bluuebunny/crossref_metadata_2025_split huggingface dataset:
A designathon to co-create HPV screening and vaccination approaches for mothers and daughters in Nigeria: findings from a community-led participatory event
Authors: Kpokiri Eneyi E , Wapmuk Agatha E , Obiezu-Umeh Chisom , Nwaozuru Ucheoma , Gbaja-Biamila Titilola , Obionu Ifeoma , Kokelu Ekenechukwu , Smith Jennifer , Azuogu Benedict N , Ajenifuja Kayode , Babatunde Abdulhammed O , Ezechi Oliver , Tucker Joseph D , Iwelunmor Juliet 
Published: June 2024

Abstract
Background
Oncogenic types of human Papillomavirus (HPV) infection cause substantial morbidity and mortality in Nigeria. Nigeria has low cervical cancer screening and vaccination rates, suggesting the need for community engagement to enhance reach and uptake. We organised a designathon to identify community-led, innovative approaches to promote HPV screening and vaccination for women and girls, respectively, in Nigeria. A designathon is a three-phase participatory process informed by design thinking that includes the preparation phase that includes soliciting innovative ideas from end-users, an intensive collaborative event to co-create intervention components, and follow-up activities.

Methods
We organised a three-phase designathon for women (30-65yrs) and girls (11-26yrs) in Nigeria. First, we launched a national crowdsourcing open call for ideas on community-driven strategies to support HPV screening among women and vaccination among girls. The open call was promoted widely on social media and at in-person gatherings. All eligible entries were graded by judges and 16 exceptional teams (with 4-6members each). All six geo-political zones of Nigeria were invited to join an in-person event held over three days in Lagos to refine their ideas and present them to a panel of expert judges. The ideas from teams were reviewed and scored based on relevance, feasibility, innovation, potential impact, and mother-daughter team dynamics. We present quantitative data on people who submitted and themes from the textual submissions.

Results
We received a total of 612 submissions to the open call from mother-daughter dyads. Participants submitted ideas via a website designated for the contest (n = 392), in-person (n = 99), email (n = 31), or via an instant messaging application (n = 92). Overall, 470 were eligible for judging after initial screening. The average age of participants for daughters was 19 years and 39 years for mothers. Themes from the top 16 proposals included leveraging local leaders (5/16), faith-based networks (4/16), educational systems (4/16), and other community networks (7/16) to promote awareness of cervical cancer prevention services. After an in-person collaborative event, eight teams were selected to join an innovation training boot camp, for capacity building to implement ideas.

Conclusions
Innovative strategies are needed to promote HPV screening for mothers and vaccination for girls in Nigeria. Our designathon was able to facilitate Nigerian mother-daughter teams to develop cervical cancer prevention strategies. Implementation research is needed to assess the effectiveness of these strategies.
Spatiotemporal epidemiology of substance-related accidental acute toxicity deaths in Canada from 2016 to 2017
Authors: Howard-Azzeh Mohammad , Wasfi Rania , Kakkar Tanya , Flynn Mallory , Rotondo Jenny , Schleihauf Emily , Bowes Matthew , Rees Erin E. 
Published: June 2024

Abstract
Objectives
In Canada, substance-related accidental acute toxicity deaths (AATDs) continue to rise at the national and sub-national levels. However, it is unknown if, where, when, and to what degree AATDs cluster in space, time, and space–time across the country. The objectives of this study were to 1) assess for clusters of AATDs that occurred in Canada during 2016 and 2017 at the national and provincial/territorial (P/T) levels, and 2) examine the substance types detected in AATD cases within each cluster.

Methods
Two years of person-level data on AATDs were abstracted from coroner and medical examiner files using a standardized data collection tool, including the decedent's postal code and municipality information on the places of residence, acute toxicity (AT) event, and death, and the substances detected in the death. Data were combined with Canadian census information to create choropleth maps depicting AATD rates by census division. Spatial scan statistics were used to build Poisson models to identify clusters of high rates (p < 0.05) of AATDs at the national and P/T levels in space, time, and space–time over the study period. AATD cases within clusters were further examined for substance types most present in each cluster.

