bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of COVID-19 on health service utilisation in sub-Saharan Africa: protocol for a scoping review
Authors: Tannor Elliot Koranteng , Quentin Wilm , Busse Reinhard , Opoku Daniel , Amuasi John 
Published: September 2023

IntroductionThe COVID-19 pandemic has exposed weaknesses in health systems of many countries, including those in sub-Saharan Africa. Despite comparatively low rates of COVID-19 admissions and deaths in sub-Saharan Africa, the pandemic still had a significant impact by disrupting health service utilisation (HSU). The aim of this scoping review is to synthesise the available evidence on HSU in sub-Saharan Africa during the COVID-19 pandemic, especially focusing on (1) changes in HSU compared with the prepandemic period, (2) changes in HSU among particular patient groups studied and (3) identifying factors determining changes in HSU as a result of the COVID-19 pandemic.Method and analysisThe scoping review will be guided by the methodological framework for conducting scoping reviews developed by Arskey and O’Malley. We will identify relevant studies on HSU in sub-Saharan Africa during the COVID-19 pandemic using PubMed (MEDLINE), Embase, Scopus and Web of Science databases from 1 December, 2019 to 31 March 2023. We will search grey literature, government and organisational websites for reports and conference proceedings. Included studies will be restricted to those reported in English or French. Two reviewers will independently screen articles at the title and abstract stage for inclusion into full text screening. We will provide a general descriptive overview, tabular summaries and content analysis for the extracted data.Ethics and disseminationEthical approval is not required for the conduct of the scoping review. We will disseminate our findings via open access peer-reviewed journals and scientific presentations. Our scoping review findings will help to determine the feasibility of a subsequent systematic review (and meta-analysis) on HSU during the COVID-19 pandemic.
Inequalities in children’s mental health before and during the COVID-19 pandemic: findings from the UK Household Longitudinal Study
Authors: Miall Naomi , Pearce Anna , Moore Jamie C , Benzeval Michaela , Green Michael J 
Published: September 2023

BackgroundThere are concerns that child mental health inequalities may have widened during the COVID-19 pandemic. We investigated whether child mental health inequalities changed in 2020/2021 compared with prepandemic.MethodsWe analysed 16 361 observations from 9272 children in the population representative UK Household Longitudinal Study. Child mental health was measured using the Strengths and Difficulties Questionnaire (SDQ) at ages 5 and 8 years in annual surveys 2011–2019, and at ages 5–11 years in July 2020, September 2020 and March 2021. Inequalities in cross-sectional SDQ scores among 5 and 8 year olds, before and during the pandemic, were modelled using linear regression. Additionally, interactions between time (before/during pandemic) and: sex, ethnicity, family structure, parental education, employment, household income and area deprivation on mental health were explored.ResultsA trend towards poorer mental health between 2011 and 2019 continued during the pandemic (b=0.12, 95% CI 0.08 to 0.17). Children with coupled, highly educated, employed parents and higher household income experienced greater mental health declines during the pandemic than less advantaged groups, leading to narrowed inequalities. For example, the mean difference in child SDQ scores for unemployed compared with employed parents was 2.35 prepandemic (1.72 to 2.98) and 0.02 during the pandemic (−1.10 to 1.13). Worse scores related to male sex and area deprivation were maintained. White children experienced worse mental health than other ethnicities, and greater declines during the pandemic.ConclusionMental health among UK 5 and 8 year olds deteriorated during the pandemic, although several inequalities narrowed. Interventions are needed to improve child mental health while ensuring inequalities do not widen.
Maternal health-related quality of life at 1 year after a preterm birth: role of socioeconomic status at birth
Authors: Benhammou Valerie , Marchand-Martin Laetitia , Pierrat Véronique , Charkaluk Marie-Laure , Romito Patrizia , Kaminski Monique , Ancel Pierre-Yves , Saurel-Cubizolles Marie-Josèphe 
Published: September 2023

