bluuebunny/crossref_metadata_2025_split huggingface dataset:
Anti-corruption in global health systems: using key informant interviews to explore anti-corruption, accountability and transparency in international health organisations
Authors: Gorodensky Ariel , Bowra Andrea , Saeed Gul , Kohler Jillian 
Published: December 2022

ObjectivesCorruption undermines the quality of healthcare and leads to inequitable access to essential health products. WHO, Global Fund, United Nations Development Programme (UNDP) and World Bank are engaged in anti-corruption in health sectors globally. Throughout the COVID-19 pandemic, weakened health systems and overlooked regulatory processes have increased corruption risks. The objective of this study is thus to explore the strengths and weaknesses of these organisations’ anti-corruption mechanisms and their trajectories since the pandemic began.Design, setting and participants25 semistructured key informant interviews with a total of 27 participants were conducted via Zoom between April and July 2021 with informants from WHO, World Bank, Global Fund and UNDP, other non-governmental organisations involved in anti-corruption and academic institutions. Key informant selection was guided by purposive and snowball sampling. Detailed interview notes were qualitatively coded by three researchers. Data analysis followed an inductive-deductive hybrid thematic analysis framework.ResultsThe findings demonstrate that WHO, World Bank, Global Fund and UNDP have shifted from criminalisation/punitive approaches to anti-corruption to preventative ones and that anti-corruption initiatives are strong when they are well funded, explicitly address corruption and are complemented by strong monitoring and evaluation mechanisms. Weaknesses in the organisations’ approaches to anti-corruption include one-size-fits-all approaches, lack of political will to address corruption and zero-tolerance policies for corruption. The COVID-19 pandemic has highlighted the necessity of improving anti-corruption by promoting strong accountability and transparency in health systems.ConclusionsResults from this study highlight the strengths, weaknesses and recent trajectories of anti-corruption in the Global Fund, World Bank, UNDP and WHO. This study underscores the importance of implementing strong and robust anti-corruption mechanisms specifically geared towards corruption prevention that remain resilient even in times of emergency.
Correlation between the ratio of physician consultation fees to hourly minimum wage and consultation length: a cross-sectional study of nine countries
Authors: Kim Ju-Ryoung , Byun Se-Jin , Son Dae-Soon , Kim Hyun Ah 
Published: December 2022

ObjectivesCurrent healthcare reimbursement system is criticised for not adequately compensating physicians’ cognitive services. This study was performed to examine primary care physicians’ consultation fees in nine countries, relative to the national hourly minimum wage and to examine the correlations of the physician consultation fee with consultation length and other healthcare indices.Design and outcome measuresNine reference countries for which healthcare statistics are publicly available and outpatient consultation is compensated by fee-for-service payment were selected. A representative consultation fee was chosen to calculate the ratio of the consultation fee to the hourly minimum wage. The primary outcome was the correlation between the consultation fee/hourly minimum wage ratio and consultation length. In addition, the consultation fees were compared with fees for haemoglobin A1c tests and brain imaging. Pearson’s method was primarily used for correlation analysis.ResultsThe mean representative consultation fee/hourly minimum wage ratio was 4.02 (median, 2.7; range, 0.80–10.36). The mean consultation length was 12.9 min (median, 14.7 min; range, 5–21.1 min). A significant correlation (r=0.79) was found between consultation length and the consultation fee/hourly minimum wage ratio. The ratio of consultation fee to hourly minimum wage was moderately negatively correlated with the annual number of physician visits, number of consultations per doctor and length of hospital stay. The brain CT fee/consultation fee ratio was moderately positively correlated with the number of CT units per 1 million population. In Japan and Korea, where the brain CT/consultation fee ratio was highest, the number of CT examinations per population was also highest.ConclusionsThe relationship of consultation fees to each country’s hourly minimum wage varied in nine reference countries; however, it was strongly correlated with consultation length. The imbalance in compensation for cognitive services might drive increased use of imaging tests in some countries.
Comanagement with rheumatology and prescription biologics filled during pregnancy in women with rheumatic diseases: a retrospective analysis of US administrative claims data
Authors: Shridharmurthy Divya , Lapane Kate L , Baek Jonggyu , Nunes Anthony , Kay Jonathan , Liu Shao-Hsien 
Published: December 2022

