bluuebunny/crossref_metadata_2025_split huggingface dataset:
Barriers and facilitators to accessing and utilising sexual and reproductive health services during the COVID-19 pandemic in Africa: a systematic review and meta-analysis
Authors: Bolarinwa Obasanjo Afolabi , Odimegwu Clifford , Ajayi Kobi V. , Oni Tosin Olajide , Sah Rajeeb Kumar , Akinyemi Akanni 
Published: December 2024

Abstract
Background
Ensuring uninterrupted access and utilisation of sexual and reproductive health (SRH) services remains crucial for preventing adverse SRH outcomes. However, the unprecedented emergence of the 2019 coronavirus disease (COVID-19) significantly disrupted most of these services in Africa. Thus, we systematically reviewed and examined barriers and facilitators to accessing and utilising SRH services during the COVID-19 pandemic in Africa.

Methods
We systematically searched five databases for relevant articles published between January 2020 to December 2022, and the articles were screened following the JBI and PRISMA guidelines. Meta-synthesis of barriers and facilitators to accessing and utilising SRH services during the COVID-19 pandemic were reported, while a meta-analysis of the pooled prevalence of barriers to accessing and utilising SRH services during the COVID-19 pandemic in Africa was analysed using R.

Results
The pooled prevalence of barriers to accessing and utilising SRH services during the COVID-19 pandemic in Africa was 26%. Seven themes were developed for the identified barriers (disruption of healthcare services, fear and misinformation, limited availability of resources, place & region of residence, healthcare staff attitude/manpower, limited access to transportation, and stigma and discrimination), whilst six themes were developed for the identified facilitators (support for vulnerable populations, socio-demographic characteristics, community outreach programs, policy adaptations, telemedicine and digital health, and change in choice of sexual and reproductive commodities).

Conclusion
This study found that the COVID-19 pandemic significantly impacted SRH service access and utilisation in Africa. We recommend that future research consider a longitudinal examination of the pandemic on African SRH services.

Trial registration
PROSPERO registration number: CRD42022373335.
Impact of pay-for-performance on hospital readmissions in Lebanon: an ARIMA-based intervention analysis using routine data
Authors: Khalife Jade , Ammar Walid , El-Jardali Fadi , Emmelin Maria , Ekman Björn 
Published: December 2024

Abstract
Background
The objective of this paper was to estimate the impact of country-wide hospital pay-for-performance on readmissions for a set of common conditions in Lebanon.

Methods
This retrospective cohort study included all hospitalizations under the coverage of the Ministry of Public Health in Lebanon between 2011 and 2019. We calculated 30-day all-cause readmissions following general, pneumonia, cholecystectomy and stroke cases. We used an interrupted time series design, including the use of AutoRegressive Integrated Moving Average models. This nationwide study including 1,333,691 hospitalizations was undertaken in Lebanon, using hospitalizations at about 140 private and public hospitals contracted by the Ministry. The participants included citizens across all ages under the Ministry’s coverage (52% of citizens). The intervention was the engagement of hospital leaders by the Ministry, informing them of the addition of a readmissions component to the ongoing pay-for-performance initiative. Engagement participants included hospital directors and managers, and the leadership of the Syndicate of Private Hospitals. The main outcome measure was age-adjusted monthly all-cause readmission rates for each of general, pneumonia, cholecystectomy and stroke cases. We also assessed for change in readmissions for three conditions not included in the intervention (myocardial infarction, cataract surgery and appendectomy).

Results
Across 2011–2019, the overall readmission rates were 6.00% (SD 0.24%) for general readmissions, 5.06% (SD 0.22%) for pneumonia, 2.54% (SD 0.16%) for cholecystectomy, and 6.55% (SD 0.25%) for stroke. Using ARIMA models we found a relative percentage decrease in mean monthly readmissions in the post-intervention period for cholecystectomy (5.9%; CI 0.1%-11.8%) and stroke (13.6%; CI 3.1%-24.2%). There was no evidence of intervention impact on pneumonia and general readmissions, both overall and among small, medium and large hospitals. There was also no evidence of change in non-P4P readmissions of myocardial infarction, cataract surgery and appendectomy.

