each Health and Social Care (HSC) Trust in Northern Ireland. The survey was issued via clinical directors in each Trust using the REDCap platform.ResultsThe findings showed widespread support for decriminalisation of abortion up until 24 weeks’ gestation (n=169, 54%). The majority of clinicians stated they were willing to provide abortions in certain circumstances (which were undefined) (n=188, 60% medical abortions; n=157, 50% surgical abortions). Despite regional variation, the results show that there are sufficient numbers of clinicians to provide a service within each HSC Trust. The results indicate that many clinicians who report a religious affiliation are also supportive of decriminalisation (n=46, 51% Catholic; n=53, 45% Protestant) and are willing to provide care, countering the assumption that those of faith would all raise conscientious objections to service provision.ConclusionsThe findings of this study are very encouraging for the development, implementation and delivery of local abortion care within HSC Trusts in Northern Ireland and should be of value in informing commissioners and providers about the design of a service model and its underpinning training programmes.
Suppression of Myocardial Hypoxia-Inducible Factor-1α Compromises Metabolic Adaptation and Impairs Cardiac Function in Patients With Cyanotic Congenital Heart Disease During Puberty
Authors: Liu Yiwei , Luo Qipeng , Su Zhanhao , Xing Junyue , Wu Jinlin , Xiang Li , Huang Yuan , Pan Haizhou , Wu Xie , Zhang Xiaoling , Li Jun , Yan Fuxia , Zhang Hao 
Published: March 2021

Background:
Cyanotic congenital heart disease (CCHD) is a complex pathophysiological condition involving systemic chronic hypoxia (CH). Some patients with CCHD are unoperated for various reasons and remain chronically hypoxic throughout their lives, which heightens the risk of heart failure as they age. Hypoxia activates cellular metabolic adaptation to balance energy demands by accumulating hypoxia-inducible factor 1-α (HIF-1α). This study aims to determine the effect of CH on cardiac metabolism and function in patients with CCHD and its association with age. The role of HIF-1α in this process was investigated, and potential therapeutic targets were explored.

Methods:
Patients with CCHD (n=25) were evaluated for cardiac metabolism and function with positron emission tomography/computed tomography and magnetic resonance imaging. Heart tissue samples were subjected to metabolomic and protein analyses. CH rodent models were generated to enable continuous observation of changes in cardiac metabolism and function. The role of HIF-1α in cardiac metabolic adaptation to CH was investigated with genetically modified animals and isotope-labeled metabolomic pathway tracing studies.

Results:

Prepubertal patients with CCHD had glucose-dominant cardiac metabolism and normal cardiac function. In comparison, among patients who had entered puberty, the levels of myocardial glucose uptake and glycolytic intermediates were significantly decreased, but fatty acids were significantly increased, along with decreased left ventricular ejection fraction. These clinical phenotypes were replicated in CH rodent models. In patients with CCHD and animals exposed to CH, myocardial HIF-1α was upregulated before puberty but was significantly downregulated during puberty. In cardiomyocyte-specific
Hif-1α
–knockout mice, CH failed to initiate the switch of myocardial substrates from fatty acids to glucose, thereby inhibiting ATP production and impairing cardiac function. Increased insulin resistance during puberty suppressed myocardial HIF-1α and was responsible for cardiac metabolic maladaptation in animals exposed to CH. Pioglitazone significantly reduced myocardial insulin resistance, restored glucose metabolism, and improved cardiac function in pubertal CH animals.

Conclusions:
In patients with CCHD, maladaptation of cardiac metabolism occurred during puberty, along with impaired cardiac function. HIF-1α was identified as the key regulator of cardiac metabolic adaptation in animals exposed to CH, and pubertal insulin resistance could suppress its expression. Pioglitazone administration during puberty might help improve cardiac function in patients with CCHD.
Identifying At‐Risk Patients for Sustained Atrial High‐Rate Episodes Using the C
2
HEST Score: The West Birmingham Atrial Fibrillation Project
Authors: Li Yan‐Guang , Pastori Daniele , Miyazawa Kazuo , Shahid Farhan , Lip Gregory Y. H. 
Published: March 2021

Background

Sustained atrial high‐rate episodes (SAHREs) among individuals with a cardiac implantable electronic device are associated with an increased risk of adverse outcomes. Risk stratification for the development of SAHREs has never been investigated. We aimed to assess the performance of the C
2
HEST (coronary artery disease or chronic obstructive pulmonary disease [1 point each], hypertension [1 point], elderly [age ≥75 years, 2 points], systolic heart failure [2 points], thyroid disease [1 point]) score in predicting SAHREs in patients with cardiac implantable electronic devices without atrial fibrillation.