ObjectivesTo evaluate comanagement with rheumatology and biological prescriptions filled during pregnancy among women with axial spondyloarthritis (axSpA), rheumatoid arthritis (RA) or psoriatic arthritis (PsA) and to examine factors associated with receiving comanagement with rheumatology during pregnancy.DesignA retrospective analysis of US claims data.SettingCommercially insured enrollees using data from the 2013–2018 IBM MarketScan Commercial Claims and Encounters Database.ParticipantsWe identified 4131 pregnant women aged ≤55 years from the 2013–2018 IBM MarketScan Commercial Claims and Encounters Database with an International Classification of Disease, 9th Revision/10th Revision codes for RA, axSpA or PsA, with continuous enrolment at ≥3 months before the date of the last menstrual period (LMP) (index date) and throughout pregnancy.Primary outcomesFilled biologics (prescriptions and infusions) claims were categorised by 90 days before the LMP and trimester, as were primary care, obstetrician and rheumatological claims.ResultsThe prevalence of axSpA, RA and PsA was 0.7%, 0.2% and 0.04% among reproductive age women. The average maternal age was 32.7 years (SD 5.7). During pregnancy, 9.1% of those with axSpA (n=2,410) and 56.4% of those with RA/PsA (n=1,721) had a rheumatological claim. Biologics claims were less common among those with axSpA (90 days before LMP: 1.6%, during pregnancy: 1.1%) than those with RA/PsA (90 days before LMP: 11.9%, during pregnancy: 6.9%). Medications during pregnancy included corticosteroids (axSpA: 0.3%, RA/PsA: 2.2%), non-biological disease-modifying antirheumatic drugs (axSpA: 0.2%, RA/PsA: 1.7%), non-steroidal anti-inflammatory drugs (axSpA: 0.2%, RA/PsA: 1.3%) and opioids (axSpA: 0.2%, RA/PsA: 0.6%). Established rheumatological care and biologics claims during the 90 days before LMP showed good prediction accuracy for receiving comanagement with rheumatology during pregnancy (axSpA: area under the receiver operator curve (AUC) 0.73, RA/PsA: AUC 0.70).ConclusionComanagement with rheumatology during pregnancy occurs infrequently, especially for women with axSpA. Biologics claims during pregnancy may not align with published guidelines. Future research is warranted to improve comanagement with rheumatology during pregnancy.
Symptom descriptors and patterns in lumbar radicular pain caused by disc herniation: a 1-year longitudinal cohort study
Authors: Hasvik Eivind , Haugen Anne Julsrud , Grøvle Lars 
Published: December 2022

ObjectiveThe objective of the present study was to explore the diversity, quality, severity and distribution of symptoms in patients with radicular pain and a lumbar disc herniation.DesignLongitudinal cohort study.SettingHospital-based back clinic.ParticipantsNinety patients referred to secondary healthcare with (a) low back-related leg pain, (b) age between 18 and 65 years and (c) MRI confirmed lumbar disc herniation at a relevant side and level.Outcome measuresNeuropathic pain symptoms were assessed using the Short-Form McGill Pain Questionnaire-2 (SF-MPQ-2) and the painDETECT Questionnaire. In a subsample classified with neuropathic pain, in-depth interviews were performed, and symptomatic areas were drawn on standardised body charts.ResultsAt baseline, the most frequently used painDETECT symptom descriptor was numbness sensation, reported by 94%, followed by sudden pain attacks and tingling or prickling. The mean (SD) SF-MPQ-2 score (0–10) for aching pain was 5.9 (2.8); numbness 4.3 (3.3); tingling 4.0 (3.4); burning 2.6 (3.1); pain caused by light touch 1.5 (2.6). Leg pain was rated as extremely bothersome by 73%, numbness and tingling by 38%, weakness by 24% and back pain by 17%. In the subsample (n=52), deep-lying pain and non-painful abnormal sensations were frequent, at 71% and 85%. Drawings demonstrated substantial overlap between symptoms from compromised L5 and the S1 nerve roots. Painful and non-painful symptoms improved at approximately the same rate. At the 1-year follow-up, 45% (14/31) of patients who had received disc surgery, and 34% (18/53) of those who had received conservative treatment reported no bothersome back pain, leg pain, numbness/tingling or weakness.ConclusionPatients reported several highly bothersome symptoms, but not all are described as painful. The overall symptom profile of lumbar disc-related radicular pain differs from other neuropathic pain conditions with limited allodynia and thermal hyperalgesia. Symptomatic areas for the L5 and S1 nerve roots have a large overlap.
Evidence-based guidelines for hypertension and diabetes in sub-Saharan Africa: a scoping review
Authors: Nagavci Blin , Nyirenda John L Z , Balugaba Bonny E , Osuret Jimmy , Meerpohl Joerg J , Grummich Kathrin , Kobusingye Olive , Toews Ingrid 
Published: December 2022

