bluuebunny/crossref_metadata_2025_split huggingface dataset:
Budget impact analysis of a pilot polypharmacy clinic
Authors: Bennett Frances , Barron Andrew , Shah Neha , Webb David J , Sofat Reecha 
Published: April 2022

Background/Aims Inappropriate polypharmacy can lead to adverse events and increased healthcare costs. This study estimated the budget impact of providing a specialist onward referral service for patients with potentially problematic polypharmacy. Methods A multidisciplinary team-led pilot polypharmacy clinic, dedicated to reviewing patients prescribed more than 10 different medications, was trialled in a secondary care setting. Potentially inappropriate prescribing was identified and addressed. Data from the pilot clinic regarding costs, direct savings and indirect savings were used to create budget impact models. Two service models were proposed: an outpatient model, based on the pilot clinic, and an integrated model, a theoretical integrated service collaborating with colleagues in primary care. Base case results and sensitivity analyses were calculated for both models. Results Annual overall cost savings from the outpatient model and integrated model were estimated at £67 158 and £34 176 respectively. Both models were predicted to produce both direct and indirect savings from stopping unnecessary drugs and preventing hospital admissions for adverse drug reactions. Sensitivity analysis confirmed these results across all included variables except the number of medications stopped at review. Conclusions Specialist onward referral services, dedicated to reviewing complex patients with high-risk polypharmacy, could offer significant cost savings, while also preventing adverse side effects and drug-related events.
Estimating the effects of lockdown timing on COVID-19 cases and deaths in England: A counterfactual modelling study
Authors: Arnold Kellyn F. , Gilthorpe Mark S. , Alwan Nisreen A. , Heppenstall Alison J. , Tomova Georgia D. , McKee Martin , Tennant Peter W. G. 
Published: April 2022

Background
During the first wave of the COVID-19 pandemic, the United Kingdom experienced one of the highest per-capita death tolls worldwide. It is debated whether this may partly be explained by the relatively late initiation of voluntary social distancing and mandatory lockdown measures. In this study, we used simulations to estimate the number of cases and deaths that would have occurred in England by 1 June 2020 if these interventions had been implemented one or two weeks earlier, and the impact on the required duration of lockdown.

Methods
Using official reported data on the number of Pillar 1 lab-confirmed cases of COVID-19 and associated deaths occurring in England from 3 March to 1 June, we modelled: the natural (i.e. observed) growth of cases, and the counterfactual (i.e. hypothetical) growth of cases that would have occurred had measures been implemented one or two weeks earlier. Under each counterfactual condition, we estimated the expected number of deaths and the time required to reach the incidence observed under natural growth on 1 June.

Results
Introducing measures one week earlier would have reduced by 74% the number of confirmed COVID-19 cases in England by 1 June, resulting in approximately 21,000 fewer hospital deaths and 34,000 fewer total deaths; the required time spent in full lockdown could also have been halved, from 69 to 35 days. Acting two weeks earlier would have reduced cases by 93%, resulting in between 26,000 and 43,000 fewer deaths.

Conclusions
Our modelling supports the claim that the relatively late introduction of social distancing and lockdown measures likely increased the scale, severity, and duration of the first wave of COVID-19 in England. Our results highlight the importance of acting swiftly to minimise the spread of an infectious disease when case numbers are increasing exponentially.
Cross-disorder and disorder-specific deficits in social functioning among schizophrenia and alzheimer’s disease patients
Authors: Saris Ilja M. J. , Aghajani Moji , Jongs Niels , Reus Lianne M. , van der Wee Nic J. A. , Bilderbeck Amy C. , Winter van Rossum Inge , Arango Celso , de la Torre-Luque Alejandro , Malik Asad , Raslescu Andreea , Dawson Gerard R. , Ayuso-Mateos José L. , Kas Martien J. , Penninx Brenda W. J. H. 
Published: April 2022

Background
Social functioning is often impaired in schizophrenia (SZ) and Alzheimer’s disease (AD). However, commonalities and differences in social dysfunction among these patient groups remain elusive.