Methods and Results

Five Hundred consecutive patients with cardiac implantable electronic devices in the West Birmingham Atrial Fibrillation Project in the United Kingdom were followed since the procedure to observe the development of SAHREs, defined by atrial high‐rate episodes lasting >24 hours. Risk factors and incidence of SAHREs were analyzed. The predictive value of the C
2
HEST score for SAHRE prediction was evaluated. Over a mean follow‐up of 53.1 months, 44 (8.8%) patients developed SAHREs. SAHREs were associated with higher all‐cause mortality (
P
<0.001) and ischemic stroke (
P
=0.001). Age and heart failure were associated with SAHRE occurrence. The incidence of SAHREs increased by the C
2
HEST score (39% higher risk per point increase). Among patients with a C
2
HEST score ≥4, the incidence of SAHREs was 3.62% per year (95% CI, 2.14–5.16). The C
2
HEST score had moderate predictive capability (area under the curve, 0.73; 95% CI, 0.64–0.81) and discriminative ability (log‐rank
P
=0.003), which was better than other clinical scores (CHA
2
DS
2
‐VASc, CHADS
2
, HATCH).

Conclusions

The C
2
HEST score predicted SAHRE incidence in patients without atrial fibrillation who had an cardiac implantable electronic device, with the highest risk seen in patients with a C
2
HEST score ≥4 The benefit of using the C
2
HEST score in clinical practice in this patient population needs further investigation.
SAYCam: A Large, Longitudinal Audiovisual Dataset Recorded From the Infant’s Perspective
Authors: Sullivan Jessica , Mei Michelle , Perfors Andrew , Wojcik Erica , Frank Michael C. 
Published: March 2021

AbstractWe introduce a new resource: the SAYCam corpus. Infants aged 6–32 months wore a head-mounted camera for approximately 2 hr per week, over the course of approximately two-and-a-half years. The result is a large, naturalistic, longitudinal dataset of infant- and child-perspective videos. Over 200,000 words of naturalistic speech have already been transcribed. Similarly, the dataset is searchable using a number of criteria (e.g., age of participant, location, setting, objects present). The resulting dataset will be of broad use to psychologists, linguists, and computer scientists.
Molecular response to imatinib in patients with chronic myeloid leukemia in Tanzania
Authors: Nasser Ahlam , Hussein Ally , Chamba Clara , Yonazi Mbonea , Mushi Rosemary , Schuh Anna , Luzzatto Lucio 
Published: March 2021

AbstractImatinib is the mainstay of treatment of patients with chronic myeloid leukemia (CML) in Tanzania. Monitoring molecular response to therapy by real-time polymerase chain reaction at defined milestones is necessary for early detection of treatment failure. However, this assay is not routinely performed in Tanzania; therefore, the depth of molecular response among patients with CML is not known. A total of 158 patients with previously diagnosed CML who received imatinib treatment were recruited from January 2019 and followed up through October 2020 at Ocean Road Cancer Institute. Information was obtained at the time of diagnosis and follow-up. Blood samples were collected in EDTA tubes to measure the BCR/ABL ratio on the Gene Xpert system for molecular response determination. The median age of the 158 adult patients was 45 years (range, 18-86). By reference to established treatment milestones, only 37 (23.4%) achieved optimal molecular response. Signs of advanced-stage disease, in particular the need for red cell transfusions before diagnosis (adjusted odds ratio [AOR], 3.4; 95% CI, 1.32-9.17) and cytopenias (AOR, 2.26; 95% CI, 1.03-4.96) necessitating drug interruptions were statistically validated predictors of treatment failure on multivariate, multinomial logistic regression. Patient survival at the 22-month follow-up was lowest, with 78.6% (95% CI, 69.4-85.4) in the failure-to-respond category and highest in patients achieving optimal response 97.0% (95% CI, 80.9-99.6). In summary, the majority of patients with CML treated with imatinib in Tanzania do not obtain deep molecular response. This outcome can be attributed to late diagnosis, the development of cytopenias requiring multiple drug interruptions, and poor adherence to treatment.
Factors associated with the nutritional status of the older population in a selected area of Dhaka, Bangladesh
Authors: Rahman K. M. Thouhidur , Khalequzzaman Md. , Khan Fahmida Afroz , Rayna Shahrin Emdad , Samin Sharraf , Hasan Md. , Islam Syed Shariful 
Published: March 2021

Abstract
Background
Globally, older population (aged ≥60 years) comprise 11% of the total population, and 23% of them are malnourished. Lack of knowledge and education, adverse dietary habits, depression or psychological disorders, poor oral and dental health, disability, and diseases are the reported factors responsible for malnutrition among them. Geriatric people comprise 7.5% of the total population of Bangladesh, and almost a quarter are malnourished. But there is scarce data on the factors associated with the nutritional status of the older population in Bangladesh.