ObjectiveThe Collaboration for Evidence-Based Healthcare and Public Health in sub-Saharan Africa (CEBHA+), a research network, aims to build capacities for evidence-based healthcare. Hypertension (HTN) and diabetes mellitus (DM) are two priority areas of the network, both are major causes of burden of disease in this region. This review aimed to: (1) identify existing evidence-based guidelines for HTN and DM, (2) map their recommendations and (3) assess their quality.SettingSub-Saharan Africa.DesignScoping review.MethodsSystematic searches for evidence-based guidelines, developed with systematic review of evidence and certainty of evidence assessment, were undertaken in electronic databases and grey literature, and ministries of health of all countries in this region were contacted. Included guidelines were assessed with the Appraisal of Guidelines for research and evaluation II (AGREE-II) tool. Searches were conducted between 7 December 2021 and 14 January 2022. Results are presented descriptively.Results66 potentially relevant guidelines were identified, developed in 23, out of 49 sub-Saharan African countries. Of these, only two guidelines (on DM) reported the use of systematic review of evidence and certainty of evidence assessment. Their quality appraisal showed that both have relatively similar scores on domains of AGREE-II, with higher scores on Scope and Purpose and Clarity and Presentation domains, and lower on Stakeholder Involvement, Applicability, Rigour of Development and Editorial independence domains. The overall scores of both guidelines were 50% and 58%, respectively.ConclusionsLess than half of the countries in sub-Saharan Africa developed and published their own guidelines for HTN or DM. The quality appraisal showed that the two included guidelines scored relatively low in several crucial domains of AGREE-II. Countries in this region could consider adopting or adapting already published high-quality recommendations, in order to facilitate a more efficient and faster development of much needed trustworthy evidence-based guidance.
Registry-based cohort study of alpha-1 antitrypsin deficiency prevalence, incidence and mortality in Denmark 2000–2018
Authors: Acquavella John , Vágó Emese , Sorensen Henrik Toft , Horváth-Puhó Erzsébet , Hess Gregory P 
Published: December 2022

ObjectiveTo estimate the prevalence of diagnosed alpha-1 antitrypsin deficiency (dAATD) in Denmark as of 31 December 2018, and dAATD incidence and mortality from 1 January 2000 to 31 December 2018.Study design and settingWe used the Danish National Patient Registry to identify patients with dAATD based on the International Classification of Diseases, 10th Revision (ICD-10) code E88.0A and the Danish Civil Registration System (CRS) for population counts and vital status. We estimated dAATD prevalence, incidence and mortality. We compared mortality among patients with dAATD and an age-matched and sex-matched cohort extracted from the Danish CRS. We conducted a sensitivity analysis to examine whether coding changes during 2000–2018, from a general to a more specific ICD-10 code for AATD, and left truncation affected results appreciably.ResultsThe prevalence of dAATD was 12.9 (95% CI 11.9 to 13.8) per 100 000 persons. The age distribution was bimodal, with peaks at ages ≤12 and ≥45 years. The incidence rate per 100 000 person-years was 0.90 (95% CI 0.85 to 0.96), again with a bimodal age distribution. Mortality was higher for patients with dAATD than for the general population (mortality rate ratio (mRR) 4.7, 95% CI 4.1 to 5.3), especially for children (mRR 33.8, 95% CI 6.8 to 167.4). The sensitivity analysis indicated that dAATD prevalence might have been as high as 19.7 per 100 000 persons due to less specific ICD-10 coding for AATD early in the study period or 21.4 per 100 000 persons correcting for left truncation.ConclusionDiagnosed AATD was associated with increased mortality, especially for children. The finding for children was based on few deaths and had very wide 95% CIs.
Biallelic frameshift variants inPHLDB1cause mild-type osteogenesis imperfecta with regressive spondylometaphyseal changes
Authors: Tuysuz Beyhan , Uludag Alkaya Dilek , Geyik Filiz , Alaylıoğlu Merve , Kasap Busra , Kurugoğlu Sebuh , Akman Yunus Emre , Vural Mehmet , Bilguvar Kaya 
Published: December 2022