Materials and methods
Using data from the PRISM study, behavioral (all subscales and total score of the Social Functioning Scale) and affective (perceived social disability and loneliness) indicators of social functioning were measured in patients with SZ (N = 56), probable AD (N = 50) and age-matched healthy controls groups (HC, N = 29 and N = 28). We examined to what extent social functioning differed between disease and age-matched HC groups, as well as between patient groups. Furthermore, we examined how severity of disease and mood were correlated with social functioning, irrespective of diagnosis.

Results
As compared to HC, both behavioral and affective social functioning seemed impaired in SZ patients (Cohen’s d’s 0.81–1.69), whereas AD patients mainly showed impaired behavioral social function (Cohen’s d’s 0.65–1.14). While behavioral indices of social functioning were similar across patient groups, SZ patients reported more perceived social disability than AD patients (Cohen’s d’s 0.65). Across patient groups, positive mood, lower depression and anxiety levels were strong determinants of better social functioning (p’s <0.001), even more so than severity of disease.

Conclusions
AD and SZ patients both exhibit poor social functioning in comparison to age- and sex matched HC participants. Social dysfunction in SZ patients may be more severe than in AD patients, though this may be due to underreporting by AD patients. Across patients, social functioning appeared as more influenced by mood states than by severity of disease.
Margin between success and failure of PDA stenting for duct-dependent pulmonary circulation
Authors: Agha Hala Mounir , Abd -El Aziz Osama , Kamel Ola , Sheta Sahar S. , El-Sisi Amal , El-Saiedi Sonia , Fatouh Aya , Esmat Amira , Abdelmohsen Gaser , Hanna Baher , Hussien Mai , Sobhy Rodina 
Published: April 2022

Objectives
Percutaneous patent ductus arteriosus (PDA) stenting is a therapeutic modality in patients with duct-dependent pulmonary circulation with reported success rates from 80–100%. The current study aims to assess the outcome and the indicators of success for PDA stenting in different ductal morphologies using various approaches.

Methods
A prospective cohort study from a single tertiary center presented from January 2018 to December 2019 that included 96 consecutive infants with ductal-dependent pulmonary circulation and palliated with PDA stenting. Patients were divided according to PDA origin into 4 groups: Group 1: PDA from proximal descending aorta, Group 2: from undersurface of aortic arch, Group 3: opposite the subclavian artery, Group 4: opposite the innominate/brachiocephalic artery.

Results
The median age of patients was 22 days and median weight was 3 kg. The procedure was successful in 78 patients (81.25%). PDA was tortuous in 70 out of 96 patients. Femoral artery was the preferred approach in Group 1 (63/67), while axillary artery access was preferred in the other groups (6/11 in Group 2, 11/17 in Group 3, 1/1 in Group 4, P <0.0001). The main cause of procedural failure was inadequate parked coronary wire inside one of the branch of pulmonary arteries (14 cases; 77.7%), while 2 cases (11.1%) were complicated by acute stent thrombosis, and another 2 cases with stent dislodgment. Other procedural complications comprised femoral artery thrombosis in 7 cases (7.2%). Patients with straight PDA, younger age at procedure and who had larger PDA at pulmonary end had higher odds for success (OR = 8.01, 2.94, 7.40, CI = 1.011–63.68, 0.960–0.99, 1.172–7.40,respectively, P = 0.048, 0.031,0.022 respectively).

Conclusions
The approach for PDA stenting and hence the outcome is markedly determined by the PDA origin and morphology. Patients with straight PDA, younger age at procedure and those who had relatively larger PDA at the pulmonary end had better opportunity for successful procedure.
Candidate genetic variants and antidepressant-related fall risk in middle-aged and older adults
Authors: Pronk A. C. , Seppala L. J. , Trajanoska K. , Stringa N. , van de Loo B. , de Groot L. C. P. G. M. , van Schoor N. M. , Koskeridis F. , Markozannes G. , Ntzani E. , Uitterlinden A. G. , Rivadeneira F. , Stricker B. H. , van der Velde N. 
Published: April 2022

Background
Antidepressant use has been associated with increased fall risk. Antidepressant-related adverse drug reactions (e.g. orthostatic hypotension) depend partly on genetic variation. We hypothesized that candidate genetic polymorphisms are associated with fall risk in older antidepressant users.

