bluuebunny/crossref_metadata_2025_split huggingface dataset:
Changing the eligibility criteria for welfare payments at the end of life – a budget impact analysis for England and Wales
Authors: Webb Edward J. D. , Meads David , Gardiner Clare 
Published: May 2021

Abstract
Background
Terminal illness can cause a financial burden for many households. In England and Wales, fast-track access to welfare payments is available through special rules for the terminally ill (SRTI). Individuals are eligible for SRTI if they are judged to have 6 months or less to live. This criterion has been criticised as lacking a clinical basis, and being unfair for people with conditions where life-expectancy is difficult to accurately assess.

Aim
To conduct a budget impact analysis on the possible increase in expenditure of personal independence payments (PIP) following a change in England and Wales to SRTI so that everyone with a terminal illness is eligible.

Methods
The fraction of individuals with a given long-term condition was estimated by combining data from the Health Survey for England, the Office for National Statistics (ONS) and the Department for Work and Pensions. Logistic growth modelling and ONS population projections were used to project PIP expenditure from 2020 to 2025. The increased expenditure was calculated for hypothetical scenarios which may occur following an SRTI regime change, specifically an increase of 1, 2 and 3 percentage points in the fraction of individuals claiming PIP under SRTI. Data from the literature on the projected prevalence of mild, moderate and severe dementia was used to calculate the cost if everyone with a given severity of dementia claimed PIP under SRTI.

Results
Under the current SRTI regime, PIP expenditure under SRTI was projected to increase from £0.231bn in 2020 to £0.260bn in 2025, compared to equivalent figures of £11.1bn and £12.7bn under non-SRTI. Expenditure in 2025 following an increase in the fraction claiming of 1, 2 and 3 percentage points was projected to be £1.1bn, £1.9bn and £2.7bn respectively. In 2025, PIP expenditure was estimated to be £7.4bn if everyone with dementia claimed under SRTI, compared to £6.4bn if only individuals with moderate and severe dementia claimed, and £4.7bn if only individuals with severe dementia claimed.

Conclusion
Changes in SRTI are projected to lead to increases in PIP expenditure. However, the increased cost is small compared to expenditure under non-SRTI, especially as the highest costs were associated with extreme scenarios.
Barriers to responding to reproductive coercion and abuse among women presenting to Australian primary care
Authors: Wellington Molly , Hegarty Kelsey , Tarzia Laura 
Published: May 2021

Abstract
Background
Reproductive coercion and abuse is defined as any behaviour that seeks to control a woman’s reproductive autonomy. In Australia, women often access reproductive health care through a primary care clinician, however, little is known about clinicians’ experiences responding to reproductive coercion and abuse. This study aims to address this gap by exploring the barriers to responding to reproductive coercion and abuse in Australian primary care.

Methods
In this qualitative study, twenty-four primary care clinicians from diverse clinical settings in primary care across Australia were recruited to participate in a semi-structured interview. Data were analysed thematically.

Results
Through analysis, three themes were developed: It’s not even in the frame; which centred around clinicians lack of awareness around the issue. There’s not much we can do, where clinicians described a lack of confidence in responding correctly as well as a lack of services to refer on to. Lastly There’s no one to help us, explaining the disconnect between referral services and primary care as well as the impacts of lack of abortion on women experiencing reproductive coercion and abuse.

Conclusions
Clinicians expressed similar experiences of barriers to respond to reproductive coercion and abuse. Many clinicians felt ill-equipped to identify and respond to reproductive coercion and abuse. Some clinicians hadn’t received any formal training, others were trained but had nowhere to refer women. Further complicating responses was a lack of support from referral services. This study highlights the need for more training and a streamlined referral pathways for women who experience reproductive coercion and abuse, as well as better access to reproductive health services in rural areas.
The impact of child health interventions and risk factors on child survival in Kenya, 1993–2014: a Bayesian spatio-temporal analysis with counterfactual scenarios
Authors: Macharia Peter M. , Joseph Noel K. , Snow Robert W. , Sartorius Benn , Okiro Emelda A. 
Published: May 2021