Results
Eight clusters in five regions of Canada at the national level and 24 clusters in 15 regions at the P/T level were identified, highlighting where AATDs occurred at far higher rates than the rest of the country. The risk ratios of identified clusters ranged from 1.28 to 9.62. Substances detected in clusters varied by region and time, however, opioids, stimulants, and alcohol were typically the most commonly detected substances within clusters.

Conclusion
Our findings are the first in Canada to reveal the geographic disparities in AATDs at national and P/T levels using spatial scan statistics. Rates associated with substance types within each cluster highlight which substance types were most detected in the identified regions. Findings may be used to guide intervention/program planning and provide a picture of the 2016 and 2017 context that can be used for comparisons of the geographic distribution of AATDs and substances with different time periods.
Unpacking the impact of COVID-19 on child immunization: evidence from Ghana
Authors: Durizzo Kathrin , Awoonor-Williams Koku , Harttgen Kenneth , Günther Isabel 
Published: June 2024

Abstract
Background
With the onset of the COVID-19 pandemic, governments implemented social distancing regulations to limit the spread of the disease. Some health experts warned that these measures could negatively affect access to essential health services, such as routine childhood immunizations. Others noted that without these regulations, COVID-19 cases would increase, leading to overburdened health systems.

Methods
We analyze four years (2018–2021) of monthly administrative data on childhood immunizations in all administrative districts in Ghana and exploit variations in social distancing regulations across districts. Given variations in social distancing regulations across Ghanaian districts, we can further differentiate between the effect of public lockdowns and the effect of the pandemic.

Results
We find that child immunizations in Ghana declined by 6% during the public lockdown in April 2020, but the country compensated with higher vaccination rates starting in June, and immunization services recovered to pre-pandemic growth levels by 2021. Time-critical vaccines, such as polio, were not affected at all. We do find a substantially larger disruption in April 2020 (14%) and a slower recovery in 2020 in the 40 lockdown-affected districts. Interestingly, vaccination rates already decreased in February and March by about 5% before the public lockdown and before the pandemic had reached Ghana, but with the pandemic already spreading globally and in the news.

Conclusion
Our results indicate that the negative effect on child immunization was less severe and shorter than predicted by experts. Fear of COVID-19 and delayed vaccination campaigns had a substantial impact on childhood immunization while rising COVID-19 cases and moderate social distancing regulations did not seem to affect immunization rates.
Surgical outcomes of robotic-assisted percutaneous fixation for thoracolumbar fractures in patients with ankylosing spondylitis
Authors: Ye Zhi-Yuan , Bai Jin-Yu , Ye Zhi-Min , Zhao Xu-Shen , Song Fang-Long , Zhou Zhen-Tao , Shan Bing-Chen , Zhou Xiao-Zhong 
Published: June 2024

Abstract
Background
Spinal fractures in patients with ankylosing spondylitis (AS) mainly present as instability, involving all three columns of the spine, and surgical intervention is often considered necessary. However, in AS patients, the significant alterations in bony structure and anatomy result in a lack of identifiable landmarks, which increases the difficulty of pedicle screw implantation. Therefore, we present the clinical outcomes of robotic-assisted percutaneous fixation for thoracolumbar fractures in patients with AS.

Methods
A retrospective review was conducted on a series of 12 patients diagnosed with AS. All patients sustained thoracolumbar fractures between October 2018 and October 2022 and underwent posterior robotic-assisted percutaneous fixation procedures. Outcomes of interest included operative time, intra-operative blood loss, complications, duration of hospital stay and fracture union. The clinical outcomes were assessed using the visual analogue scale (VAS) and Oswestry Disability Index (ODI). To investigate the achieved operative correction, pre- and postoperative radiographs in the lateral plane were analyzed by measuring the Cobb angle.

Results
The 12 patients had a mean age of 62.8 ± 13.0 years and a mean follow-up duration of 32.7 ± 18.9 months. Mean hospital stay duration was 15 ± 8.0 days. The mean operative time was 119.6 ± 32.2 min, and the median blood loss was 50 (50, 250) ml. The VAS value improved from 6.8 ± 0.9 preoperatively to 1.3 ± 1.0 at the final follow-up (P < 0.05). The ODI value improved from 83.6 ± 6.1% preoperatively to 11.8 ± 6.6% at the latest follow-up (P < 0.05). The average Cobb angle changed from 15.2 ± 11.0 pre-operatively to 8.3 ± 7.1 at final follow-up (P < 0.05). Bone healing was consistently achieved, with an average healing time of 6 (5.3, 7.0) months. Of the 108 screws implanted, 2 (1.9%) were improperly positioned. One patient experienced delayed nerve injury after the operation, but the nerve function returned to normal upon discharge.