BackgroundMaternal problems in the postpartum period may lead to suboptimal long-term health for women and could affect mother–child attachment. Social disadvantage is a risk factor for preterm birth, which carries its own burden of health issues and stress. The main aim of this study was to investigate the role for social factors in mothers’ physical and emotional health-related quality of life (HRQoL) at 1 year after a preterm birth.MethodsEPIPAGE-2 is a French nationwide, prospective, population-based cohort of preterm children born before 35 weeks’ gestation (N=3614 women). At birth, detailed data on the family’s social status were collected. At 1 year after birth, mothers completed a mailed questionnaire to report information on their HRQoL, assessed by the Medical Outcomes Study 12-item Short Form. We used multivariate linear regression models to assess the association between social factors and maternal HRQoL.ResultsAt 1 year after childbirth, the emotional HRQoL of mothers of preterm children was worse than their physical HRQoL, even in women without any previous signs of psychological distress at the infant’s discharge from hospital. Baseline social characteristics were the most important factors influencing the physical component of HRQoL. None of the studied social factors had any clear association with the mental component of HRQoL.ConclusionOur study underlines the importance of social disadvantage during pregnancy as risk factors for poor physical HRQoL at 1 year after a preterm birth.
Haematopoietic stem cell transplantation for treatment of relapsing-remitting multiple sclerosis in Sweden: an observational cohort study
Authors: Silfverberg Thomas , Zjukovskaja Christina , Ljungman Per , Nahimi Adjmal , Ahlstrand Erik , Dreimane Arta , Einarsdottir Sigrun , Fagius Jan , Iacobaeus Ellen , Hägglund Hans , Lange Niclas , Lenhoff Stig , Lycke Jan , Mellergård Johan , Piehl Fredrik , Svenningsson Anders , Tolf Andreas , Cherif Honar , Carlson Kristina , Burman Joachim 
Published: September 2023

BackgroundA growing evidence base supports the use of autologous haematopoietic stem cell transplantation (aHSCT) for treatment of relapsing-remitting multiple sclerosis (RRMS), but it has not yet been integrated into most national clinical guidelines. The objective of this study was to assess efficacy and safety when aHSCT is implemented in routine healthcare.MethodsWe assessed 231 patients and the final analysis included 174 RRMS patients who were treated with aHSCT in Sweden before 1 January 2020. Efficacy was evaluated by performing a retrospective analysis of prospectively collected data from the Swedish MS registry. Procedure-related safety was assessed by analysing data from electronic patient records covering a period of 100 days following aHSCT.ResultsWith a median follow-up time of 5.5 (IQR: 3.4–7.5) years, the Kaplan-Meier estimate for no evidence of disease activity was 73% (95% CI 66% to 81%) at 5 years and 65% (95% CI 57% to 75%) at 10 years. Out of the 149 patients with baseline disability, 80 (54%) improved, 55 (37%) were stable and 14 (9%) deteriorated. The mean number of adverse events per patient was 1.7 (±SD: 1.5) for grade 3 events and 0.06 (±SD: 0.3) for grade 4 events. Febrile neutropenia was the most common adverse event, affecting 68% of patients. There was no treatment-related mortality.ConclusionsTreatment with aHSCT for RRMS is associated with freedom from disease activity in a majority of patients, with acceptable adverse events. This procedure should be considered a standard of care for patients with highly active RRMS.
ALL: Supporting Experiential Accessibility Education and Inclusive Software Development
Authors: Shi Weishi , Moses Heather , Yu Qi , Malachowsky Samuel , Krutz Daniel E. 
Published: September 2023

Creating accessible software is imperative for making software inclusive for all users.Unfortunately, the topic of accessibility is frequently excluded from computing education, leading to scenarios where students are unaware of either how to develop accessible software or see the need to create it. To address this challenge, we have created a set of educational labs that are systematically designed to not only inform students about fundamental topics in producing accessible software but also demonstrate its importance. Over the previous year, these labs were included in several Computer Science 2 offerings at the Rochester Institute of Technology, comprising a total of 500 student participants. This article discusses instructional observations from these offerings, some of which include the following: (i) many of the research findings from previous efforts remain true with the larger, more diverse evaluation; (ii) our created material and format reduced students’ belief that creating accessible software was difficult in relation to the baseline,; (iii) we observed that our created material and format benefited student opinion that creating accessible software is important, and (iv) computing majors may not be uniformly impacted by experiential educational accessibility material. The educational labs are publicly available on the project website (https://all.rit.edu).
TMEM215 Prevents Endothelial Cell Apoptosis in Vessel Regression by Blunting BIK-Regulated ER-to-Mitochondrial Ca Influx
Authors: Zhang Peiran , Yan Xianchun , Zhang Xiaoyan , Liu Yuan , Feng Xingxing , Yang Ziyan , Zhang Jiayulin , Xu Xinyuan , Zheng Qijun , Liang Liang , Han Hua 
Published: September 2023