Methods
A cross-sectional study was conducted among 125 older individuals (male 59, female 66) living in three villages of Uttarkhan, Dhaka, Bangladesh, to identify the factors associated with their nutritional status. The Mini Nutritional Assessment scale, Geriatric Depression Scale-Short Form, and Geriatric Oral Health Assessment Index were used for assessing the nutritional status, mental health status, and oral health quality of the respondents, respectively. Information on socio-demographic characteristics, comorbidities and dietary factors, and food behaviors were gathered by a pretested semi-structured questionnaire. Ethical approval was obtained from the Institutional Review Board of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh.

Results
The participants’ mean age was 67.9 ± 7.1 years. Most of them (53.6%) had no formal education. Among the respondents, 22.0% male and 28.8% female were malnourished. The proportion of malnourished and at risk of malnutrition among the respondents living without a partner were 28.6 and 65.3%, respectively. A significantly (p < 0.05) higher odds of having depression (OR 15.6; 95% CI 3.1–78.1), poor oral health (OR 7.3; 95% CI 1.3–41.8), and no formal education (OR 6.5; 95% CI 1.3–32.1) was observed among the malnourished respondents. Though it was not statistically significant, among the malnourished, 31.3, 25.0 and 25.0% avoided highly oily food, beef/mutton, and sugary food, respectively.

Conclusions
More than two-thirds of the older population were malnourished or at risk of malnutrition, where the female respondents were more vulnerable. Depression, inadequate oral health, and lack of education were negatively associated with the nutritional status of the older population.
Behavioural and psychological symptoms of dementia in patients with Alzheimer’s disease and family caregiver burden: a path analysis
Authors: Kim Bokyoung , Noh Gie Ok , Kim Kyunghee 
Published: March 2021

Abstract
Background
Studies reported the relationship between behavioural and psychological symptoms of dementia (BPSD), cognitive function, caregiver burden, and therapeutic effects. However, the causal relationship between BPSD in community-dwelling patients with Alzheimer’s disease (AD) and caregiver burden is yet to be established. This study aimed to classify BPSD in patients with AD and identify the relationship between BPSD and the factors affecting family caregiver burden.

Methods
Path analysis was conducted at a neurology outpatient clinic of a tertiary general hospital in South Korea. The medical records of 170 patients, aged ≥50 years, diagnosed with or suspected for AD were retrospectively reviewed. We investigated cognitive function (Korean version of the Mini-Mental-State Exam), dementia stages (Korean version of the Expanded Clinical Dementia Rating scale), depression (Short-form Geriatric Depression Scale-Korea), activities of daily living (ADL; Korean version of the Barthel Activities of Daily Living index), instrumental activities of daily living (IADL; Seoul-Instrumental Activities of Daily Living), and BPSD and caregiver burden (Korean Neuropsychiatric Inventory). Considering the characteristic features of BPSD with various symptoms, BPSD was classified using factor analysis. Factor extraction was performed using principal component analysis, followed by Varimax factor rotation.

Results
Mean total BPSD score was 17.66 ± 20.67, and the mean score for family caregiver burden was 9.65 ± 11.12. Symptom cluster-1 (hyperactivity symptoms) included disinhibition, irritability, and agitation/aggression. Symptom cluster-2 (psychosis symptoms) included hallucinations, anxiety, elation/euphoria, delusions, and depression/dysphoria. Symptom cluster-3 (physical behaviour symptoms) included appetite and eating abnormalities, apathy/indifference, aberrant motor behaviour, sleep, and night-time behaviour disturbances. Dementia stages, ADL, and IADL had indirect effects on family caregiver burden through hyperactivity, psychosis, and physical behaviour symptoms, indicating that BPSD exerted a complete mediating effect.