Conclusion
Posterior robotic-assisted percutaneous internal fixation can be used as an ideal surgical treatment for thoracolumbar fractures in AS patients. However, while robot-assisted pedicle screw placement can enhance the accuracy of pedicle screw insertion, it should not be relied upon solely.
Evaluation of the re-bond strength of debonded metal and ceramic brackets following Er: YAG laser treatment
Authors: Zheng Xiaowan , Huang Xiaofeng 
Published: June 2024

Abstract
Background
Failure of orthodontic bracket bonds is a common occurrence during orthodontic treatment. This study investigated the impact of Er: YAG laser-based removal of adhesive from the bases of metal and ceramic brackets for re-bonding.

Methods
A total of 168 extracted premolars were collected from patients. 84 metal brackets were used to be bonded on the buccal surface of the premolars in Groups 1, 2, 3 and 4, while 84 ceramic brackets were applied in Groups I, II, III and IV. Group 1/I represented the initial bonding group, with Group 2/II being the re-bonding group with new brackets, while Groups 3/III and 4/ IV received recycled brackets treated by Er: YAG laser or flaming respectively. Both the first and second de-bonding were performed in all samples using a universal testing machine to determine the shear bond strength (SBS). The adhesive remnant index (ARI) was evaluated using a stereo-microscope. The new and the treated bracket bases were evaluated using scanning electron microscopy (SEM). Differences in initial bonding and re-bonding ability were analyzed through one-way ANOVAs, and differences in ARI were assessed with the Kruskal–Wallis test.

Results
Greater amounts of adhesive residue were observed on ceramic brackets treated by laser. The SBS values for recycled metal brackets in Group 3 (26.13 MPa) were comparable to Group 1 (23.62 MPa) whereas they differed significantly from Group 4 (12.54 MPa). No significant differences in these values were observed when comparing the 4 groups with ceramic brackets. ARI score in Group 4 (2–3 points) differed significantly from the three other groups (P < 0.05). For Group I, II, III and IV, similar ARI scores were observed (P > 0.05). SEM analysis didn’t show apparent damage of bracket bases consisting of either metal or ceramic material treated by Er: YAG laser.

Conclusions
Er: YAG laser treatment was superior to flame treatment as a means of removing adhesive without damaging the brackets. SBS values and ARI scores following Er: YAG laser treatment were similar to those for new brackets, offering further support for Er: YAG laser treatment as a viable means of recycling debonded brackets.
Effect of acupuncture on tic disorder: a randomized controlled clinical trial based on energy metabolomics and infrared thermography
Authors: Fan Yi-ming , Li Ying-xin , Zhang Yi , Chen Dong , Yuan Meng-qian , Li Yan-cai , Teo Elsie Sin May , Xu Ming-hui , Zhou Yang-yang , Yang Pan-feng , Zhao Cheng-mei , Zheng Jing-jing , Li Jian-bing , Bao Chao 
Published: June 2024

Abstract
Background
Acupuncture is a method for treating tic disorder. However, there is a lack of sufficient clinical objective basis in regards of its treatment efficacy. Indeed, there are structural abnormalities present in energy metabolism and infrared thermography in children with tic disorder. Therefore, this study proposes a clinical trial scheme to explore the possible mechanism of acupuncture in treating tic disorder.

Methods
This randomized controlled trial will recruit a total of 90 children, in which they will be divided into non-intervention group and intervention group. The non-intervention group consists of 30 healthy children while the intervention group consists of 60 children with tic disorder. The intervention group will be randomly allocated into either the treatment group or the control group, with 30 children randomly assigned in each group. Children either received acupuncture treatment and behavioral therapy (treatment group) or sham acupuncture treatment and behavioral therapy (control group), 3 treatment sessions per week for a period of 12 weeks, with a total of 36 treatment sessions. Outcome measures include YGTSS, urinary and fecal metabolomics, infrared thermography of body surface including governor vessel. For the intervention group, these outcome measures will be collected at the baseline and 90th day prior to intervention. Whereas for the non-intervention group, outcome measures (excluding YGTSS) will be collected at the baseline.