Methods
The association between antidepressant use and falls was cross-sectionally investigated in a cohort of Dutch older adults by logistic regression analyses. In case of significant interaction product term of antidepressant use and candidate polymorphism, the association between the variant genotype and fall risk was assessed within antidepressant users and the association between antidepressant use and fall risk was investigated stratified per genotype. Secondly, a look-up of the candidate genes was performed in an existing genome-wide association study on drug-related falls in antidepressant users within the UK Biobank. In antidepressant users, genetic associations for our candidate polymorphisms for fall history were investigated.

Results
In antidepressant users(n = 566), for rs28371725 (CYP2D6*41) fall risk was decreased in TC/variant allele carriers compared to CC/non-variant allele carriers (OR = 0.45, 95% CI 0.26–0.80). Concerning rs1057910 (CYP2C9*3), fall risk was increased in CA/variant allele carriers compared to AA/non-variant allele carriers (OR = 1.95, 95% CI 1.17–3.27). Regarding, rs1045642 (ABCB1), fall risk was increased in AG/variant allele carriers compared to GG/non-variant allele carriers (OR = 1.69, 95% CI 1.07–2.69). Concerning the ABCB1-haplotype (rs1045642/rs1128503), fall risk was increased in AA-AA/variant allele carriers compared to GG-GG/non-variant allele carriers (OR = 1.86, 95% CI 1.05–3.29). In the UK Biobank, in antidepressant users(n = 34,000) T/variant-allele of rs28371725 (CYP2D*41) was associated with increased fall risk (OR = 1.06, 95% CI 1.01–1.12). G/non-variant-allele of rs4244285 (CY2C19*2) was associated with decreased risk (OR = 0.96, 95% CI 0.92–1.00).

Conclusion
This is the first study showing that certain genetic variants modify antidepressant-related fall risk. The results were not always consistent across the studies and should be validated in a study with a prospective design. However, pharmacogenetics might have value in antidepressant (de)prescribing in falls prevention.
The role of telepathology in diagnosis of pre-malignant and malignant cervical lesions: Implementation at a tertiary hospital in Northern Tanzania
Authors: Mremi Alex , Bentzer Nina Karnøe , Mchome Bariki , Mlay Joseph , Blaakær Jan , Rasch Vibeke , Schledermann Doris 
Published: April 2022

Introduction
Adequate and timely access to pathology services is a key to scale up cancer control, however, there is an extremely shortage of pathologists in Tanzania. Telepathology (scanned images microscopy) has the potential to increase access to pathology services and it is increasingly being employed for primary diagnosis and consultation services. However, the experience with the use of telepathology in Tanzania is limited. We aimed to investigate the feasibility of using scanned images for primary diagnosis of pre-malignant and malignant cervical lesions by assessing its equivalency to conventional (glass slide) microscopy in Tanzania.

Methods
In this laboratory-based study, assessment of hematoxylin and eosin stained glass slides of 175 cervical biopsies were initially performed conventionally by three pathologists independently. The slides were scanned at x 40 and one to three months later, the scanned images were reviewed by the pathologists in blinded fashion. The agreement between initial and review diagnoses across participating pathologists was described and measured using Cohen’s kappa coefficient (κ).

Results
The overall concordance of diagnoses established on conventional microscopy compared to scanned images across three pathologists was 87.7%; κ = 0.54; CI (0.49–0.57).The overall agreement of diagnoses established by local pathologist on conventional microscopy compared to scanned images was 87.4%; κ = 0.73; CI (0.65–0.79). The concordance of diagnoses established by senior pathologist compared to local pathologist on conventional microscopy and scanned images was 96% and 97.7% respectively. The inter-observer agreement (κ) value were 0.93, CI (0.87–1.00) and 0.94, CI (0.88–1.00) for conventional microscopy and scanned images respectively.

