bluuebunny/crossref_metadata_2025_split huggingface dataset:
Utilization, Timing, and Outcomes of BRCA Genetic Testing Among Women With Newly Diagnosed Breast Cancer From a National Commercially Insured Population: The ABOARD Study
Authors: Armstrong Joanne , Lynch Kristian , Virgo Katherine S. , Schwartz Marc D. , Friedman Sue , Dean Marleah , Andrews James E. , Bourquardez Clark Elizabeth , Clasen Joanna , Conaty Jessica , Parrillo Olivia , Sutphen Rebecca 
Published: February 2021

PURPOSE:To evaluate timing and outcomes of BRCA testing and definitive surgical treatment among patients with newly diagnosed breast cancer.METHODS:Patient-reported (n = 1,381) and deidentified health-plan (n = 2,369) data were analyzed from a consecutive national series of 3,750 women whose healthcare providers ordered BRCA testing between March 2014 and June 2015, within 1 year following breast cancer diagnosis.RESULTS:Among 1,209 respondents, 54.4% received the genetic test results presurgery, 23.2% tested presurgery but received the results postsurgery, and 22.3% tested postsurgery. Patients aware of mutation-positive results presurgery were more likely to choose bilateral mastectomy (BLM) (n = 32/37) compared with patients who learned of positive results postsurgery (n = 14/32), (odds ratio [OR] = 8.23, 95% CI = 2.55 to 26.59, P < .001). When compared with women tested postsurgery, only women unaware of negative results presurgery had higher BLM rates (adjusted OR = 1.70, 95% CI = 1.07 to 2.69, P = .02). Among women > 50 tested presurgery, those unaware of negative results presurgery were more likely to choose BLM (n = 28/81) compared with those aware of negative results (n = 32/168) (OR = 2.25, 95% CI = 1.23 to 4.08, negative results awareness × age interaction, and P = .007).CONCLUSION:Nearly half of participants did not receive BRCA results presurgery, which limited their ability to make fully informed surgical treatment decisions. This may represent suboptimal care for unaware mutation-positive patients compared with those who were aware presurgery. Women > 50 who test negative are significantly less likely to choose BLM, a costly surgery that does not confer survival advantage, if they are aware of negative results presurgery. These results have important implications for quality of care and costs in the US health system.
Patient Perspectives on the Financial Costs and Burdens of Breast Cancer Surgery
Authors: Oshima Sachiko M. , Tait Sarah D. , Rushing Christel , Lane Whitney , Hyslop Terry , Offodile Anaeze C. , Wheeler Stephanie B. , Zafar S. Yousuf , Greenup Rachel , Fish Laura J. 
Published: February 2021

PURPOSE:Although financial toxicity is a well-documented aspect of cancer care, little is known about how patients narratively characterize financial experiences related to breast cancer treatment. We sought to examine these patient experiences through mixed methods analysis.METHODS:Women (≥ 18 years old) with a history of breast cancer were recruited from the Love Research Army and Sisters Network to complete an 88-item electronic survey including an open-ended response. Quantitative data were used to sort and stratify responses to the open-ended question, which comprised the qualitative data evaluated here. Descriptive statistics and qualitative content analysis were used to evaluate the financial costs and other burdens resulting from breast cancer surgery.RESULTS:In total, 511 respondents completed the survey in its entirety and wrote an open-ended response. Participants reported significant financial burden in different categories including direct payments for medical care and indirect costs such as lost wages and travel expenses. Treatment-related costs burdened participants for years after diagnosis, forming a financial arc for many participants. Discrepancies existed between the degree of financial burden reported on multiple-choice questions and participants’ corresponding open-ended descriptions of financial burden. Participants described a lack of communication surrounding costs with their providers and difficulty negotiating payments with insurance.CONCLUSION:Breast cancer care can result in ongoing financial burden years after diagnosis among all patients, even those with adequate insurance patient populations.
Association of Metformin with Susceptibility to COVID-19 in People with Type 2 Diabetes
Authors: Wang Jingya , Cooper Jennifer M , Gokhale Krishna , Acosta-Mena Dionisio , Dhalla Samir , Byne Nathan , Chandan Joht Singh , Anand Astha , Okoth Kelvin , Subramanian Anuradhaa , Bangash Mansoor N , Jackson Thomas , Zemedikun Dawit , Taverner Tom , Hanif Wasim , Ghosh Sandip , Narendran Parth , Toulis Konstantinos A , Tahrani Abd A , Surenthirakumaran Rajendra , Adderley Nicola J , Haroon Shamil , Khunti Kamlesh , Sainsbury Christopher , Thomas G Neil , Nirantharakumar Krishnarajah 
Published: February 2021