AbstractBackgroundDuring the millennium development goals period, reduction in under-five mortality (U5M) and increases in child health intervention coverage were characterised by sub-national disparities and inequities across Kenya. The contribution of changing risk factors and intervention coverage on the sub-national changes in U5M remains poorly defined.MethodsSub-national county-level data on U5M and 43 factors known to be associated with U5M spanning 1993 and 2014 were assembled. Using a Bayesian ecological mixed-effects regression model, the relationships between U5M and significant intervention and infection risk ecological factors were quantified across 47 sub-national counties. The coefficients generated were used within a counterfactual framework to estimate U5M and under-five deaths averted (U5-DA) for every county and year (1993–2014) associated with changes in the coverage of interventions and disease infection prevalence relative to 1993.ResultsNationally, the stagnation and increase in U5M in the 1990s were associated with rising human immunodeficiency virus (HIV) prevalence and reduced maternal autonomy while improvements after 2006 were associated with a decline in the prevalence of HIV and malaria, increase in access to better sanitation, fever treatment-seeking rates and maternal autonomy. Reduced stunting and increased coverage of early breastfeeding and institutional deliveries were associated with a smaller number of U5-DA compared to other factors while a reduction in high parity and fully immunised children were associated with under-five lives lost. Most of the U5-DA occurred after 2006 and varied spatially across counties. The highest number of U5-DA was recorded in western and coastal Kenya while northern Kenya recorded a lower number of U5-DA than western. Central Kenya had the lowest U5-DA. The deaths averted across the different regions were associated with a unique set of factors.ConclusionContributions of interventions and risk factors to changing U5M vary sub-nationally. This has important implications for targeting future interventions within decentralised health systems such as those operated in Kenya. Targeting specific factors where U5M has been high and intervention coverage poor would lead to the highest likelihood of sub-national attainment of sustainable development goal (SDG) 3.2 on U5M in Kenya.
Day time, night time, over time: geographic and temporal uncertainty when linking event and contextual data
Authors: Folch David C. , Fowler Christopher S. , Mikaelian Levon 
Published: May 2021

Abstract
Background
The growth of geolocated data has opened the door to a wealth of new research opportunities in the health fields. One avenue of particular interest is the relationship between the spaces where people spend time and their health outcomes. This research model typically intersects individual data collected on a specific cohort with publicly available socioeconomic or environmental aggregate data. In spatial terms: individuals are represented as points on map at a particular time, and context is represented as polygons containing aggregated or modeled data from sampled observations. Uncertainty abounds in these kinds of complex representations.

Methods
We present four sensitivity analysis approaches that interrogate the stability of spatial and temporal relationships between point and polygon data. Positional accuracy assesses the significance of assigning the point to the correct polygon. Neighborhood size investigates how the size of the context assumed to be relevant impacts observed results. Life course considers the impact of variation in contextual effects over time. Time of day recognizes that most people occupy different spaces throughout the day, and that exposure is not simply a function residential location. We use eight years of point data from a longitudinal study of children living in rural Pennsylvania and North Carolina and eight years of air pollution and population data presented at 0.5 mile (0.805 km) grid cells. We first identify the challenges faced for research attempting to match individual outcomes to contextual effects, then present methods for estimating the effect this uncertainty could introduce into an analysis and finally contextualize these measures as part of a larger framework on uncertainty analysis.

Results
Spatial and temporal uncertainty is highly variable across the children within our cohort and the population in general. For our test datasets, we find greater uncertainty over the life course than in positional accuracy and neighborhood size. Time of day uncertainty is relatively low for these children.

Conclusions
Spatial and temporal uncertainty should be considered for each individual in a study since the magnitude can vary considerably across observations. The underlying assumptions driving the source data play an important role in the level of measured uncertainty.
Coronary lesion complexity in patients with heterozygous familial hypercholesterolemia hospitalized for acute myocardial infarction: data from the RICO survey
Authors: Yao Hermann , Farnier Michel , Tribouillard Laura , Chague Frédéric , Brunel Philippe , Maza Maud , Brunet Damien , Rochette Luc , Bichat Florence , Cottin Yves , Zeller Marianne 
Published: May 2021

Abstract
Background
Although patients with familial heterozygous hypercholesterolemia (FH) have a high risk of early myocardial infarction (MI), the coronary artery disease (CAD) burden in FH patients with acute MI remains to be investigated.

