bluuebunny/crossref_metadata_2025_split huggingface dataset:
Re‐evaluating Africa's growth, poverty and inequality nexus
Authors: Aiyemo Babatunde 
Published: May 2024

AbstractThis study evaluates the role of growth in poverty reduction within the sub‐Saharan Africa (SSA) region in direct comparison to other global regions along time‐delineated thresholds. The study's results show (i) A significant gulf in the performance of SSA economies in comparison to their global cohorts; (ii) An improved role played by growth after the mid‐2000s for poverty reduction in SSA; (iii) A less deleterious impact of rising income inequality on poverty reduction within the SSA sub‐region relative to other global regions, and (iv) An improved performance of resource‐dependent SSA economies in translating growth to poverty reduction since the mid‐2000s. The convergence in growth‐induced poverty reduction between SSA and its global cohorts energizes prospects for attaining the Sustainable Development Goal of eradicating global extreme poverty by 2030; it however also calls for renewed strategies toward improving the efficacy of growth in future poverty reduction within the sub‐region.
Severe neonatal thrombocytopenia due to anti‐HPA‐4b alloantibodies: Third report described in a Caucasian mother
Authors: Petermann Rachel , Bianchi Frédéric , Saib Loubna , Ferré Nicolas , Francelle Nathalie , Oudin Olivier , Chenet Christophe , Mammasse Yasmine , Jallu Vincent , Chaussade Amélie , Cornu Antonin , Dubray Laureline , Mailloux Agnès 
Published: May 2024

AbstractBackgroundFetal and Neonatal Alloimmune Thrombocytopenia (FNAIT) results from maternal platelet alloimmunization against paternal antigens inherited by the fetus, most often due to the Human Platelet Antigen (HPA)‐1 system in Caucasians. We investigated in 2023, a 30‐year‐old Caucasian woman Gravida 2 Para 1 who gave birth at 35 weeks of gestation to a male (body weight 2210 g) without signs of bleeding. A severe thrombocytopenia (platelet count at 3 G/L) was discovered incidentally a few hours after delivery in the context of the management of a respiratory distress. The newborn recovered after one platelet concentrate transfusion and normalized his platelet count at Day 5.Study Design and MethodsFNAIT investigation was performed according to guideline recommendations. Platelet genotyping was carried out by multiplex PCR. Maternal serological investigation included Monoclonal Antibody‐specific Immobilization of Platelet Antigens method (MAIPA) and Luminex technology.ResultsParental and newborn genotyping pointed out an HPA‐4 incompatibility between the mother and the newborn and the father. Serological investigation revealed an anti‐HPA‐4b alloantibody confirming the diagnosis of neonatal alloimmune thrombocytopenia.ConclusionWe described the third case of anti‐HPA‐4b alloantibody discovered in a Caucasian mother. This case strengthens the need for reference laboratory to genotype a panel of HPA alleles reflecting local genetic population diversity and for crossmatch of maternal serum with fresh paternal platelets in clinical suspected cases of neonatal alloimmune thrombocytopenia.
System-wide governance challenges of the Ebonyi State Malaria Elimination Programme and recommendations for malaria health system strengthening: a qualitative study among stakeholders in Ebonyi state, Nigeria
Authors: Omale Ugwu I , Ogbonnaya Lawrence U , Iyare Osarhiemen , Nnachi Olaedo O 
Published: May 2024