Abstract

Objective
Diabetes has emerged as an important risk factor for mortality from COVID-19. Metformin, the most commonly prescribed glucose-lowering agent, has been proposed to influence susceptibility to and outcomes of COVID-19 via multiple mechanisms. We investigated whether, in patients with diabetes, metformin is associated with susceptibility to COVID-19 and its outcomes.

Research Design and Methods
We performed a propensity score–matched cohort study with active comparators using a large UK primary care dataset. Adults with type 2 diabetes patients and a current prescription for metformin and other glucose-lowering agents (MF+) were compared to those with a current prescription for glucose-lowering agents that did not include metformin (MF−). Outcomes were confirmed COVID-19, suspected/confirmed COVID-19, and associated mortality. A negative control outcome analysis (back pain) was also performed.

Results
There were 29 558 and 10 271 patients in the MF+ and MF− groups, respectively, who met the inclusion criteria. In the propensity score–matched analysis, the adjusted hazard ratios for suspected/confirmed COVID-19, confirmed COVID-19, and COVID-19-related mortality were 0.85 (95% CI 0.67, 1.08), 0.80 (95% CI 0.49, 1.30), and 0.87 (95% CI 0.34, 2.20) respectively. The negative outcome control analysis did not suggest unobserved confounding.

Conclusion
Current prescription of metformin was not associated with the risk of COVID-19 or COVID-19-related mortality. It is safe to continue prescribing metformin to improve glycemic control in patients with.
Under-reported COVID-19 cases in South Asian countries
Authors: Khan Soban Qadir , Moheet Imran Alam , Farooqi Faraz Ahmed , Alhareky Muhanad , Alonaizan Faisal 
Published: February 2021

Background: The purpose of the study was to compare trends in the progression of COVID-19 among South Asian countries with more developed Western countries. Methods: COVID-19 data from South Asian countries were used for this observational study. Data were taken up to April 21, 2020 from the outbreak of the COVID-19. Four of the seven countries met the inclusion criteria and were included in the analysis. Results: An exponential increase in the average number of weekly cases was reported after the fifth week following the first case. The correlation between reported cases and tests was found to be strong and significant (r=0.90, p=0.037). However, on average, 315.25 tests per million population were performed, which was at least 12 times lower than the number of tests performed in countries with a large number of COVID-19 cases. Conclusions: At present, the number of confirmed cases from South Asia was found to be significantly lower than in Western countries. However, this could be due to the smaller number of tests performed. Hence, an increase in the strength of performing diagnostic tests is highly recommended. Strict measures are required to make the people of these countries follow the instructions of social distancing and comply with preventive measures.
Recommendations from long-term care reports, commissions, and inquiries in Canada
Authors: Wong Eric K. C. , Thorne Trina , Estabrooks Carole , Straus Sharon E. 
Published: February 2021