Conclusions
All κ coefficients expressed good intra- and inter-observer agreement, suggesting that telepathology is sufficiently accurate for primary diagnosis in surgical pathology. The discrepancies in interpretation of pre-malignant lesions highlights the importance of p16 immunohistochemistry in definitive diagnosis in these lesions. Sustainability factors including hardware and internet connectivity are essential components to be considered before telepathology may be deemed suitable for widely use in Tanzania.
Two-way text message interventions and healthcare outcomes in Africa: Systematic review of randomized trials with meta-analyses on appointment attendance and medicine adherence
Authors: Ødegård Emilie S. , Langbråten Lena S. , Lundh Andreas , Linde Ditte S. 
Published: April 2022

BackgroundThe growing access to mobile phones in Africa has led to an increase in mobile health interventions, including an increasing number of two-way text message interventions. However, their effect on healthcare outcomes in an African context is uncertain. This systematic review aims to landscape randomized trials involving two-way text message interventions and estimate their effect on healthcare outcomes.MethodsWe searched Medline, Embase, Cochrane Central Register of Controlled Trials, The Global Health Library (up to 12 August 2021) and trial registries (up to 24 April 2020). Published and unpublished trials conducted in Africa comparing two-way text message interventions with standard care and/or one-way text message interventions were included. Trials that reported dichotomous effect estimates on healthcare appointment attendance and/or medicine adherence were assessed for risk of bias and included in meta-analyses. Results of other outcomes were reported descriptively.ResultsWe included 31 trials (28,563 participants) all set in Sub-Saharan Africa with a wide range of clinical conditions. Overall, ten different trials were included in the primary meta-analyses, and two of these had data on both medicine adherence and appointment attendance. An additional two trials were included in sensitivity analyses. Of the 12 included trials, three were judged as overall low risk of bias and nine as overall high risk of bias trials. Two-way text messages did not improve appointment attendance, RR: 1.03; 95% CI: 0.95–1.12, I2= 53% (5 trials, 4374 participants) but improved medicine adherence compared to standard care, RR: 1.14, 95% CI: 1.07–1.21, I2= 8% (6 trials, 2783 participants).ConclusionTwo-way text messages seemingly improve medicine adherence but has an uncertain effect on appointment attendance compared to standard care.Systematic review registrationPROSPERO CRD42020175810.
Incidence, risk factors, and prognosis of acute kidney injury in hospitalized patients with acute cholangitis
Authors: Lee Tae Won , Bae Wooram , Kim Seongmin , Choi Jungyoon , Bae Eunjin , Jang Ha Nee , Chang Se-Ho , Park Dong Jun 
Published: April 2022

Background
The association between acute cholangitis (AC) and acute kidney injury (AKI) remains unclear. We investigated the incidence, and clinical course of AKI in patients with AC, and the long-term prognosis.

Methods
We performed a single-center retrospective study of patients hospitalized with AC in a tertiary care center from January 2011 to December 2017. The risk factors for AKI were evaluated, and AKI severity was analyzed using the Systemic Inflammatory Response System (SIRS), quick sequential organ failure assessment (qSOFA) score, and 2018 Tokyo Guidelines (TG) grade. To calculate the relative risk of death based on AKI, hazard ratios (HRs) and 95% confidence intervals (CIs) were obtained using Cox’s proportional hazard models.