Discussion
The main outcome will be to observe the changes of the severity of tic condition, the secondary outcome will be to observe the changes of structural characteristic of infrared thermography of body surface/acupoints along the governor vessel and to evaluate the changes of urinary and fecal metabolomics at the end of the treatment, so as to analyze the relationship between them and to provide further knowledge in understanding the possible mechanism of acupuncture in improving the clinical symptoms via regulating and restoring the body metabolomics network, which in future it can develop as a set of clinical guideline (diagnosis, treatment, assessment, prognosis) in treating tic disorder. ChiCTR2300075188(Chinese Clinical Trial Registry, http://www.chictr.org.cn, registered on 29 August 2023).
“Out of the frying pan and into the fire” – the UKFPO’s recent changes are a short-sighted response to a complicated problem
Authors: Skan Oliver , Saini Kiran , Armstrong Edward 
Published: June 2024

AbstractIn June 2023, the UK Foundation Programme Office announced that the previous method of ranking students based on their educational performance measure and situational judgement test performance would be superseded by a preferencing algorithm that disregards academic merit. We outline our strong objections to this policy.
Healthcare utilisation in people with long COVID: an OpenSAFELY cohort study
Authors: Lin Liang-Yu , Henderson Alasdair D. , Carlile Oliver , Dillingham Iain , Butler-Cole Ben F. C. , Marks Michael , Briggs Andrew , Jit Mark , Tomlinson Laurie A. , Bates Chris , Parry John , Bacon Sebastian C. J. , Goldacre Ben , Mehrkar Amir , MacKenna Brian ,   The OpenSAFELY Collaborative, Eggo Rosalind M. , Herrett Emily 
Published: June 2024

Abstract
Background
Long COVID potentially increases healthcare utilisation and costs. However, its impact on the NHS remains to be determined.

Methods
This study aims to assess the healthcare utilisation of individuals with long COVID. With the approval of NHS England, we conducted a matched cohort study using primary and secondary care data via OpenSAFELY, a platform for analysing anonymous electronic health records. The long COVID exposure group, defined by diagnostic codes, was matched with five comparators without long COVID between Nov 2020 and Jan 2023. We compared their total healthcare utilisation from GP consultations, prescriptions, hospital admissions, A&E visits, and outpatient appointments. Healthcare utilisation and costs were evaluated using a two-part model adjusting for covariates. Using a difference-in-difference model, we also compared healthcare utilisation after long COVID with pre-pandemic records.

Results
We identified 52,988 individuals with a long COVID diagnosis, matched to 264,867 comparators without a diagnosis. In the 12 months post-diagnosis, there was strong evidence that those with long COVID were more likely to use healthcare resources (OR: 8.29, 95% CI: 7.74–8.87), and have 49% more healthcare utilisation (RR: 1.49, 95% CI: 1.48–1.51). Our model estimated that the long COVID group had 30 healthcare visits per year (predicted mean: 29.23, 95% CI: 28.58–29.92), compared to 16 in the comparator group (predicted mean visits: 16.04, 95% CI: 15.73–16.36). Individuals with long COVID were more likely to have non-zero healthcare expenditures (OR = 7.66, 95% CI = 7.20–8.15), with costs being 44% higher than the comparator group (cost ratio = 1.44, 95% CI: 1.39–1.50). The long COVID group costs approximately £2500 per person per year (predicted mean cost: £2562.50, 95% CI: £2335.60–£2819.22), and the comparator group costs £1500 (predicted mean cost: £1527.43, 95% CI: £1404.33–1664.45). Historically, individuals with long COVID utilised healthcare resources more frequently, but their average healthcare utilisation increased more after being diagnosed with long COVID, compared to the comparator group.

