bluuebunny/crossref_metadata_2025_split huggingface dataset:
La revolución fintech en los medios de pago: situación actual y perspectivas
Authors: Soto Pacheco Gloria M. , Botía Martínez María Teresa 
Published: December 2020

La tecnología y la nueva era digital están suponiendo grandes transformaciones en todos los sectores de la economía. En el ámbito financiero, la aplicación de la tecnología da como resultado lo que se conoce como fintech. Aunque la combinación de finanzas y tecnología nos lleva acompañando desde hace décadas, en los últimos años ha adquirido una gran relevancia debido a la rapidez con que se suceden las innovaciones como consecuencia de la democratización de la digitalización, esto es, del acceso masivo y barato a las nuevas tecnologías por empresas y consumidores. El fenómeno fintech abarca una gran variedad de áreas, también denominadas verticales, que incluyen desde los medios de pago hasta la financiación alternativa, pasando por las criptomonedas o el big data, por citar algunos ejemplos.
Este trabajo se centra en las repercusiones fintech en el segmento de los medios de pago, en donde viene registrándose toda una revolución. El uso del efectivo se está reduciendo debido a la aparición de nuevas y variadas alternativas como los monederos digitales, las plataformas P2P y otras alternativas cuyo uso está menos generalizado, como los pagos mediante factura telefónica. Realizamos un detallado análisis sobre estas innovaciones explicando su funcionamiento, los principales operadores y su evolución. También se abordan las perspectivas futuras, al objeto de conocer qué nos depara el futuro y las posibles implicaciones y adaptaciones de los cambios que están por venir relacionados con la tecnología blockchain, la inteligencia artificial, el internet de las cosas o la computación cuántica.
Demography of corneal dystrophies at a tertiary eye care centre in South India
Authors: Sridhar Sriya , Kumar Kiran , B Preethi , Mittal Preeti , Gangasagara Suresh Babu 
Published: December 2020

To report the frequency of corneal dystrophies. All patients who presented to the out-patient department were examined for signs of corneal dystrophy from January 2017 to December 2019. All patients underwent a thorough evaluation for demographics, clinical presentation, history of consanguinity, family medical history, and clinical outcome of keratoplasty (in those who required it) and a clinicopathologic correlation was attempted. Complete ophthalmological examination was conducted for all patients which included vision (distance & near), slit lamp examination, retinoscopy, auto refractometer readings, dilated fundus examination, pentacam as well as anterior segment OCT. Photographic documentation was done for all dystrophy patients. During this time period we had 118 patients who were included in the study. History of consanguineous marriage was noted in 62% of the study population. History of a similar problem in siblings and other members was elicited in 27 (22.88%) and 15 (12.71%) patients, respectively. 23 patients required keratoplasty. The average follow-up of each keratoplasty case was 36±14 months. Among these cases, only 2 groups had graft failure, viz, CHED and macular dystrophy. The higher frequency of dystrophies could be due to higher consanguineous marriage, which indicates a need for counselling. Also, there is an increased need for thorough work-up before planning intraocular procedures.
RiskScape: A Data Visualization and Aggregation Platform for Public Health Surveillance Using Routine Electronic Health Record Data
Authors: Cocoros Noelle M. , Kirby Chaim , Zambarano Bob , Ochoa Aileen , Eberhardt Karen , Rocchio, SB Catherine , Ursprung W. Sanouri , Nielsen Victoria M. , Durham Natalie Nguyen , Menchaca John T. , Josephson Mark , Erani Diana , Hafer Ellen , Weiss Michelle , Herrick Brian , Callahan Myfanwy , Isaac Thomas , Klompas Michael 
Published: December 2020