BackgroundOsteogenesis imperfecta (OI) is a heterogeneous group of inherited disorders characterised by susceptibility to fractures, primarily due to defects in type 1 collagen. The aim of this study is to present a novel OI phenotype and its causative candidate gene.MethodsWhole-exome sequencing and clinical evaluation were performed in five patients from two unrelated families.PHLDB1mRNA expression in blood and fibroblasts was investigated by real-time PCR, and western blot analysis was further performed on skin fibroblasts.ResultsThe common findings among the five affected children were recurrent fractures and/or osteopaenia, platyspondyly, short and bowed long bones, and widened metaphyses. Metaphyseal and vertebral changes regressed after early childhood, and no fractures occurred under bisphosphonate treatment. We identified biallelic NM_001144758.3:c.2392dup and NM_001144758.3:c.2690_2693del pathogenic variants inPHLDB1in the affected patients, respectively, in the families; parents were heterozygous for these variants.PHLDB1encodes pleckstrin homology-like domain family B member-1 (PHLDB1) protein, which has a role in insulin-dependent Akt phosphorylation. Compared with controls, a decrease in the expression levels ofPHLDB1in the blood and skin fibroblast samples was detected. Western blot analysis of cultured fibroblasts further confirmed the loss of PHLDB1.ConclusionTwo biallelic frameshift variants in the candidate genePHLDB1were identified in independent families with a novel, mild-type, autosomal recessive OI. The demonstration of decreasedPHLDB1mRNA expression levels in blood and fibroblast samples supports the hypothesis thatPHLDB1pathogenic variants are causative for the observed phenotype.
Association between malignancy risk and Janus kinase inhibitors versus tumour necrosis factor inhibitors in Korean patients with rheumatoid arthritis: a nationwide population-based study
Authors: Song Yeo-Jin , Cho Soo-Kyung , You Seung-Hun , Kim Jeong-Yeon , Kim Hyoungyoung , Jung Sun-Young , Sung Yoon-Kyoung 
Published: December 2022

ObjectiveTo determine the risk of malignancy in Korean patients with rheumatoid arthritis (RA) receiving Janus kinase inhibitors (JAKis) compared with tumour necrosis factor inhibitors (TNFis).MethodsA retrospective cohort of patients with RA initiating their first JAKi or TNFi was established using the Korean National Health Insurance database between 2015 and 2019. They were followed up from treatment initiation to the occurrence of malignancy, drug discontinuation, death or until December 2019. Baseline features of the patients were balanced through inverse probability of treatment weighting (IPTW) using a propensity score. A Cox proportional hazard model was established to estimate the HR for malignancy risk in JAKi users compared with TNFi users.ResultsA total of 4929 patients (1064 JAKi-treated and 3865 TNFi-treated patients) were included, and the observation periods were 1288.6 person-years (PYs) for JAKi users and 6823.8 PYs for TNFi users. The incidence rates of overall malignancy were 0.54 per 100 PYs (95% CI 0.26 to 1.14) in JAKi users and 0.85 per 100 PYs (95% CI 0.66 to 1.10) in TNFi users. In IPTW analysis with a balanced sample (4101 JAKi-treated and 5131 TNFi-treated patients), HR was 0.83 (95% CI 0.55 to 1.27) for overall malignancy: 0.77 (95% CI 0.50 to 1.19) for solid malignancy and 2.86 (95% CI 0.41 to 20.00) for haematological malignancy.ConclusionMalignancy risk in Korean patients with RA was not increased with JAKi use compared with TNFi use.
Constraints on light leptophilic dark matter mediators from decay experiments
Authors: Bickendorf Gerrit , Drees Manuel 
Published: December 2022

AbstractWe study the influence of leptophilic dark matter interactions on decays of muons and ground state mesons in existing experiments. We consider a secluded dark sector exclusively interacting with leptons via either a (leptophilic) scalar or vector mediator. These interactions will therefore influence leptonic decays and deform the energy spectra. We first study the Michel decay of muons, $$\mu ^+\rightarrow e^+\nu _e \bar{\nu }_\mu $$

μ
+

→

e
+

ν
e

ν

¯

μ

, which allow us to constrain the parameter space reasonably well. Secondly, the rare $$\pi ^\pm $$

π
±

, $$K^\pm $$

K
±

, $$D^\pm $$

D
±

and $$D_s^\pm $$

D
s
±

decays to $$e\nu $$

e
ν

will be considered. Scalar mediators would remove the Standard Model helicity suppression, so that strong constraints can be derived. The resulting bounds on the couplings of the light mediators to electrons and muons still turn out to be somewhat weaker than those from searches at low-energy $$e^+e^-$$

e
+

e
-

colliders and the magnetic moment of the muon, respectively. Finally, we show that kaon and pion decays basically exclude a “Co-SIMP” scenario where a scalar dark matter particle has a dimension-5 coupling to electrons.
An Exploration of the Emergence of Machine Consciousness and the Risk of Robocentrism
Authors: Davis Matthew 
Published: December 2022