BACKGROUND:
In developmental and pathological tissues, nascent vessel networks generated by angiogenesis require further pruning/regression to delete nonfunctional endothelial cells (ECs) by apoptosis and migration. Mechanisms underlying EC apoptosis during vessel pruning remain elusive. TMEM215 (transmembrane protein 215) is an endoplasmic reticulum–located, 2-pass transmembrane protein. We have previously demonstrated that TMEM215 knockdown in ECs leads to cell death, but its physiological function and mechanism are unclear.

METHODS:

We characterized the role and mechanism of TMEM215 in EC apoptosis using human umbilical vein endothelial cells by identifying its interacting proteins with immunoprecipitation-mass spectrometry. The physiological function of TMEM215 in ECs was assessed by establishing a conditional knockout mouse strain. The role of TMEM215 in pathological angiogenesis was evaluated by tumor and choroidal neovascularization models. We also tried to evaluate its translational value by delivering a
Tmem215
small interfering RNA (siRNA) using nanoparticles in vivo.

RESULTS:

TMEM215
knockdown in ECs induced apoptotic cell death. We identified the chaperone BiP as a binding partner of TMEM215, and TMEM215 forms a complex with and facilitates the interaction of BiP (binding immunoglobin protein) with the BH (BCL-2 [B-cell lymphoma 2] homology) 3-only proapoptotic protein BIK (BCL-2 interacting killer).
TMEM215
knockdown triggered apoptosis in a BIK-dependent way and was abrogated by BCL-2. Notably,
TMEM215
knockdown increased the number and diminished the distance of mitochondria-associated endoplasmic reticulum membranes and increased mitochondrial calcium influx. Inhibiting mitochondrial calcium influx by blocking the IP
3
R (inositol 1,4,5-trisphosphate receptor) or MCU (mitochondrial calcium uniporter) abrogated
TMEM215
knockdown–induced apoptosis.
TMEM215
expression in ECs was induced by physiological laminar shear stress via
EZH2
downregulation. In EC-specific
Tmem215
knockout mice, induced
Tmem215
depletion impaired the regression of retinal vasculature characterized by reduced vessel density, increased empty basement membrane sleeves, and increased EC apoptosis. Moreover, EC-specific
Tmem215
ablation inhibited tumor growth with disrupted vasculature. However,
Tmem215
ablation in adult mice attenuated lung metastasis, consistent with reduced
Vcam1
expression. Administration of nanoparticles carrying
Tmem215
siRNA also inhibited tumor growth and choroidal neovascularization injury.

CONCLUSIONS:

TMEM215
, which is induced by blood flow-derived shear stress via downregulating
EZH2
, protects ECs from BIK-triggered mitochondrial apoptosis mediated by calcium influx through mitochondria-associated ER membranes during vessel pruning, thus providing a novel target for antiangiogenic therapy.
Common Cancer Types and Risk of Stroke and Bleeding in Patients With Nonvalvular Atrial Fibrillation: A Population‐Based Study in England
Authors: Ajabnoor Alyaa M. , Parisi Rosa , Zghebi Salwa S. , Ashcroft Darren M. , Faivre‐Finn Corinne , Morris Charlotte , Mamas Mamas A. , Kontopantelis Evangelos 
Published: September 2023

Background
The association between cancer and stroke or bleeding outcomes in atrial fibrillation is unclear. We sought to examine how certain types of cancer influence the balance between stroke and bleeding risk in patients with nonvalvular atrial fibrillation (NVAF).