Automated analysis of electronic health record (EHR) data is a complementary tool for public health surveillance. Analyzing and presenting these data, however, demands new methods of data communication optimized to the detail, flexibility, and timeliness of EHR data. RiskScape is an open-source, interactive, Web-based, user-friendly data aggregation and visualization platform for public health surveillance using EHR data. RiskScape displays near-real-time surveillance data and enables clinical practices and health departments to review, analyze, map, and trend aggregate data on chronic conditions and infectious diseases. Data presentations include heat maps of prevalence by zip code, time series with statistics for trends, and care cascades for conditions such as HIV and HCV. The platform’s flexibility enables it to be modified to incorporate new conditions quickly—such as COVID-19. The Massachusetts Department of Public Health (MDPH) uses RiskScape to monitor conditions of interest using data that are updated monthly from clinical practice groups that cover approximately 20% of the state population. RiskScape serves an essential role in demonstrating need and burden for MDPH’s applications for funding, particularly through the identification of inequitably burdened populations.
Do Exposures to Green Space Reduce the Risk of Hypertension?
Authors: Jiang Jie , Chen Gongbo , Li Baojing , Lu Yuanan , Guo Yuming , Li Shanshan , Wang Chongjian , Xiang Hao 
Published: December 2020

Abstract
Background: Few epidemiological research examined the effects of greenness on cardiovascular diseases in developing countries. We aimed to explore the relationships between green space and hypertension and blood pressure in China.Methods: This cross-sectional study recruited 39, 259 adults from five counties in central China. Blood pressure measurements were performed according to a standardized protocol. Normalized diﬀerence vegetation index (NDVI) and enhanced vegetation index (EVI) was used to assess the exposure to greenness. We used mixed linear models to test greenspace-cardiovascular disease outcome pathways.Results: Higher green space was related to decreased hypertension prevalence and blood pressure. After fully adjusting the covariates, each interquartile range increase in NDVI500m and EVI500m were related to an 8% decrease in odds of hypertension. The changes in SBP and DBP (95% CI) were - 0.88 mm Hg (- 1.17, - 0.58) and - 0.64 mm Hg (- 0.82, - 0.46) for NDVI, and - 0.79 mm Hg (- 1.14, - 0.45) and - 0.67 mm Hg (- 0.87, - 0.46) for EVI, respectively. Subgroup analyses showed that the effects of green space were more pronounced in males, smokers, and drinkers.Conclusions: The effects of green space may reduce the risk of hypertension. Also, behavioral factors may affect this potential pathway.
Exploring the role and nature of trust in institutional capacity building in low- and middle-income countries: a systematic review
Authors: Manoj Malvikha , Brough Richard , Kalbarczyk Anna 
Published: December 2020

Abstract
Background Global concern with strengthening institutions is evident and has been underscored in the wake of the COVID-19 pandemic. Trusted or trustworthy institutions are vital in addressing institutional capacity strengthening, but there is limited research on institutional trust and how to build it. A preliminary approach entitled, Trusted Institutions (TI), identifies six essential elements of trust including: team culture, autonomy, scale and longevity, commitment to quality and ethics, sustainability, and good fit with local context and culture. We aimed to explore capacity building initiatives and the notion of ‘trust’ within non-government health institutions in low- and middle-income countries (LMICs) and validate these essential elements of trust through a systematic review.Methods We searched the published literature in PubMed and EMBASE in March 2020 and employed a three-concept search that included “health-related institutions”; “capacity building”; and “LMICs”. The study team used PRISMA reporting guidelines to conduct title and full-text reviews and conduct data extraction and analysis.Results The search yielded 342 unique articles. Seventy-seven references met initial inclusion criteria and underwent full-text extraction; 31 studies were included in the final analysis. Capacity building activities ranged from individual-level skills to institutional systems and structures. All articles addressed at least one element of trust with over half of articles describing sustainability (n = 18; 58%) and good fit with local context and culture (n = 18; 58%). Only 14 (45%) of articles explicitly mentioned the concept of trust either within an institution (intra-institutional) or between two or more institutions (interinstitutional). Four additional themes emerged as relevant to institutional trust including collaboration, communication, extent of institutional networks, and intersectionality.Conclusions This review validates essential elements of trust in the TI approach and documents the importance of building trust both within and between institutions. The TI approach can be used by public health institutions in LMICs to enhance their abilities to achieve institutional missions and meet global targets.
Low Engagement in HIV Services and Progress through the Treatment Cascade among&nbsp;Key Populations Living with HIV in Mozambique: Alarming Gaps in Knowledge of Status
Authors: Boothe Makini , Sathane Isabel , Baltazar Cynthia Semá , Chicuecue Noela , Horth Roberta , Fazito Erika , Raymond Henry Fisher 
Published: December 2020