This paper explores how the development of real-world artificial agents could lead to the evolution of machine consciousnesses with their own moral standards, and give rise to artificial intelligences that subscribe to Robocentrism; an ethical perspective that prioritizes the welfare of artificial agents. In doing so, it explores relevant concepts from contemporary, as well as more traditional literature, and blends theoretical models of consciousness with empirical examples from other scientific domains. This paper contributes to current literature in several ways, the first of which is by clarifying and solidifying some important prerequisite concepts. At the beginning of the paper, key considerations for developing true artificial intelligence are problematized, and a view on how the emergence of machine consciousness might realistically occur is presented, supported by several empirical examples and thought experiments. Three hierarchical ontological states are categorized and discussed in detail: Sensory experience, instinctual awareness, and reflexive awareness. What this might look like for different forms of artificial agents is also explored. Second, upon presenting a path to the emergence of machine consciousness, the novel ethical perspective ‘Robocentrism’ is introduced, and a discussion follows on how such a potentiality might come to pass given the pre-existing socio-technological system. For the sake of argument and to move forward with the premise of this paper, an explicit assumption is made, which builds upon the prior section, that the AI in question has reached a state of self-reflexive autonomy such that it could be considered a moral agent, can reason for itself, and learn; that is, code its own improvements. Consequently, the output of this review asserts that as machines become more advanced and capable of autonomous self-learning and improvement, we should reasonably conclude that they will develop their own sense of ethical and moral standards in relation to their surroundings, to engage successfully with wider society and one another.
Assessing biotic response to anthropogenic forcing using mollusc assemblages from the Po–Adriatic System (Italy)
Authors: Scarponi Daniele , Rojas Alexis , Nawrot Rafał , Cheli Alessandro , Kowalewski Michał 
Published: December 2022

Abstract

Preserving the adaptive capacities of coastal ecosystems in the Anthropocene requires an understanding of their natural variability prior to modern times. We quantified responses of nearshore molluscs assemblages to past environmental changes using 101 samples (
c.
57 300 specimens) retrieved from the subsurface Holocene succession and present-day seabed of the Po–Adriatic System (Italy). Present-day assemblages shifted in their faunal composition with respect to their mid-late Holocene counterparts. Major differences are observed in lower nearshore settings, where present-day samples show higher heterogeneity, reduced standardized richness, reduced relative abundance of
Lentidium mediterraneum,
and increased relative abundance of
Varicorbula gibba
, scavengers (genus
Tritia
), and deposit feeders (nuculid bivalves). A dominance of infaunal opportunistic species and shifts towards detritus-feeding and scavenging are often associated with disturbed benthic habitats. Our results suggest that the ongoing anthropogenic stressors (mainly bottom trawling and non-native species) are currently shifting benthic communities into novel states outside the range of natural variability archived in the fossil record.

Supplementary material:
A document containing additional statistics, figures, and tables, also considering different filters applied to the molluscan dataset, is provided as a Word file. In addition, appendices concerning sample and taxa information and R-scripts are provided as .csv and .r files. These are available at
https://doi.org/10.6084/m9.figshare.c.6351348
The Anatomy of Hardware Reverse Engineering: An Exploration of Human Factors During Problem Solving
Authors: Wiesen Carina , Becker Steffen , Walendy René , Paar Christof , Rummel Nikol 
Published: December 2022

Understanding of microchips, known as Hardware Reverse Engineering (HRE), is driven by analysts’ problem solving. This work sheds light on these hitherto poorly understood problem-solving processes. We propose a methodology addressing the problem of HRE experts being unavailable for research. We developed a training enabling students to acquire intermediate levels of HRE expertise. Besides one expert, we recruited eight top-performing students from this training for our exploratory study.
All participants completed a realistic HRE task involving the removal of a copyright protection mechanism from a hardware circuit. We analyzed 2,445 log entries by applying an iterative open coding and developed a detailed hierarchical problem-solving model. Our exploration yielded insights into problem-solving strategies and revealed that two intermediates solved the task with a comparable solution time to the expert. We discuss that HRE problem solving may be a function of both expertise and cognitive abilities, and outline ideas for novel countermeasures.