ObjectivesThe burden of malaria has persistently been high in Ebonyi state and Nigeria despite long-standing collaborations with international partners with huge and increased amounts of financial investments. We explored the system-wide governance challenges of the Ebonyi State Malaria Elimination Programme (SMEP) and the factors responsible in order to make recommendations for malaria health system strengthening.DesignWe did a qualitative study informed by the health system governance framework by Mikkelsen-Lopezet aland Savedoff’s concept of governance.Setting and participantsBetween 18 October 2022 and 8 November 2022, 25 semistructured face-to-face in-depth interviews were conducted in English with purposively selected key stakeholders in the Ebonyi SMEP aged 18 years or older with at least 2 years of involvement in the SMEP and who gave consent.AnalysisData were analysed deductively and the analytical strategy was informed by the framework method for the analysis of qualitative data by Galeet al.ResultsMany system-wide governance challenges of the SMEP were identified including the absence of state’s strategic vision and plans for malaria elimination; very weak primary and secondary healthcare systems; inadequate financial allocation and untimely release of budgeted funds by the state government; lack of human resources for health and very poor mosquito net distribution system. Other challenges were inadequate stakeholders’ participation; poor accountability culture; impaired transparency and corruption and impaired ability to address corruption. The fundamental responsible factors were the lack of state government’s concern for people’s welfare and lack of interest and commitment to the malaria elimination effort, chronic non-employment of staff and lack of human resources in the entire health sector including SMEP, and nepotism and godfatherism.ConclusionsThe system-wide governance challenges and the responsible factors call for changing the ‘business as usual’ and refocusing on strengthening malaria health system governance in addressing the persisting malaria health problems in Ebonyi state (and Nigeria).
Acceptability of digital vending machines to improve access to sexual and reproductive health in Brighton, UK: a qualitative analysis
Authors: Dhillon Syra , Wenlock Rhys D , Dean Gillian Louise , Mear John , Cooper Richard , Vera Jaime H 
Published: May 2024

IntroductionSexual health remains a public health priority and relies on widely available testing to enable prompt diagnosis and treatment. Technology-based approaches to distribute tests have potential to increase access and enable prompt diagnosis and treatment. We evaluated the acceptability of vending machines (VMs) to distribute HIV self-test (HIVST) and sexually transmitted infection (STI) self-sample kits, from the service user and stakeholder perspective.MethodsSix VMs were placed across Brighton and Hove (UK) in publicly accessible locations. After use, individuals received a text with an online questionnaire link. Participants completing the questionnaire were invited to a semistructured interview. Stakeholders were staff on sites where the VM was placed. Data analysis took place on NVivo, using a thematic approach.Results12 users completed the interview. 42% within the age 18–25 years with equal male and female identifying distributions. 33% were heterosexual, 25% homosexual and 33% bisexual. VM acceptability was high with anonymity and instant access as main benefits. Some participants expressed concern that the public location of the VM may deter others from using it. Participants found the HIVST mouth swabs were acceptable, although there was concern over accuracy. Participants welcomed being able to access comprehensive sexual health screening through a VM. Five stakeholders completed the interview. There was recognition that a publicly visible VM led to positive sexual health conversations between service users and staff. There were initial issues with restocking and machine hardwiring.ConclusionsVMs to distribute HIV and STI testing kits is acceptable to service users and stakeholders. The main reported benefits are increased confidentiality, privacy and immediate access. Further education referencing the accuracy of the HIVST mouth swab may alleviate concerns. From a stakeholder perspective, the pathway is beneficial and the role of community champions to reduce stigma is favourable.
Factors affecting implementation of interventions for oral health, substance use, smoking and diet for people with severe and multiple disadvantage: a community-based qualitative study in England
Authors: Jain Neha , Adams Emma A , Joyes Emma C , McLellan Gillian , Burrows Martin , Paisi Martha , McGowan Laura J , Iafrate Lorenzo , Landes David , Watt Richard G , Sniehotta Falko F , Kaner Eileen , Ramsay Sheena E 
Published: May 2024