Conclusions
Including readmissions within pay-for-performance has the potential to improve hospital performance and patient outcomes, even in countries with more limited resources. Effects may vary across conditions, indicating the need for careful design and understanding of the particular context, both with respect to implementation and to evaluation of impact.
Clinical and genomic profiling of a patient with a de novo ring chromosome 18: a case report highlighting autoimmune and neurological implications
Authors: Montanari Annalaura , Caforio Paola , Paparella Annalisa , Casieri Paola , Nuzzi Maria Cristina , Antonucci Maria Fatima , Catacchio Claudia Rita , Tampoia Marilina , Gentile Mattia , Bucci Roberta , Cecinati Valerio , Cellamare Angelo , Antonacci Francesca 
Published: December 2024

AbstractRing chromosome 18 (r(18)) is a rare chromosomal abnormality characterized by the circular rearrangement of chromosome 18, which presents significant challenges in genotype-phenotype correlations due to variability in deletions across the 18p and 18q arms. We report the case of a pediatric patient with a de novo ring chromosome 18, diagnosed by karyotype analysis and confirmed by high-resolution SNP arrays. The patient exhibited pathogenic copy number variants (CNVs) in the 18p11.32p11.22 and 18q23 regions, involving 36 and 10 OMIM genes, respectively. Clinically, the patient presented with hypothyroidism secondary to autoimmune thyroiditis, autoimmune hepatitis type II, and genetic predisposition to celiac disease and insulin-dependent diabetes mellitus (IDDM) along with notable dysmorphic features. The 18q microdeletion encompasses the MBP gene, involved in the development and functionality of the nervous system, as supported by hypotonia and gliosis shown by the MRI. This case highlights the complex interplay between genetic imbalances on chromosome 18 and autoimmune phenotypes, emphasizing the need for ongoing research to elucidate underlying mechanisms and optimize clinical management for individuals with r(18).
Sexually dimorphic metabolic effects of a high fat diet on knee osteoarthritis in mice
Authors: Griffin Timothy M. , Lopes Erika Barboza Prado , Cortassa Dominic , Batushansky Albert , Jeffries Matlock A. , Makosa Dawid , Jopkiewicz Anita , Mehta-D’souza Padmaja , Komaravolu Ravi K. , Kinter Michael T. 
Published: December 2024

Abstract
Background
Women have a higher risk of developing osteoarthritis (OA) than men, including with obesity. To better understand this disparity, we investigated sex differences in metabolic and inflammatory factors associated with OA using a diet-induced mouse model of obesity. We hypothesized that 20 weeks of high-fat diet (HFD) would induce sexually dimorphic changes in both systemic and local risk factors of knee OA.

Methods
Male and female C57BL/6J mice were fed Chow or HFD from 6 to 26 weeks of age (n = 12 per diet and sex). We performed broad metabolic phenotyping, 16 S gut microbiome analysis, targeted gene expression analysis of synovium-infrapatellar fat tissue, targeted gene expression and proteomic analysis of articular cartilage, chondrocyte metabolic profiling, and OA histopathology. Two-way ANOVA statistics were utilized to determine the contribution of sex and diet and their interaction on outcomes.

Results
Mice fed HFD weighed 1.76-fold (p < 0.0001) and 1.60-fold (p < 0.0001) more than male and female Chow cohorts, respectively, with both sexes reaching similar body fat levels (male: 43.9 ± 2.2%; female: 44.1 ± 3.8%). HFD caused greater cartilage pathology (p < 0.024) and synovial hyperplasia (p < 0.038) versus Chow in both sexes. Cartilage pathology was greater in male versus female mice (p = 0.048), and only male mice developed osteophytes with HFD (p = 0.044). Both sexes exhibited metabolic inflexibility on HFD, but only male mice developed glucose intolerance (p < 0.0001), fatty liver (p < 0.0001), and elevated serum amylase (p < 0.0001) with HFD versus Chow. HFD treatment caused sex-dependent differences in gut microbiota beta diversity (p = 0.01) and alteration in specific microbiome clades, such as a HFD-dependent reduction in abundance of Bifidobacterium only in male mice. In knee synovium and infrapatellar fat tissue, HFD upregulated the expression of pro-inflammatory and pro-fibrotic genes predominantly in female mice. In cartilage, lipid metabolism proteins were more abundant with HFD in male mice, whereas proteins involved in glycolysis/gluconeogenesis and biosynthesis of amino acids were greater in cartilage of female mice. Sex-dependent metabolic differences were observed in cartilage from young, healthy mice prior to pubertal maturation, but not in primary juvenile chondrocytes studied in vitro.

Conclusions
HFD induced numerous sex differences in metabolic and inflammatory outcomes, especially in joint tissues, suggesting that sex-specific cellular processes are involved during development of early-stage OA with obesity.
CSearch: chemical space search via virtual synthesis and global optimization
Authors: Kim Hakjean , Ryu Seongok , Jung Nuri , Yang Jinsol , Seok Chaok 
Published: December 2024