Conclusions
Long COVID increases healthcare utilisation and costs. Public health policies should allocate more resources towards preventing, treating, and supporting individuals with long COVID.
Late gestation fetal hypothyroidism alters cell cycle regulation across multiple organ systems
Authors: Smith Alyssa A. , Vesey Alexa , Helfrich Caden , Pasternak J. Alex 
Published: June 2024

Abstract
Background
Hypothyroidism is a common endocrine disruption observed in utero that adversely affects fetal growth and maturation leading to long-term impacts on health; however, the exact molecular mechanisms by which these deleterious effects occur are unknown. We hypothesize that fetal hypothyroidism during late gestation will disrupt cell cycle regulation in a tissue-specific manner. To evaluate this, eight pregnant gilts were dosed with either methimazole or an equivalent negative control during days 85–106 out of 114 days of gestation (n = 4/group). Following treatment, the gilts were humanely euthanized, and tissue samples of fetal heart, ileum, kidney, lung, liver, muscle, spleen, and thymus taken from two male and two female fetuses (n = 32) from each gilt.

Results
The relative expression of three cell cycle promoters (CDK1, CDK2, and CDK4), and one cell cycle inhibitor (CDKN1A) was compared in each tissue to determine the effect of hypothyroidism on the developing fetus. All of the eight tissues examined experienced at least one significant up- or downregulation in the expression of the aforementioned genes as a result of treatment with methimazole. Substantial changes were observed in the liver and muscle, with the latter experiencing significant downregulations of CDK1, CDK2, and CDK4 as a result of treatment. In addition, all tissues were examined for changes in protein content, which further elucidated the impact of hypothyroidism on the fetal liver by the observation of a marked increase in protein content in the methimazole-treated group. Finally, the heart and liver were histologically examined for evidence of cellular hyperplasia and hypertrophy by measuring average nuclei density and size in each tissue, with the results showing a significant decrease in average nuclei size in the liver of hypothyroid fetuses.

Conclusions
Collectively, these findings indicate the occurrence of organ-specific disruptions in cell cycle progression as a result of in utero hypothyroidism, which may explain the long term and widespread effects of hypothyroidism on fetal development.
Combined SERS-Raman screening of HER2-overexpressing or silenced breast cancer cell lines
Authors: Spaziani Sara , Esposito Alessandro , Barisciano Giovannina , Quero Giuseppe , Elumalai Satheeshkumar , Leo Manuela , Colantuoni Vittorio , Mangini Maria , Pisco Marco , Sabatino Lina , De Luca Anna Chiara , Cusano Andrea 
Published: June 2024

Abstract
Background
Breast cancer (BC) is a heterogeneous neoplasm characterized by several subtypes. One of the most aggressive with high metastasis rates presents overexpression of the human epidermal growth factor receptor 2 (HER2). A quantitative evaluation of HER2 levels is essential for a correct diagnosis, selection of the most appropriate therapeutic strategy and monitoring the response to therapy.

Results
In this paper, we propose the synergistic use of SERS and Raman technologies for the identification of HER2 expressing cells and its accurate assessment. To this end, we selected SKBR3 and MDA-MB-468 breast cancer cell lines, which have the highest and lowest HER2 expression, respectively, and MCF10A, a non-tumorigenic cell line from normal breast epithelium for comparison. The combined approach provides a quantitative estimate of HER2 expression and visualization of its distribution on the membrane at single cell level, clearly identifying cancer cells. Moreover, it provides a more comprehensive picture of the investigated cells disclosing a metabolic signature represented by an elevated content of proteins and aromatic amino acids. We further support these data by silencing the HER2 gene in SKBR3 cells, using the RNA interference technology, generating stable clones further analysed with the same combined methodology. Significant changes in HER2 expression are detected at single cell level before and after HER2 silencing and the HER2 status correlates with variations of fatty acids and downstream signalling molecule contents in the context of the general metabolic rewiring occurring in cancer cells. Specifically, HER2 silencing does reduce the growth ability but not the lipid metabolism that, instead, increases, suggesting that higher fatty acids biosynthesis and metabolism can occur independently of the proliferating potential tied to HER2 overexpression.

Conclusions
Our results clearly demonstrate the efficacy of the combined SERS and Raman approach to definitely pose a correct diagnosis, further supported by the data obtained by the HER2 gene silencing. Furthermore, they pave the way to a new approach to monitor the efficacy of pharmacologic treatments with the aim to tailor personalized therapies and optimize patients’ outcome.