Abstract
Background. Mozambique has a generalized HIV epidemic of 13.5% among the general population. Early modeling exercises in Mozambique estimate that key populations (KP), defined as men who have sex with men (MSM), female sex workers (FSW), and people who inject drugs (PWID), along with their partners account for about one third of all new infections. There is limited data describing the engagement of KP living with HIV in testing, care and treatment services. Methods. We conducted a secondary data analysis of HIV-positive participants in the first Bio-behavioral Surveillance (BBS) surveys in Mozambique conducted 2011-2014 in order to assess service uptake and progress though the HIV treatment cascade among MSM, FSW, and PWID. Unweighted pooled estimates were calculated for each key population group.Results. Among HIV-positive MSM, 63.2% of participants had ever received an HIV test, 8.8% were aware of their status, 6.1% reported having been linked to care, while 3.5% initiated ART and were currently on treatment. Of the HIV-infected FSW participants, 76.5% reported a previous HIV test and 22.4% were previously aware of their status. Linkage to care was reported by 20.1%, while 12.7% reported having initiated ART and 11.8% reported being on treatment at the time of the survey. Among HIV-infected PWID participants, 79.9% had previously received an HIV test, 63.2% were aware of their HIV status, and 49.0% reported being linked to care for their HIV infection. ART initiation was reported by 42.7% of participants, while 29.4% were on ART at the time of the survey. Conclusion. Among the three high risk populations in Mozambique, losses occurred throughout critical areas of service uptake with the most alarming breakpoint occurring at knowledge of HIV status. Special attention should be given to increasing HIV testing and linkage to ART treatment. Future surveys will provide the opportunity to monitor improvements across the cascade in line with global targets and should include viral load testing to guarantee a more complete picture of the treatment cascade.
A Cross-Sectional Survey Of Fertility Knowledge In Obstetrics And Gynecology Residents
Authors: Roberts Leah May , Kudesia Rashmi , Zhao Huaqing , Dolan Shaliz , Rose Marisa 
Published: December 2020

Abstract
BACKGROUND: To evaluate fertility knowledge among current Obstetrics and Gynecology (OB-GYN) residents using a recently published validated instrument, the Fertility and Infertility Treatment Knowledge Score (FIT-KS).METHODS: OB-GYN residents in the United States were recruited through an email to all residency coordinators nationwide. They were asked to voluntarily respond to a short questionnaire including demographic information and the FIT-KS instrument, through an online survey platform. Of approximately 5,000 OB-GYN residents in the country, 177 responded. RESULTS: The sample was 91% female, with 69% between the ages of 26 and 30. Participants evenly represented all four years of training. Mean FIT-KS score was 21.2 (73% correct; range 17-26). No statistically significant differences were noted across the level of training. Several knowledge gaps were noted. Residents could define the common assisted reproductive technologies; however overestimated their success rates per cycle. CONCLUSIONS: Substantial gaps exist in fertility knowledge among OB-GYN residents, with understanding of male fertility and success rates of Assisted Reproductive Technologies (ART) being particularly limited. Knowledge of fertility does not change throughout residency training, demonstrating consistent gaps in fertility knowledge. Knowledge during post graduate year (PGY)-1 year is consistent with mean scores found in prior research in Internal Medicine residents (65%), as well as a cohort of female medical students and obstetrics and gynecology residents and fellows (64.9%)(1, 2).
Effectiveness of Hospital Emergency Department Regionalization and Categorization Policy on Appropriate Patient Emergency Care Use: A Nationwide Observational Study in Taiwan
Authors: Lin Chih-Yuan , Lee Yue-Chune 
Published: December 2020