Conclusions
Unlike previous studies, we classified BPSD symptoms into similar symptom clusters to evaluate its effect on caregiver burden, rather than collectively investigating the 12 symptoms of BPSD. As the dementia stage worsens, symptom clusters in BPSD serve as a medium between ADL and IADL degradation and for the increase in caregivers’ burden. The development and implementation of therapeutic, nursing interventions, and policies focusing on dementia stages, ADL, and IADL, delaying and preventing BPSD can alleviate family caregivers’ burden.
Implementing ICHOM standard set for cataract surgery at IPO-Porto (Portugal): clinical outcomes, quality of life and costs
Authors: Queirós Lara , Redondo Patrícia , França M. , Silva Sérgio Estrela , Borges Pedro , de Melo António Benevides , Pereira Nuno , da Costa Paulo Freitas , Carvalho Nazaré , Borges Marina , Sequeira Isabel , Gonçalves Francisco Nuno Rocha , Lemos José 
Published: March 2021

Abstract
Background
This paper fills a gap in the applied research field, for a local context, by addressing the topics of describing cataract surgery’ clinical outcomes; quality of life (QoL); and costs of the patients treated after the implementation of the ICHOM standard set.

Methods
This is a retrospective observational study using real-world data (RWD). We included all patients subjected to cataract surgery at the Portuguese Institute of oncology - Porto (IPO-Porto), Portugal, after 3 months follow up period completed between 5th June 2017 and 21st May 2018. The following inclusion criteria: corrected visual acuity of ≤ 6/10 or other significant visual disturbance due to lens opacity or the existence of a large anisometropia. A circuit was implemented based on the ICHOM standard for cataract, to measure clinical variables (e.g. visual acuity) and QoL (CATQUEST-9SF) before and after surgery, and cost of treatment. The results were explored by means of a paired-sample t-test, considering normality assumptions.

Results
Data refers to 268 patients (73 P25-P75:32–95 years old), regarding 374 eyes. The cataract surgery had a positive effect on visual acuity (p < 0.001), refraction (right and left cylinder; p < 0.001) and all QoL dimensions. The vast majority of patients, around 98%, reported improvements in QoL. Based on IPO-Porto administrative records, the direct cost of treating cataracts (per eye) is of 500€, representing a total cost of 187,000€ for the number of patients operated herein.

Conclusion
This study reports the successful implementation of the ICHOM standard set for cataracts in a Portuguese institution and confirms that cataract surgery provides a rapid visual recovery, with excellent visual outcomes and minimal complications in most patients, while also having a positive impact on patients’ quality of life.
“Impact of COVID-19 pandemic lockdown on early onset of puberty: experience of an Italian tertiary center”
Authors: Verzani Martina , Bizzarri Carla , Chioma Laura , Bottaro Giorgia , Pedicelli Stefania , Cappa Marco 
Published: March 2021

AbstractAt the end of 2019, an emerging atypical pneumonia called COVID-19 (coronavirus disease 2019), caused by the novel coronavirus defined as SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2), was first reported. COVID-19 rapidly expanded leading to an epidemic in China, followed by a global pandemic during the year 2020. In few weeks Italy was assaulted by a severe health emergency, constraining the Italian government to put in place extraordinary restrictive measures, such as school closures and a strict lockdown extended to the entire country at the beginning of March 2020. Since the beginning of lockdown, the Endocrinology Unit of Bambino Gesù Children’s Hospital has recorded a rapid increase of the outpatient consultations for suspected precocious or early puberty. We have now retrospectively analyzed all the consultations recorded in the database of our outpatient clinic from March to September 2020, and compared them with the consultations recorded in the same database from March to September 2019. Our preliminary data suggest a significant increase of precocious puberty cases in girls during the first period of COVID-19 pandemic. Further investigations in larger cohorts of children are needed in order to correlate the observed increase of precocious puberty with specific pathogenic factors.
A Note on “Sequential Neighborhood Effects” by Hicks et al. (2018)
Authors: Handcock Mark S. , Hicks Andrew L. , Sastry Narayan , Pebley Anne R. 
Published: March 2021

Abstract
We revisit a novel causal model published in Demography by Hicks et al. (2018), designed to assess whether exposure to neighborhood disadvantage over time affects children's reading and math skills. Here, we provide corrected and new results. Reconsideration of the model in the original article raised concerns about bias due to exposure-induced confounding (i.e., past exposures directly affecting future exposures) and true state dependence (i.e., past exposures affecting confounders of future exposures). Through simulation, we show that our originally proposed propensity function approach displays modest bias due to exposure-induced confounding but no bias from true state dependence. We suggest a correction based on residualized values and show that this new approach corrects for the observed bias. We contrast this revised method with other causal modeling approaches using simulation. Finally, we reproduce the substantive models from Hicks et al. (2018) using the new residuals-based adjustment procedure. With the correction, our findings are essentially identical to those reported originally. We end with some conclusions regarding approaches to causal modeling.