Methods
The data for all consecutive patients hospitalized in 2012–2019 for an acute MI and who underwent coronary angiography were collected from a multicenter database (RICO database). FH (n = 120) was diagnosed using Dutch Lipid Clinic Network criteria (score ≥ 6). We compared the angiographic features of MI patients with and without FH (score 0–2) (n = 234) after matching for age, sex, and diabetes (1:2).

Results
Although LDL-cholesterol was high (208 [174–239] mg/dl), less than half of FH patients had chronic statin treatment. When compared with non-FH patients, FH increased the extent of CAD (as assessed by SYNTAX score; P = 0.005), and was associated with more frequent multivessel disease (P = 0.004), multiple complex lesions (P = 0.022) and significant stenosis location on left circumflex and right coronary arteries. Moreover, FH patients had more multiple lesions, with an increased rate of bifurcation lesions or calcifications (P = 0.021 and P = 0.036, respectively). In multivariate analysis, LDL-cholesterol levels (OR 1.948; 95% CI 1.090–3.480, P = 0.024) remained an independent estimator of anatomical complexity of coronary lesions, in addition to age (OR 1.035; 95% CI 1.014–1.057, P = 0.001).

Conclusions
FH patients with acute MI had more severe CAD, characterized by complex anatomical features that are mainly dependent on the LDL-cholesterol burden. Our findings reinforce the need for more aggressive preventive strategies in these high-risk patients, and for intensive lipid-lowering therapy as secondary prevention.
Motivations, dating app relationships, unintended consequences and change in sexual behaviour in dating app users at an Australian music festival
Authors: Garga Shirali , Thomas Meryl T. , Bhatia Ashneet , Sullivan Aidan , John-Leader Franklin , Pit Sabrina W. 
Published: May 2021

Abstract
Background
Despite the popularity of dating apps, there remain scarce data on the motivations, consequences and their influence on sexual behaviour change in the Australian population.

Objective
To explore motivations, dating app relationships, unintended consequences and change in sexual behaviour in dating app users at an Australian music festival.

Methods
A cross-sectional study design was used. Festival patrons aged 18–30 at a major Australian music festival completed a paper-based survey. Logistic regression was used to identify which factors were associated with an increase in sexual partners since using dating apps.

Results
The primary reasons for dating app use (N = 437) were boredom (59.7%), casual sex (45.1%) and casual dating (42.8%). A third of users used them at music festivals (33.8%, n = 432). A third of participants had used dating apps for more than 2 years (33.3%) and a third (33.0%) of users claimed to have changed their sexual behaviour after app use, including increased frequency of sexual activity (70.0%), number of sexual partners (57.1%) and sexual experimentation (42.1%). Dating app users tended not to discuss sexually transmitted infections (STI) status with a sexual partner regardless of whether they had met them on an app or not: 38.5% would ‘never’ and 36.9% would ‘sometimes’ have safe sex discussions with partners met via apps. Condoms were ‘always’ used for 36.9% of dating app users when meeting partners via dating apps, compared to 29.9% met by other means. 8.6% of dating app users reported having contracted STIs, and 2.8% had unwanted pregnancies with those met on dating apps. After adjusting for socio-demographics, those who had an STI after engaging in sexual activity with a person met via a dating app had 2.4 times the odds of reporting an increase in sexual partners, and those who had used a dating app for over 2 years had twice the odds of reporting an increase in sexual partners. When condom use was entered into the model, those that ‘often’ or ‘sometimes’ used a condom with a new dating app partner were twice as likely to report an increase in sexual partners since using dating apps, compared to those who ‘always’ used a condom with a new dating app partner. Sexual orientation and STI discussions with a new sexual dating app partner were not associated with an increase in dating app partners.