Background:Multiple long-term care (LTC) reports have issued similar recommendations for improvement across Canadian LTC homes. Our primary objective was to identify the most common recommendations made over the past 10 years. Our secondary objective was to estimate the total cost of studying LTC issues repeatedly from 1998 to 2020.Methods:The qualitative and cost analyses were conducted in Canada from July to October 2020. Using a list of reports, inquiries and commissions from The Royal Society of Canada Working Group on Long-Term Care, we coded recurrent recommendations in LTC reports. We contacted the sponsoring organizations for a cost estimate, including direct and indirect costs. All costs were adjusted to 2020 Canadian dollar values.Results:Of the 80 Canadian LTC reports spanning the years of 1998 to 2020, 24 (30%) were based on a national level and 56 (70%) were focused on provinces or municipalities. Report length ranged from 4 to 1491 pages and the median number of contributors was 14 (interquartile range, IQR, 5–26) per report. The most common recommendation was to increase funding to LTC to improve staffing, direct care and capacity (67% of reports). A median of 8 (IQR 3.25–18) recommendations were made per report. The total cost for all 80 reports was estimated to be $23,626,442.78.Conclusions:Problems in Canadian LTC homes and their solutions have been known for decades. Despite this, governments and non-governmental agencies continue to produce more reports at a monetary and societal cost to Canadians.
Evolución antropojurídica y sociojurídica de la mediación y las prácticas reconciliatorias
Authors: Moreno Buján Marcela 
Published: February 2021

El presente artículo visibiliza el uso de la mediación y las prácticas reconciliatorias (PRs) para tratar los conflictos sociales de forma autocompositiva en distintas culturas. La identificación de estos procesos, de forma diacrónica, es posible al aplicar una perspectiva antropojurídica y sociojurídica (PAS) al fenómeno de estudio. Esto por cuanto es frecuente analizarlos desde un abordaje técnico-jurídico disciplinar, lo cual descuida los contextos: social, histórico, cultural, político y plurijurídico en los cuales también pueden verse inmersos estos procesos.
Adoptar el paradigma antropojurídico enunciado por Merry, permite separarse de la forma jurídica heterocompositiva hegemónica (el juicio) para intervenir los conflictos sociales. También, habilita la percepción de las disputas desde una concepción dinámica e influenciable por los cambios sociales.
Así, se analizarán los procesos mencionados desde la PAS. Lo cual permite considerar como mediadores efectivos a aquellos neutrales que tienen la habilidad de trabajar con las partes de manera transcultural. La PAS habilita entrever en los procesos autocompositivos, las experiencias, motivaciones, razones y patrones de conducta presentes en la disputa, sobrepasando los límites culturales para arribar a un espacio de entendimiento recíproco. Este abordaje conlleva un claro acceso a la justicia con perspectiva multicultural y plurijurídica.
LGBTQ+ people living with dementia: an under-served population
Authors: Cousins Emily , De Vries Kay , Dening Karen Harrison 
Published: February 2021

Background: Lesbian, gay, bisexual, transgender and queer (LGBTQ+) people living with dementia are an under-served population. They are often at greater risk of vulnerability, discrimination, loneliness, health inequalities and poorer health outcomes. Aims: The aim of this applied practice paper was to produce an introductory summary of some of the challenges and considerations facing LGBTQ+ people living with dementia. This is the second in a series of clinical articles on dementia in underserved populations. Methods: A literature overview was undertaken comprising a number of literature searches. Salient academic articles, policy papers and third sector reports were analysed to identify themes. Findings: Three main themes emerged from the analysis regarding LGBTQ+ people living with dementia: an increasing awareness of needs; challenges and considerations; and recommendations for improving practice and care. Conclusions: Challenges and considerations facing LGBTQ+ people living with dementia include living with memory problems, remembering the past, reminiscence, personal relationships and receiving care. Recommendations include comprehensive training for health and care professionals, as well as strengthened peer support networks. Areas for future research to fully understand the needs of this under-served population are also suggested.
Identification of Longjing Teas with Different Geographic Origins Based on E-Nose and Computer Vision System Combined with Data Fusion Strategies
Authors: Xu Min , Wang Jun , Jia Pengfei , Dai Yuting 
Published: February 2021