Methods and Results
We estimated stroke and bleeding risk among adult patients with NVAF and certain types of cancer (breast, prostate, colorectal, lung, and hematological cancer) from 2009 to 2019 based on data from the UK Clinical Practice Research Datalink GOLD and Aurum databases. The control group included patients with NVAF only. Of 177 065 patients with NVAF, 11379 (6.4%) had cancer (1691 breast, 3955 prostate, 1666 colorectal, 2491 hematological, and 1576 lung). Compared with patients without cancer, stroke risk was higher in patients with breast cancer (adjusted hazard ratio [aHR], 1.20 [95% CI, 1.07–1.35) and with prostate cancer (aHR, 1.11 [95% CI, 1.01–1.12) if diagnosed within 6 months before NVAF. The risk of bleeding was increased in subjects with hematological cancer (aHR, 1.55 [95% CI, 1.40–1.71]), lung cancer (aHR, 1.49 [95% CI, 1.25, 1.77]), prostate cancer (aHR, 1.38 [95% CI, 1.28–1.49]), and colorectal cancer (aHR, 1.36 [95% CI, 1.21–1.53]), but not for subjects with breast cancer. The more recent the cancer diagnosis before NVAF diagnosis (within 6 months), the higher the risk of bleeding.

Conclusions
Breast and prostate cancer are associated with increased stroke risk, whereas in some cancer types, the risk of bleeding seemed to exceed stroke risk. In these patients, prescribing of oral anticoagulant should be carefully evaluated to balance bleeding and stroke risk.
Cancer Therapy–Related Cardiac Dysfunction in Patients With Prostate Cancer Undergoing Androgen Deprivation Therapy
Authors: Chen Dong‐Yi , Lee Cheng‐Hung , Tsai Ming‐Lung , Hsieh Ming‐Jer , Chuang Cheng‐Keng , Pang See‐Tong , Chen Shao‐Wei , Tseng Chi‐Nan , Chang Shang‐Hung , Chu Pao‐Hsien , Hsieh I‐Chang , Wu Victor Chien‐Chia , Huang Wen‐Kuan 
Published: September 2023

Background
The risk of cardiac dysfunction for patients with prostate cancer undergoing androgen deprivation therapy (ADT) in the real‐world setting remains unclear.

Methods and Results
A total of 1120 patients with prostate cancer and a baseline echocardiography scan were identified from Chang Gung Research Database between January 1, 2001 and December 31, 2019. Patients were treated with gonadotropin‐releasing hormone agonist therapy, gonadotropin‐releasing hormone antagonist therapy, or bilateral orchiectomy. Changes in left ventricular ejection fraction (LVEF) were further assessed in 421 patients using repeated measurements of LVEF before and during ADT treatment. The incidence of cancer therapy–related cardiac dysfunction (CT‐RCD) was evaluated and defined as a ≥10% absolute decline in LVEF from baseline to a value of <53%. Among 421 patients undergoing ADT, LVEF declined from 66.3±11.3% to 62.5±13.6% (95% CI of mean difference: −5.0% to −2.7%) after a mean follow‐up period of 1.6±0.8 years. CT‐RCD occurred in 58 patients (13.7%) with a nadir LVEF of 40.3±9.1% after ADT. Lower baseline LVEF was significantly associated with CT‐RCD (odds ratio, 1.07 [95% CI, 1.04–1.10]). The area under the curve of baseline LVEF for discriminating CT‐RCD was 75.6%, with the corresponding optimal cutoff value of 64.5% (sensitivity, 79.3%; specificity, 67.2%).

Conclusions
ADT with gonadotropin‐releasing hormone agonist therapy, gonadotropin‐releasing hormone antagonist therapy, and bilateral orchiectomy were associated with an increased risk of CT‐RCD in patients with prostate cancer. In addition, lower baseline LVEF was a significant predictor of CT‐RCD in patients with prostate cancer undergoing treatment with ADT.
Was COVID‐19 Associated With Worsening Inequities in Stroke Treatment and Outcomes?
Authors: Glance Laurent G. , Benesch Curtis G. , Joynt Maddox Karen E. , Bender Matthew T. , Shang Jingjing , Stone Patricia W. , Lustik Stewart J. , Nadler Jacob W. , Galton Christopher , Dick Andrew W. 
Published: September 2023

Background
COVID‐19 stressed hospitals and may have disproportionately affected the stroke outcomes and treatment of Black and Hispanic individuals.