BackgroundPopulations facing severe and multiple disadvantage (SMD), co-occurring homelessness, substance use and repeat offending have high levels of physical and mental ill-health. Poor oral health is one of the most common health problems in this population and is closely linked with substance use, smoking and poor diet. Issues related to the implementation of interventions among SMD populations to address oral health and related health behaviours are poorly understood. This study aimed to understand the factors that affect implementation (relevance of setting, acceptability and adverse effects of interventions) and the sustainability of interventions targeting oral health, substance use, smoking and diet for people experiencing SMD.MethodsBetween August 2021 and April 2023, interviews and focus group discussions were conducted with two groups of participants: (1) people experiencing SMD in Newcastle Upon Tyne/Gateshead and (2) frontline staff, volunteers, policymakers and commissioners from London, Plymouth and Newcastle Upon Tyne/Gateshead. Information was gathered on factors related to the implementation and acceptability of interventions related to oral health and related behaviours. The data were analysed iteratively using thematic analysis.ResultsTwenty-eight people experiencing SMD (age range: 27–65 years; 21% females) and 78 service providers, commissioners and policymakers (age range: 28–72 years; 63% females) were interviewed or included in focus groups. The data were organised into three overarching themes: environmental, organisational and interpersonal factors. Environmental factors included funding and integrated services; organisational factors included inclusive services, health promotion, prevention and training healthcare providers; interpersonal factors included the presence of support workers and motivation among service providers.ConclusionThe implementation and sustainability of health interventions for people experiencing SMD are influenced by factors across environmental, organisational and interpersonal levels that interact with the inherent challenges of disadvantaged groups. The findings highlight the need for tailoring healthcare interventions according to the needs of people experiencing SMD. Further research on the implementation of diet interventions and co-producing interventions is needed.
Impact of COVID-19 on the veteran population: evidence from the Trends in Scottish Veterans Health study
Authors: Bergman Beverly P , Mackay D F , Pell J P 
Published: May 2024

IntroductionThere have been few epidemiological studies on the impact of the SARS-CoV-2 (COVID-19) pandemic on the veteran population, other than on specific aspects such as mental health, and none in the UK. We used data from the Trends in Scottish Veterans Health cohort to explore the risk of hospitalisation and death associated with COVID-19 in veterans resident in Scotland in comparison with matched non-veterans.MethodsRetrospective cohort study of 71 000 veterans and a comparison group of 230 000 non-veterans matched for age, sex and geography, using Cox proportional hazard analysis to explore the risk of hospitalisation with COVID-19 and COVID-19-associated death overall and by birth cohort, sex and length of military service.ResultsBetween 1 January 2020 and 31 December 2021, 564 (0.79%) veterans had been hospitalised with COVID-19 compared with 1728 (0.75%) non-veterans. The Cox model showed no significant difference overall, HR 0.99, 95% CIs 0.90 to 1.11, p=0.800. Subgroup analysis showed increased risk in older, short-serving (<20 weeks) Early Service Leavers (ESL). There was no overall difference in COVID-19-associated deaths, HR 0.99, 95% CI 0.79 to 1.23, p=0.993, but subgroup analysis showed a non-significant reduced risk of death in veterans aged 61–70 years, and a 38% higher risk in veterans aged over 70 years which almost reached statistical significance, p=0.054. This was only partially explained by socioeconomic factors and common comorbidities, although we had no data on domestic circumstances or care home residence.ConclusionsOverall, military service was not a risk factor for either hospitalisation or death associated with COVID-19. Older ESLs were at increased risk compared with non-veterans, but military service is unlikely to have been causal. The risk of death was increased in the oldest veterans and further studies are needed to explain this once census data become available for linkage.
Evolving methodology of national tobacco control investment cases
Authors: Nugent Rachel , Hutchinson Brian , Mann Nathan , Ngongo Carrie , Spencer Garrison , Grafton Daniel , Small Roy 
Published: May 2024