HighlightsE-nose and computer vision combined with data fusion strategies were applied to trace tea origins.Pearson correlation analysis, IG, and F-scores were applied to modify the fusion strategies.The classification performances of different fusion strategies were compared.The strategies of IG_SVM_FL and IG_SVM_DS achieved the best results.Abstract. The traceability of tea origins is of great significance. In this study, an electronic nose (E-nose) and computer vision system (CVS) were jointly applied to acquire aroma and image signals of tea samples, aiming at identifying Longjing teas from different geographic origins including Jinyun (120° 7' E, 28° 65' N), Xihu (120° 13' E, 30° 27' N), Xinchang (120° 9' E, 29° 50' N), and Qian Daohu (119° 3' E, 29° 60' N). Data fusion was used to integrate the E-nose and CVS signals for comprehensively characterizing the tea samples. Four traditional fusion strategies including k-nearest neighbors (KNN) and support vector machine (SVM) based feature-level fusion (KNN_FL and SVM_FL) and Dempster-Shafer (D-S) evidence theory based decision-level strategies (KNN_DS and SVM_DS) were applied for classification modeling. Pearson analysis, information gain (IG), and F-scores were employed to modify the traditional fusion strategies to reduce inconsistent and redundant information in the fusion process. The results indicated that the original fusion strategies had no superiority over independent E-nose and CVS decision-making. With the feature selection methods, the modified fusion strategies generally exhibited better performance than the independent decision-making and original fusion strategies. Moreover, the IG-based fusion strategies, encompassing IG_SVM_FL and IG_SVM_DS, achieved the highest classification accuracy of 100%. Keywords: Computer vision, Electronic nose, Feature selection, Fusion strategies, Tea origins.
Progress towards onchocerciasis elimination in Côte d’Ivoire: A geospatial modelling study
Authors: Eneanya Obiora A. , Koudou Benjamin G. , Aboulaye Meite , Elvis Aba Ange , Souleymane Yeo , Kouakou Marie-Madeleine , Weil Gary J. , Fischer Peter U. 
Published: February 2021

Background
Côte d’Ivoire has had 45 years of intervention for onchocerciasis by vector control (from 1975 to 1991), ivermectin mass drug administration (MDA) (from 1992 to 1994) and community directed treatment with ivermectin (CDTi) from 1995 to the present. We modeled onchocerciasis endemicity during two time periods that correspond to the scale up of vector control and ivermectin distribution, respectively. This analysis illustrates progress towards elimination during these periods, and it has identified potential hotspots areas that are at risk for ongoing transmission.

Methods and findings
The analysis used Ministry of Health skin snip microfilaria (MF) prevalence and intensity data collected between 1975 and 2016. Socio-demographic and environmental factors were incorporated into a predictive, machine learning algorithm to create continuous maps of onchocerciasis endemicity. Overall predicted mean MF prevalence decreased from 51.8% circa 1991 to 3.9% circa 2016. The model predicted infection foci with higher prevalence in the southern region of the country. Predicted mean community MF load (CMFL) decreased from 10.1MF/snip circa 1991 to 0.1MF/snip circa 2016. Again, the model predicts foci with higher Mf densities in the southern region. For assessing model performance, the root mean squared error and R2 values were 1.14 and 0.62 respectively for a model trained with data collected prior to 1991, and 1.28 and 0.57 for the model trained with infection survey data collected later, after the introduction of ivermectin. Finally, our models show that proximity to permanent inland bodies of water and altitude were the most informative variables that correlated with onchocerciasis endemicity.

Conclusion/Significance
This study further documents the significant reduction of onchocerciasis infection following widespread use of ivermectin for onchocerciasis control in Côte d’Ivoire. Maps produced predict areas at risk for ongoing infection and transmission. Onchocerciasis might be eliminated in Côte d’Ivoire in the future with a combination of sustained CDTi with high coverage, active surveillance, and close monitoring for persistent infection in previously hyper-endemic areas.
What do blind people “see” with retinal prostheses? Observations and qualitative reports of epiretinal implant users
Authors: Erickson-Davis Cordelia , Korzybska Helma 
Published: February 2021