Conclusion
Dating app usage is common and users report increased sexual activity, sexual partners and experimentation. STI discussions with potential partners and condom use remained low regardless of how partners were met and despite an increase in sexual partners since using dating apps. Given the high-risk nature of individuals that utilise dating apps, safe sex discussion, including STIs, pregnancies and condom use should be promoted to improve sexual health outcomes.
CMV infection, CD19+ B cell depletion, and Lymphopenia as predictors for unexpected admission in the institutionalized elderly
Authors: Chen Liang-Yu , Hwang An-Chun , Huang Chung-Yu , Chen Liang-Kung , Wang Fu-Der , Chan Yu-Jiun 
Published: May 2021

AbstractBackgroundChronic infections played a detrimental role on health outcomes in the aged population, and had complex associations with lymphocyte subsets distribution. Our study aimed to explore the predictive roles of chronic infections, lymphopenia, and lymphocyte subsets on unexpected admission and mortality in the institutionalized oldest-old during 3 year follow-up period.ResultsThere were 163 participants enrolled prospectively with median age of 87.3 years (IQR: 83.1–90.2), male of 88.3%, and being followed for 156.4 weeks (IQR: 136.9–156.4 weeks). The unexpected admission and mortality rates were 55.2 and 24.5% respectively. The Cox proportional hazards models demonstrated the 3rd quartile of cytomegalovirus IgG (OR: 3.26, 95% CI: 1.55–6.84), lymphopenia (OR: 2.85, 95% CI: 1.2–6.74), and 1st quartile of CD19+B cell count (OR: 2.84, 95% CI: 1.29–6.25) predicted elevated risks of unexpected admission after adjusting for potential confounders; while the 3rd quartile of CD3+T cell indicated a reduced risk of mortality (OR: 0.19, 95% CI: 0.05–0.71). Negative association between CMV IgG and CD19+B cell count suggested that CMV infection might lead to B cell depletion via decreasing memory B cells repertoire.ConclusionsCMV infection, lymphopenia, and CD19+B cell depletion might predict greater risk of unexpected admission, while more CD3+T cell would suggest a reduced risk of mortality among the oldest-old population. A non-linear or U-shaped relationship was supposed between health outcomes and CMV infection, CD3+T cell, or CD19+B cell counts. Further prospective studies with more participants included would be needed to elucidate above findings.
Benefit of replanning in MR-guided online adaptive radiation therapy in the treatment of liver metastasis
Authors: Mayinger Michael , Ludwig Roman , Christ Sebastian M. , Dal Bello Riccardo , Ryu Alex , Weitkamp Nienke , Pavic Matea , Garcia Schüler Helena , Wilke Lotte , Guckenberger Matthias , Unkelbach Jan , Tanadini-Lang Stephanie , Andratschke Nicolaus 
Published: May 2021

Abstract
Purpose
To assess the effects of daily adaptive MR-guided replanning in stereotactic body radiation therapy (SBRT) of liver metastases based on a patient individual longitudinal dosimetric analysis.

Methods
Fifteen patients assigned to SBRT for oligometastatic liver metastases underwent daily MR-guided target localization and on-table treatment plan re-optimization. Gross tumor volume (GTV) and organs at risk (OARs) were adapted to the anatomy-of-the-day. A reoptimized plan (RP) and a rigidly shifted baseline plan (sBP) without re-optimization were generated for each fraction. After extraction of DVH parameters for GTV, planning target volume (PTV), and OARs (stomach, duodenum, bowel, liver, heart) plans were compared on a per-patient basis.

Results
Median pre-treatment GTV and PTV were 14.9 cc (interquartile range (IQR): 7.7–32.9) and 62.7 cc (IQR: 42.4–105.5) respectively. SBRT with RP improved PTV coverage (V100%) for 47/75 of the fractions and reduced doses to the most proximal OARs (D1cc, Dmean) in 33/75 fractions compared to sBP. RP significantly improved PTV coverage (V100%) for metastases within close proximity to an OAR by 4.0% (≤ 0.2 cm distance from the edge of the PTV to the edge of the OAR; n = 7; p = 0.01), but only by 0.2% for metastases farther away from OAR (> 2 cm distance; n = 7; p = 0.37). No acute grade 3 treatment-related toxicities were observed.

Conclusions
MR-guided online replanning SBRT improved target coverage and OAR sparing for liver metastases with a distance from the edge of the PTV to the nearest luminal OAR < 2 cm. Only marginal improvements in target coverage were observed for target distant to critical OARs, indicating that these patients do not benefit from daily adaptive replanning.
Improving metagenomic binning results with overlapped bins using assembly graphs
Authors: Mallawaarachchi Vijini G. , Wickramarachchi Anuradha S. , Lin Yu 
Published: May 2021

Abstract
Background
Metagenomic sequencing allows us to study the structure, diversity and ecology in microbial communities without the necessity of obtaining pure cultures. In many metagenomics studies, the reads obtained from metagenomics sequencing are first assembled into longer contigs and these contigs are then binned into clusters of contigs where contigs in a cluster are expected to come from the same species. As different species may share common sequences in their genomes, one assembled contig may belong to multiple species. However, existing tools for binning contigs only support non-overlapped binning, i.e., each contig is assigned to at most one bin (species).