Methods and Results

This retrospective study used 100% Medicare Provider Analysis and Review file data from between 2016 and 2020. We used interrupted time series analyses to examine whether the COVID‐19 pandemic exacerbated disparities in stroke outcomes and reperfusion therapy. Among 1 142 560 hospitalizations for acute ischemic strokes, 90 912 (8.0%) were Hispanic individuals; 162 752 (14.2%) were non‐Hispanic Black individuals; and 888 896 (77.8%) were non‐Hispanic White individuals. The adjusted odds of mortality increased by 51% (adjusted odds ratio [aOR], 1.51 [95% CI, 1.34–1.69];
P
<0.001), whereas the rates of nonhome discharges decreased by 11% (aOR, 0.89 [95% CI, 0.82–0.96];
P
=0.003) for patients hospitalized during weeks when the hospital's proportion of patients with COVID‐19 was >30%. The overall rates of motor deficits (
P
=0.25) did not increase, and the rates of reperfusion therapy did not decrease as the weekly COVID‐19 burden increased. Black patients had lower 30‐day mortality (aOR, 0.70 [95% CI, 0.69–0.72];
P
<0.001) but higher rates of motor deficits (aOR, 1.14 [95% CI, 1.12–1.16];
P
<0.001) than White individuals. Hispanic patients had lower 30‐day mortality and similar rates of motor deficits compared with White individuals. There was no differential increase in adverse outcomes or reduction in reperfusion therapy among Black and Hispanic individuals compared with White individuals as the weekly COVID‐19 burden increased.

Conclusions
This national study of Medicare patients found no evidence that the hospital COVID‐19 burden exacerbated disparities in treatment and outcomes for Black and Hispanic individuals admitted with an acute ischemic stroke.
Measuring Convective Organization
Authors: Biagioli Giovanni , Tompkins Adrian Mark 
Published: September 2023

Abstract
Organized systems of deep convective clouds are often associated with high-impact weather and changes in such systems may have implications for climate sensitivity. This has motivated the derivation of many organization indices that attempt to measure the level of deep convective aggregation in models and observations. Here we conduct a comprehensive review of existing methodologies and highlight some of their drawbacks, such as only measuring organization in a relative sense, being biased toward particular spatial scales, or being very sensitive to the details of the calculation algorithm. One widely used metric, Iorg, uses statistics of nearest-neighbor distances between convective storms to address the first of these concerns, but we show here that it is insensitive to organization beyond the meso-β scale and very contingent on the details of the implementation. We thus introduce a new and complementary metric, Lorg, based on all-pair convective storm distances, which is also an absolute metric that can discern regular, random, and clustered cloud scenes. It is linearly sensitive to spatial scale in most applications and robust to the implementation methodology. We also derive a discrete form suited to gridded data and provide corrections to account for cyclic boundary conditions and finite, open boundary domains of nonequal aspect ratios. We demonstrate the use of the metric with idealized synthetic configurations, as well as model output and satellite rainfall retrievals in the tropics. We claim that this new metric usefully supplements the existing family of indices that can help to understand convective organization across spatial scales.

Significance Statement
The clustering and organization of convection is associated with high-impact weather and changes could impact climate sensitivity, but no consensus exists on how to best measure organization. Here we suggest a new metric that is robust to the calculation details and can classify scenes as random, clustered, or regular. This new metric can therefore account for spacing of organized convective systems and convective storms on scales spanning tens of kilometers to the entire tropics. We suggest that the new metric Lorg addresses many shortcomings of existing measures and can act as a useful additional tool to further understanding of convective organization.
Acute Large Ovarian Cyst After Surgical Resection of Juvenile Granulosa Cell Tumor Stage 1C
Authors: Spencer Brianna L. , Lotakis Dimitra M. , Imel Sydni , Speck K. Elizabeth 
Published: September 2023

Juvenile granulosa cell tumors (JGCTs) are rare, though carry significant burden of morbidity and mortality. A 15-year-old menstruating female with abdominal pain was diagnosed with a large 22.3 cm pelvic mass. CA-125 and LDH were elevated. Exploratory laparotomy was undertaken due to lesion size, and left salpingo-oophorectomy with omentectomy was completed. Pathology confirmed JGCTs with focal disruption, consistent with Stage IC disease. Six weeks postoperatively, the patient experienced recurrent abdominal pain and ultrasound revealed a 7.9 cm right ovarian cystic structure. Given size and nodularity, management was discussed with a multidisciplinary team. Serial ultrasounds demonstrated resolution of the cyst. Workup for ovarian masses in pediatric patients has added complexity of fertility preservation. Once ovarian torsion is ruled out, imaging and laboratory studies are completed to characterize the mass. In pediatric patients with cancer of the Mullerian structures and risk of infertility, decision-making can be challenging and is best managed with a multidisciplinary approach.