IntroductionRetinal implants have now been approved and commercially available for certain clinical populations for over 5 years, with hundreds of individuals implanted, scores of them closely followed in research trials. Despite these numbers, however, few data are available that would help us answer basic questions regarding the nature and outcomes of artificial vision: what do recipients see when the device is turned on for the first time, and how does that change over time?MethodsSemi-structured interviews and observations were undertaken at two sites in France and the UK with 16 recipients who had received either the Argus II or IRIS II devices. Data were collected at various time points in the process that implant recipients went through in receiving and learning to use the device, including initial evaluation, implantation, initial activation and systems fitting, re-education and finally post-education. These data were supplemented with data from interviews conducted with vision rehabilitation specialists at the clinical sites and clinical researchers at the device manufacturers (Second Sight and Pixium Vision). Observational and interview data were transcribed, coded and analyzed using an approach guided by Interpretative Phenomenological Analysis (IPA).ResultsImplant recipients described the perceptual experience produced by their epiretinal implants as fundamentally, qualitatively different than natural vision. All used terms that invoked electrical stimuli to describe the appearance of their percepts, yet the characteristics used to describe the percepts varied significantly between recipients. Artificial vision for these recipients was a highly specific, learned skill-set that combined particular bodily techniques, associative learning and deductive reasoning in order to build a “lexicon of flashes”—a distinct perceptual vocabulary that they then used to decompose, recompose and interpret their surroundings. The percept did not transform over time; rather, the recipient became better at interpreting the signals they received, using cognitive techniques. The process of using the device never ceased to be cognitively fatiguing, and did not come without risk or cost to the recipient. In exchange, recipients received hope and purpose through participation, as well as a new kind of sensory signal that may not have afforded practical or functional use in daily life but, for some, provided a kind of “contemplative perception” that recipients tailored to individualized activities.ConclusionAttending to the qualitative reports of implant recipients regarding the experience of artificial vision provides valuable information not captured by extant clinical outcome measures.
Evaluation of COVID-19 related knowledge and preparedness in health professionals at selected health facilities in a resource-limited setting in Addis Ababa, Ethiopia
Authors: Desalegn Zelalem , Deyessa Negussie , Teka Brhanu , Shiferaw Welelta , Yohannes Meron , Hailemariam Damen , Addissie Adamu , Abagero Abdulnasir , Kaba Mirgissa , Abebe Workeabeba , Abrha Alem , Nega Berhanu , Ayele Wondimu , Haile Tewodros , Gebrehiwot Yirgu , Amogne Wondwossen , Kantelhardt Eva Johanna , Abebe Tamrat 
Published: February 2021

Background
The World Health Organization has declared that infection with SARS-CoV-2 is a pandemic. Experiences with SARS in 2003 and SARS-CoV-2 have shown that health professionals are at higher risk of contracting COVID-19. Hence, it has been recommended that aperiodic wide-scale assessment of the knowledge and preparedness of health professionals regarding the current COVID-19 pandemic is critical.

Objectives
This study aimed to assess the knowledge and preparedness of health professionals regarding COVID-19 among selected hospitals in Addis Ababa, Ethiopia.

Methods
A facility-based cross-sectional study was conducted from the last week of March to early April, 2020. Government (n = 6) and private hospitals (n = 4) were included. The front-line participants with high exposure were proportionally recruited from their departments. The collected data from a self-administered questionnaire were entered using EpiData and analyzed in SPSS software. Both descriptive statistics and inferential statistics (chi-square tests) are presented.

Results
A total of 1334 health professionals participated in the study. The majority (675, 50.7%) of the participants were female. Of the total, 532 (39.9%) subjects were nurses/midwives, followed by doctors (397, 29.8%) and pharmacists (193, 14.5%). Of these, one-third had received formal training on COVID-19. The mean knowledge score of participants was 16.45 (±4.4). Regarding knowledge about COVID-19, 783 (58.7%), 354 (26.5%), and 196 (14.7%) participants had moderate, good, and poor knowledge, respectively. Lower scores were seen in younger age groups, females, and non-physicians. Two-thirds (63.2%) of the subjects responded that they had been updated by their hospital on COVID-19. Of the total, 1020 (76.5%) participants responded that television, radio, and newspapers were their primary sources of information. Established hospital preparedness measures were confirmed by 43–57% of participants.

Conclusion
The current study revealed that health professionals in Addis Ababa, Ethiopia, already know important facts but had moderate overall knowledge about the COVID-19 pandemic. There were unmet needs in younger age groups, non-physicians, and females. Half of the respondents mentioning inadequate preparedness of their hospitals point to the need for more global solidarity, especially concerning the shortage of consumables and lack of equipment.