BackgroundThis article describes an investment case methodology for tobacco control that was applied in 36 countries between 2017 and 2022.MethodsThe WHO Framework Convention on Tobacco Control (FCTC) investment cases compared two scenarios: a base case that calculated the tobacco-attributable mortality, morbidity and economic costs with status quo tobacco control, and an intervention scenario that described changes in those same outcomes from fully implementing and enforcing a variety of proven, evidence-based tobacco control policies and interventions. Health consequences included the tobacco-attributable share of mortality and morbidity from 38 diseases. The healthcare expenditures and the socioeconomic costs from the prevalence of those conditions were combined to calculate the total losses due to tobacco. The monetised benefits of improvements in health resulting from tobacco control implementation were compared with costs of expanding tobacco control to assess returns on investment in each country. An institutional and context analysis assessed the political and economic dimensions of tobacco control in each context.ResultsWe applied a rigorous yet flexible methodology in 36 countries over 5 years. The replicable model and framework may be used to inform development of tobacco control cases in countries worldwide.ConclusionInvestment cases constitute a tool that development partners and advocates have demanded in even greater numbers. The economic argument for tobacco control provided by this set of country-contextualised analyses can be a strong tool for policy change.
Abstract Db1-01: Anthracyclines …to give or not to give? “For” argument
Authors: Piccart Martine , Nader-Marta Guilherme 
Published: May 2024

Abstract
Anthracyclines have been one of the mainstays of early breast cancer treatment for decades. In a recent patient-level meta-analysis including data from over 18,000 patients, anthracycline-containing regimens were associated with improvements in disease-free survival and overall survival, regardless of estrogen receptor or nodal status. Importantly, trials specifically designed and powered to assess the safety of anthracyclines omission failed to demonstrate the non-inferiority of taxane-based anthracycline-free regimens and confirmed the benefit of these agents, particularly in patients with node-positive and hormone receptor-negative breast cancer. Several therapies incorporated into the management of early breast cancer were studied in populations largely treated with anthracycline-based chemotherapy backbones in both HER2-negative (i.e., perioperative pembrolizumab, post neoadjuvant olaparib and capecitabine) and HER2-positive disease (i.e., dual HER2 blockade, adjuvant T-DM1). It is uncertain whether the benefits demonstrated by these strategies would be maintained if anthracyclines were omitted. While anthracyclines are associated with some long-term toxicities, particularly with an increased risk of lymphoproliferative malignancies and dose-dependent cardiotoxicity, these adverse events are not associated with an increased risk of death (including deaths from cardiovascular causes) when compared to anthracycline-free regimens. The identification of risk factors for cardiotoxicity, combined with improvements in monitoring strategies, allows improvements in patient selection, early detection of myocardial damage and, possibly, implementation of cardioprotective interventions, leading to improved cardiovascular outcomes. Until high-quality evidence demonstrates the safety of omitting anthracyclines in high-risk populations, these agents should continue to be used in carefully selected patients after individual risk versus benefit assessment to be shared with the patient.
Citation Format: Martine Piccart, Guilherme Nader-Marta. Anthracyclines …to give or not to give? “For” argument [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr Db1-01.
Abstract ED02-01: Biological peculiarities of ILC
Authors: Desmedt C. 
Published: May 2024

Abstract
One in 8 women will be diagnosed with breast cancer in her lifetime and approximately 15% of them have invasive lobular breast cancer (ILC). ILC differs in many ways from the most common BC subtype, called non-special type (NST) (Van Baelen et al. Ann Oncol 2022). The microscopic hallmark of ILC is the presence of single files of relatively small discohesive tumor cells, which stems from a dysfunctional E-cadherin-catenins complex at the intercellular junctions, a feature that is uncommon in NST. More than 90% of ILC express the estrogen (ER) and/or progesterone receptor (PR) and lack HER2 amplification, while this is only the case in ~65% of NST. Patients with ILC also show a distinct clinical behavior as compared to NST: generally, a poor response to chemotherapy, more late recurrences, and a peculiar metastatic pattern. The first part of the presentation will focus on presenting the biological knowledge we have accumulated over the years about primary ILC. We will review the studies which compared ILC and NST at the genomic, transcriptomic and immune level. The second part of the presentation will be focused on metastatic breast cancer. Here we will review the published evidence regarding the metastatic dissemination of ILC, its genomic landscape and the contribution of the local tumor microenvironment. We will also dedicate attention to the important biological and clinical knowledge which can be gained by studying samples collected from patients with metastatic ILC who consented to post-mortem tissue donation. Finally, the last part of the presentation will be dedicated to mixed NST/ILC tumors. These tumors account for up to 18% of all invasive breast cancers and represent an even more under investigated area of research as pure ILC.
Citation Format: C. Desmedt. Biological peculiarities of ILC [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr ED02-01.
Abstract ED05-01: Demystifying the Axilla: Challenging scenarios in the upfront surgery setting and after NAC
Authors: Barrio A. 
Published: May 2024