AbstractThe two key components of computational molecular design are virtually generating molecules and predicting the properties of these generated molecules. This study focuses on an effective method for molecular generation through virtual synthesis and global optimization of a given objective function. Using a pre-trained graph neural network (GNN) objective function to approximate the docking energies of compounds for four target receptors, we generated highly optimized compounds with 300–400 times less computational effort compared to virtual compound library screening. These optimized compounds exhibit similar synthesizability and diversity to known binders with high potency and are notably novel compared to library chemicals or known ligands. This method, called CSearch, can be effectively utilized to generate chemicals optimized for a given objective function. With the GNN function approximating docking energies, CSearch generated molecules with predicted binding poses to the target receptors similar to known inhibitors, demonstrating its effectiveness in producing drug-like binders.Scientific Contribution We have developed a method for effectively exploring the chemical space of drug-like molecules using a global optimization algorithm with fragment-based virtual synthesis. The compounds generated using this method optimize the given objective function efficiently and are synthesizable like commercial library compounds. Furthermore, they are diverse, novel drug-like molecules with properties similar to known inhibitors for target receptors.
Analysis of early childhood intestinal microbial dynamics in a continuous-flow bioreactor
Authors: Granato Alessandra , Renwick Simone , Yau Christopher , Kong Tiffany , Daigneault Michelle C. , Knip Mikael ,   DIABIMMUNE Study Group, Allen-Vercoe Emma , Danska Jayne S. 
Published: December 2024

Abstract
Background
The human gut microbiota is inoculated at birth and undergoes a process of assembly and diversification during the first few years of life. Studies in mice and humans have revealed associations between the early-life gut microbiome and future susceptibility to immune and metabolic diseases. To resolve microbe and host contributing factors to early-life development and to disease states requires experimental platforms that support reproducible, longitudinal, and high-content analyses.

Results
Here, we deployed a continuous single-stage chemostat culture model of the human distal gut to study gut microbiota from 18- to 24-month-old children integrating both culture-dependent and -independent methods. Chemostat cultures recapitulated multiple aspects of the fecal microbial ecosystem enabling investigation of relationships between bacterial strains and metabolic function, as well as a resource from which we isolated and curated a diverse library of early life bacterial strains.

Conclusions
We report the reproducible, longitudinal dynamics of early-life bacterial communities cultured in an advanced model of the human gut providing an experimental approach and a characterized bacterial resource to support future investigations of the human gut microbiota in early childhood.
Creating better internships by understanding mentor challenges: findings from a series of focus groups
Authors: Schneider Joel R. , Aaby Truls , Boessenkool Sanne , Eriksen Emma Falkeid , Holtermann Kristin , Martens Iver , Soulé Jonathan , Steele Ariel , Zazzera Susanne , van der Meeren Gro I. , Velle Gaute , Cotner Sehoya , Lane A. Kelly 
Published: December 2024

Abstract
Background
Despite demands to make higher education more relevant beyond academia, and a growing body of work testifying to the benefits of work-relevance programs (e.g., work-placements, or internships) for both students and the companies that host them, there is limited information available for those aiming to optimize these programs. For example, few have explored the challenges and needs of internship supervisors. Here, we focus on the experiences of supervisors in biology and geology programs across three Norwegian institutions. Specifically, through a series of focus groups, we asked internship supervisors about their motivations for serving as student mentors, any challenges they had faced, and what higher-education institutions could do to better prepare them for hosting students at their workplaces.

Results
Key challenges faced by supervisors include the need to tailor placements to individual student needs and capabilities, navigating the constraints imposed by academic structures, and addressing communication gaps between students, institutions, and workplace supervisors. Internship supervisors suggest enhancing communication strategies to better define roles and expectations, increasing support and training for supervisors, and establishing clearer, more collaborative frameworks for setting learning objectives with students.

Conclusions
The supervisors’ suggestions aim to ensure that internships are mutually beneficial, supporting both students' educational outcomes and the workplace needs. By focusing on the supervisor's perspective, we provide valuable insights into one aspect of implementing effective and rewarding internships (i.e., supervisor preparation), thereby suggesting pathways for future improvements in these high-impact educational practices.
Bioactive peptides and proteins for tissue repair: microenvironment modulation, rational delivery, and clinical potential
Authors: Hao Zhuo-Wen , Zhang Zhe-Yuan , Wang Ze-Pu , Wang Ying , Chen Jia-Yao , Chen Tian-Hong , Shi Guang , Li Han-Ke , Wang Jun-Wu , Dong Min-Chao , Hong Li , Li Jing-Feng 
Published: December 2024