Results
In this paper, we introduce GraphBin2 which refines the binning results obtained from existing tools and, more importantly, is able to assign contigs to multiple bins. GraphBin2 uses the connectivity and coverage information from assembly graphs to adjust existing binning results on contigs and to infer contigs shared by multiple species. Experimental results on both simulated and real datasets demonstrate that GraphBin2 not only improves binning results of existing tools but also supports to assign contigs to multiple bins.

Conclusion
GraphBin2 incorporates the coverage information into the assembly graph to refine the binning results obtained from existing binning tools. GraphBin2 also enables the detection of contigs that may belong to multiple species. We show that GraphBin2 outperforms its predecessor GraphBin on both simulated and real datasets. GraphBin2 is freely available at https://github.com/Vini2/GraphBin2.
COVID-19 in conflict border regions: a case of South Kordofan, Sudan
Authors: Sserwanja Quraish , Adam Mohammed Bashir , Kawuki Joseph , Olal Emmanuel 
Published: May 2021

AbstractThe novel coronavirus disease (COVID-19) was first reported in Sudan on 13 March 2020. Since then, Sudan has experienced one of the highest rates of COVID-19 spread and fatalities in Africa. One year later, as per 22 March 2021, Sudan had registered 29,661 confirmed cases and 2,028 deaths with a case fatality rate (CFR) of 6.8 %. By 12 December 2020, of the 18 states in Sudan, South Kordofan had the fifth highest CFR of 17.4 %, only surpassed by the other conflict affected North (57.5 %), Central (50.0 %) and East (31.8 %) Darfur States. By late March 2021, just three months from December 2020, the number of cases in South Kordofan increased by 100 %, but with a significant decline in the CFR from 17.4 to 8.5 %. South Kordofan is home to over 200,000 poor and displaced people from years of destructive civil unrests. To date, several localities such as the Nubba mountains region remain under rebel control and are not accessible. South Kordofan State Ministry of Health in collaboration with the federal government and non-governmental organizations set up four isolation centres with 40 total bed capacity, but with only two mechanical ventilators and no testing centre. There is still need for further multi-sectoral coalition and equitable allocation of resources to strengthen the health systems of rural and conflict affected regions. This article aims at providing insight into the current state of COVID-19 in South Kordofan amidst the second wave to address the dearth of COVID-19 information in rural and conflict affected regions.
Role of epigenetics in unicellular to multicellular transition in Dictyostelium
Authors: Wang Simon Yuan , Pollina Elizabeth Ann , Wang I-Hao , Pino Lindsay Kristina , Bushnell Henry L. , Takashima Ken , Fritsche Colette , Sabin George , Garcia Benjamin Aaron , Greer Paul Lieberman , Greer Eric Lieberman 
Published: May 2021

Abstract
Background
The evolution of multicellularity is a critical event that remains incompletely understood. We use the social amoeba, Dictyostelium discoideum, one of the rare organisms that readily transits back and forth between both unicellular and multicellular stages, to examine the role of epigenetics in regulating multicellularity.

Results
While transitioning to multicellular states, patterns of H3K4 methylation and H3K27 acetylation significantly change. By combining transcriptomics, epigenomics, chromatin accessibility, and orthologous gene analyses with other unicellular and multicellular organisms, we identify 52 conserved genes, which are specifically accessible and expressed during multicellular states. We validated that four of these genes, including the H3K27 deacetylase hdaD, are necessary and that an SMC-like gene, smcl1, is sufficient for multicellularity in Dictyostelium.

Conclusions
These results highlight the importance of epigenetics in reorganizing chromatin architecture to facilitate multicellularity in Dictyostelium discoideum and raise exciting possibilities about the role of epigenetics in the evolution of multicellularity more broadly.