Abstract
Management of the axilla has evolved significantly over time, with a trend toward less extensive axillary surgery. While historically, all patients underwent axillary lymph node dissection (ALND) due to the Halstedian belief that ALND was essential for the cure of breast cancer, advances in systemic therapy, radiotherapy, and understanding of tumor biology have resulted in the abandonment of ALND for a large proportion of patients having upfront surgery with limited nodal disease, and in those with no residual nodal disease after neoadjuvant systemic therapy. Over time, axillary management has become increasingly complicated, with significant variability in real-world management for different clinical scenarios. In this talk, we will address challenging scenarios in axillary management, both in the upfront surgery setting and after neoadjuvant chemotherapy (NAC). In the upfront surgery setting, we will address management of a positive sentinel node in patients treated with mastectomy, management of ≥ 3 positive sentinel nodes after lumpectomy or mastectomy, and the use of sentinel lymph node biopsy for patients with clinically node-positive hormone receptor (HR) positive/human epidermal growth factor receptor 2 (HER2) negative breast cancer. In the setting of patients receiving NAC, we will discuss the optimal approach to the axilla in patients with residual disease after NAC, and in those with locally advanced breast cancer. As we move away from ALND in low-risk scenarios where data from randomized and prospective trials have demonstrated oncologic safety, we await results from ongoing clinical trials to provide us with high-level evidence regarding the safety of omission of ALND in high-risk patients with more extensive nodal disease.
Citation Format: A. Barrio. Demystifying the Axilla: Challenging scenarios in the upfront surgery setting and after NAC [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr ED05-01.
Abstract ED05-02: When less is more: Patient-friendly radiation courses with WBI and PBI
Authors: Meattini I. 
Published: May 2024

Abstract
Over the past few decades, remarkable progress has been made in understanding the biology and pathology of breast cancer. A personalized conservative approach has been currently adopted addressing the patient's individual risk of relapse. After postoperative whole breast irradiation for early-stage breast cancer, a rate of recurrences outside the initial tumour bed lower than 4% at 5 years was observed. Thus, the highest benefits of breast irradiation seem to result from the dose delivered to the tissue neighbouring the tumour bed. Nonetheless, reducing treatment morbidity while maintaining radiation therapy's ability to decrease local recurrences is an important challenge in treating patients with radiation therapy.
In this regard, strategies such as partial-breast irradiation and whole breast hypofractionation have been developed to reduce toxicity without compromising oncologic outcomes. According to the national and international published guidelines, clinical oncologists can refer to specific dose/fractionation schedules and eligible criteria. However, there are still some areas of open questions.
Breast cancer represents a multidisciplinary paradigm; it should be considered a heterogeneous disease where a "one-treatment-fits-all" approach cannot be considered an appropriate option.
A wide overview on the main partial and whole breast irradiation advantages, risks, timings, techniques, and available recommendations is presented, providing practical findings to support clinical decision-making, exploring future perspectives, towards a balance for optimisation of breast cancer.
Citation Format: I. Meattini. When less is more: Patient-friendly radiation courses with WBI and PBI [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr ED05-02.