AbstractBioactive peptides and proteins (BAPPs) are promising therapeutic agents for tissue repair with considerable advantages, including multifunctionality, specificity, biocompatibility, and biodegradability. However, the high complexity of tissue microenvironments and their inherent deficiencies such as short half-live and susceptibility to enzymatic degradation, adversely affect their therapeutic efficacy and clinical applications. Investigating the fundamental mechanisms by which BAPPs modulate the microenvironment and developing rational delivery strategies are essential for optimizing their administration in distinct tissue repairs and facilitating clinical translation. This review initially focuses on the mechanisms through which BAPPs influence the microenvironment for tissue repair via reactive oxygen species, blood and lymphatic vessels, immune cells, and repair cells. Then, a variety of delivery platforms, including scaffolds and hydrogels, electrospun fibers, surface coatings, assisted particles, nanotubes, two-dimensional nanomaterials, and nanoparticles engineered cells, are summarized to incorporate BAPPs for effective tissue repair, modification strategies aimed at enhancing loading efficiencies and release kinetics are also reviewed. Additionally, the delivery of BAPPs can be precisely regulated by endogenous stimuli (glucose, reactive oxygen species, enzymes, pH) or exogenous stimuli (ultrasound, heat, light, magnetic field, and electric field) to achieve on-demand release tailored for specific tissue repair needs. Furthermore, this review focuses on the clinical potential of BAPPs in facilitating tissue repair across various types, including bone, cartilage, intervertebral discs, muscle, tendons, periodontal tissues, skin, myocardium, nervous system (encompassing brain, spinal cord, and peripheral nerve), endometrium, as well as ear and ocular tissue. Finally, current challenges and prospects are discussed.
A-I-D for cascades: an application of the Behaviour Change Wheel to design a theory-based intervention for addressing prescribing cascades in primary care
Authors: McCarthy Lisa M. , Farrell Barbara J. , Metge Colleen , Jeffs Lianne , Toenjes Sameera , Rodriguez M. Christine 
Published: December 2024

Abstract
Background
Prescribing cascades, which occur when a medication is used to treat the side effect of another medication, are important contributors to polypharmacy. There is an absence of studies that evaluate interventions to address them. We describe an application of the Behaviour Change Wheel (BCW) to design theory-informed interventions for addressing prescribing cascades within interprofessional primary care teams.

Methods
The BCW framework was applied to guide intervention development. This report describes the first seven steps. Three behaviours were developed based on data collected from two qualitative studies exploring why and how cascades occur across practice settings. A target behaviour was selected and the COM-B model was applied to identify relevant factors for interprofessional primary care teams. Relevant intervention types, policy options, and corresponding behaviour change techniques (BCTs) were identified, and intervention examples drafted. Prioritization of behaviours and intervention examples were guided by the APEASE criteria.

Results
The three behaviours involved supporting: (1) healthcare providers (HCPs) to ask about, investigate and manage cascades, (2) the public to ask about prescribing cascades, and (3) the public to share medication histories and experiences with HCPs. The team selected the HCP behaviour, A-I-D (ask, investigate, deprescribe), for intervention development. Psychological capability and physical opportunity were the most relevant COM-B components. Ten intervention options comprised of BCTs were developed, which are ready for further prioritization by stakeholders. These can be grouped into: provision of educational materials for use by HCPs; provision of consultation or training to support HCPs; and knowledge mobilization strategies. Through the process, the team identified that development of a practice guidance tool, which assists HCPs to investigate and manage prescribing cascades, is needed to support further intervention development.

Conclusions
The BCW framework guided the design of intervention examples to support primary HCPs practicing in interprofessional teams to address prescribing cascades. When identifying interventions for future consultation, creation of a practice guidance tool was prioritized as it underpins all proposed interventions for addressing prescribing cascades in practice. Further research is needed to determine what primary HCPs would need in this practice guidance tool and how it will be used in practice, to support its development.
Time-out under scrutiny: examining the relationships among the discipline strategy time-out, child well-being and attachment and exposure to adversity
Authors: Roach Alex , McLean Rebecca , Mendoza Diaz Antonio , Hawes David , Dadds Mark 
Published: December 2024

Background
Discipline is a crucial aspect of parenting, shaping child development and behaviour. Time-out, a widely used disciplinary strategy with a strong evidence-base, has recently come under scrutiny with concerns about potential adverse effects on children's emotional development and attachment, particularly for those with a history of adversity.

Aims
To contribute critical empirical insights to the current controversy surrounding time-out by exploring the associations among time-out implementation, parent–child attachment and child mental health, and whether adversity exposure moderated these associations.

Method
This cross-sectional study utilised a nationally representative sample of 474 primary caregivers in Australia, with children aged 6–8 years, who completed an online survey. Measures included the Implementation of Time-out Scale, Adverse Life Experiences Scale, Primary Attachment Style Questionnaire, Strengths and Difficulties Questionnaire and Spence Child Anxiety Scale.

Results
Appropriately implemented time-out was associated with enhanced mental health and attachment, while inappropriate time-out correlated with adverse child outcomes. Exposure to adversity moderated the relationship between time-out implementation and child well-being, such that children exposed to adversity were most likely to experience attachment enhancement from appropriately implemented time-out.

Conclusions
Despite recent concerns of harm caused by time-out, particularly for children with a history of adversity, findings support the beneficial impact of time-out on child well-being and attachment when implemented in accordance with evidence-based parameters. Combatting misinformation and disseminating evidence-based time-out guidelines is crucial for promoting child well-being and attachment, especially for children who have experienced adversity.