Abstract
Background: Emergency department (ED) overcrowding is a health services issue worldwide. Modern health policy emphasizes appropriate health services utilization. However, the relationship between accessibility, capability, and appropriateness of ED use is unknown. Thus, this study aimed to examine the effect of hospital ED regionalization policy and categorization of hospital emergency capability policy (categorization policy) on patient-appropriate ED use.Methods: Taiwan implemented a nationwide three-tiered hospital ED regionalization and categorization of hospital emergency capability policies in 2007 and 2009, respectively. We conducted a retrospective observational study on the effect of emergency care policy intervention on patient visit. Between 2005 and 2011, the Taiwan National Health Insurance Research Database recorded 1,835,860 ED visits from one million random samples. ED visits were categorized using the Yang-Ming modified New York University-ED algorithm. A time series analysis was performed to examine the change in appropriate ED use rate after policy implementation.Results: From 2005 to 2011, total ED visits increased by 10.7%. After policy implementation, the average appropriate ED visit rate was 66.9%. The intervention had no significant effect on the trend of appropriate ED visit rate.Conclusions: Although regionalization and categorization policies did increase emergency care accessibility, it had no significant effect on patient-appropriate ED use. Further research is required to improve data-driven policymaking.
Comparing Charlson and Elixhauser comorbidity indices with different weightings to predict in-hospital mortality: an analysis of national inpatient data
Authors: Sharma Narayan , Schwendimann René , Endrich Olga , Ausserhofer Dietmar , Simon Michael 
Published: December 2020

Abstract
Background: Understanding how comorbidity measures contribute to patient mortality is essential both to describe patient health status and to adjust for risks and potential confounding. The Charlson and Elixhauser comorbidity indices are well-established for risk adjustment and mortality prediction. Still, a different set of comorbidity weights might improve the prediction of in-hospital mortality. The present study, therefore, aimed to derive a set of new Swiss Elixhauser comorbidity weightings, to validate and compare them against those of the Charlson and Elixhauser-based van Walraven weights in an adult in-patient population-based cohort of general hospitals. Methods: Retrospective analysis was conducted with routine data of 102 Swiss general hospitals (2012–2017) for 6.09 million inpatient cases. To derive the Swiss weightings for the Elixhauser comorbidity index, we randomly halved the inpatient data and validated the results of part 1 alongside the established weighting systems in part 2, to predict in-hospital mortality. Charlson and van Walraven weights were applied to Charlson and Elixhauser comorbidity indices. Derivation and validation of weightings were conducted with generalized additive models adjusted for age, gender and hospital types. Results: Overall, the Elixhauser indices, c-statistic with Swiss weights (0.867, 95% CI: 0.865–0.868) and van Walraven’s weights (0.863, 95% CI: 0.862-0.864) had substantial advantage over Charlson’s weights (0.850, 95% CI: 0.849–0.851) and in the derivation and validation groups. The net reclassification improvement of new Swiss weights improved the predictive performance by 1.6% on the Elixhauser-van Walraven and 4.9% on the Charlson weights.Conclusions: All weightings confirmed previous results with the national dataset. The new Swiss weightings model improved slightly the prediction of in-hospital mortality in Swiss hospitals. The newly derive weights support patient population-based analysis of in-hospital mortality and seek country or specific cohort-based weightings.
Assessment of chronic disease self-management in patients with chronic heart failure based on the MCID of patient-reported outcomes by the multilevel model&nbsp;
Authors: Tian Jing , Zhao Jinghua , Zhang Qing , Ren Jia , Han Linai , Li Jing , Zhang Yanbo , Han Qinghua 
Published: December 2020

Abstract
Purpose: The minimal clinically important difference (MCID) of a patient-reported outcome (PRO) represents the threshold value of the change in the score for that PRO. It is deemed to have an important implication in clinical management. This study was performed to evaluate the clinical significance of chronic disease self-management (CDSM) for patients with chronic heart failure based on the MCID of the chronic heart failure - PRO measure (CHF-PROM).Methods: A multicenter, prospective cohort study of 555 patients with heart failure were enrolled from July 2018. Advice of CDSM was provided in written form at discharge to all patients. Information regarding CHF-PROM and CDSM were collected during follow-up. Multilevel models were applied to dynamically evaluate the effects of CDSM for CHF-PROM scores, as well as its physical and psychological domains. MCID changes of the PRO were introduced and compared with β values of CDSM obtained from the multi-level models to further evaluate the clinical significance.Results: Scores for CHF-PROM improved significantly after discharge. The multilevel models showed that a regular schedule, avoidance of over-eating, a low-sodium diet and exercise increased scores on CHF-PROM. Compared with the MCID, avoidance of over-eating (12.39 vs. 9.75) and maintenance of a regular schedule often (10.98 vs. 9.75), and exercise almost every day (11.36 vs. 9.75) reached clinical significance for the overall summary. Avoidance of over-eating (5.88 vs. 4.79) and a regular schedule almost every day (4.96 vs. 4.79) reached clinical significance for the physical scores. Avoidance of over-eating half of the time (5.26 vs. 4.87) and a regular schedule almost every day (5.84 vs. 4.87) demonstrated clinical significance for the psychological scores.Conclusions: This study observed an association of avoidance of over-eating and maintenance of a regular schedule with the improvement of CHF-PROM. It provides further evidence for management of heart failure.
Generating Real-world Evidence from Unstructured Clinical Notes to Examine Clinical Utility of Genetic Tests: Use Case in BRCAness
Authors: ZHAO Yiqing , Weroha Saravut J , Goode Ellen , Liu Hongfang , Wang Chen 
Published: December 2020

Abstract
Background: Next-generation sequencing provides comprehensive information about individuals’ genetic makeup and is commonplace in oncology clinical practice. However, the utility of genetic information in clinical decision-making process has not been examined extensively from a real-world, data-driven perspective. Through mining real-world data (RWD) from clinical notes, we could extract patients’ genetic information and further associate treatment decisions with genetic information.Methods: We proposed a real-world evidence (RWE) study framework that incorporates context-based natural language processing (NLP) methods and data quality examination before final association analysis. The framework was demonstrated in a Foundation-tested women cancer cohort (N=196). Upon retrieval of patients’ genetic information using NLP system, we assessed the completeness of genetic data captured in unstructured clinical notes according to a genetic data-model. We examined the distribution of different topics regarding BRCA1/2 throughout patients’ treatment process, and then analyzed the association between BRCA1/2 mutation status and the discussion/prescription of targeted therapy. Results: We identified seven topics in clinical context of genetic mentions including: Information, Evaluation, Insurance, Order, Negative, Positive, and Variants of unknown significance (VUS). Our rule-based system achieved a precision of 0.87, recall of 0.93 and F-measure of 0.91. Our machine learning system achieved a precision of 0.901, recall of 0.899 and F-measure of 0.9 for four-topic classification and a precision of 0.833, recall of 0.823 and F-measure of 0.82 for seven-topic classification. We found in result-containing sentences, capture of BRCA1/2 mutation information was 75%, but detailed variant information (e.g. variant types) is largely missing. Using cleaned RWD, significant associations were found between BRCA1/2 positive mutation and targeted therapies.Conclusions: In conclusion, we demonstrated a framework to generate RWE using RWD from different clinical sources. Rule-based NLP system achieved the best performance for resolving contextual variability when extracting RWD from unstructured clinical notes. Data quality issues such as incompleteness and discrepancies exist thus manual data cleaning is needed before further analysis can be performed. Finally, we were able to use cleaned RWD to evaluate real-world utility of genetic information to initiate a prescription of targeted therapy.