Results
A total of 1,438 patients with AC were included, of whom 18.2% (n = 261) developed AKI. AKI patients were older, and had a lower systolic blood pressure and more comorbidities including hypertension (HT), chronic kidney disease, and cardiovascular accidents. Disease severity (as assessed by SIRS, qSOFA, and the Tokyo Guidelines grade) was higher in the AKI group, as was the in-hospital mortality rate. Multivariate analysis revealed that age, HT, SIRS and qSOFA scores ≥ 2, and TG grade of III were significant risk factors for AKI. Kaplan-Meier analysis revealed significantly higher mortality in the AKI than non-AKI group. AKI (HR = 1.853; 95% CI: 1.115–3.079) and TG grade III (HR = 2.139; 95% CI: 1.190–3,846) were independent predictors of all-cause AC mortality, even after adjusting for all covariates. The annual rate of decline in the estimated glomerular filtration rate was faster in the AKI than non-AKI group (2.9 ± 6.7 vs. 0.5 ± 5.3 mL/min/1.73 m2/year, p < 0.001).

Conclusions
AKI development increased AC severity and mortality. Our results suggest that clinicians should monitor AKI status and perform appropriate management as soon as possible.
Clinician approaches to communicating a dementia diagnosis: An interview study
Authors: Wollney Easton N. , Bylund Carma L. , Bedenfield Noheli , Rosselli Monica , Curiel-Cid Rosie E. , Kitaigorodsky Marcela , Levy Ximena , Armstrong Melissa J. 
Published: April 2022

Background
Individuals with cognitive impairment and their families place a high value on receiving a dementia diagnosis, but clinician approaches vary. There is a need for research investigating experiences of giving and receiving dementia diagnoses. The current study aimed to investigate clinician approaches to giving dementia diagnoses as part of a larger study investigating patient, caregiver, and clinician experiences during the diagnosis encounter.

Method
Investigators conducted telephone interviews with Florida-based clinicians who give dementia diagnoses either rarely or commonly. Interviews employed a semi-structured interview guide querying communication practices used by clinicians when giving dementia diagnoses and how clinicians learned to give dementia diagnoses. Investigators used a descriptive qualitative design to conduct a thematic analysis of data.

Results
Fifteen Florida-based clinicians participated, representing diverse backgrounds related to gender, race/ethnicity, specialty, and practice setting. Participants reported using patient- and family-centered communication practices including checking patient understanding, communicating empathically, and involving family members. Some clinicians explicitly asked patients and/or family members about their preferences regarding diagnosis disclosure; many clinicians tailored their disclosure based on patient and family characteristics or reactions. Some clinicians reported using specific diagnoses, while others used general terms such as “memory disorder.” Clinicians reported positively framing information, including instilling hope, focusing on healthy behaviors, and discussing symptom management. Finally, clinicians provided patient/family education and arranged follow up. Clinicians reported learning approaches to dementia diagnosis disclosure through formal training and self-education.

Conclusions
Diverse Florida-based clinicians described dementia disclosure practices largely consistent with published guidance, but clinicians varied on approaches relating to soliciting patient disclosure preferences and terminology used. Clinicians caring for diverse populations described that cultural background affects the disclosure process, but more research is needed regarding this finding and best practices for individuals from different backgrounds.
Osseous Metaplasia in a Gastric Adenoma of the Stomach
Authors: Tawfik Ossama , Jonnalagadda Sreenivasa , Siddiqui Gulnaz , Downing Robert P. , McNally Megan 
Published: April 2022

ABSTRACT
Osseous metaplasia (OM) in the stomach is a rare finding, with less than 10 cases reported in the English literature to date. We present a rare case of a gastric adenoma with high-grade dysplasia and stromal OM in a 65-year-old man. The clinical, endoscopic, and histologic features along with a review of the literature are discussed. To the best of our knowledge, this is the first reported case of identifiable OM in a gastric polyp radiologically.
Bezgraniczny wzrost. Ramując na nowo relacje między ludźmi i roślinami
Authors: Modrzyk Ariel 
Published: April 2022

Tekst ma formę dyskusji z pracą Magdaleny Zamorskiej zatytułowanej Z Uważnością i Troską. Feministyczne studia nad roślinami. Punktem wyjścia jest zaproponowany w nim postulat konieczności pisania nowych narracji, dzięki którym moglibyśmy postrzegać rośliny w sposób wykraczający poza traktowanie ich jako półżywnych, podatnych na manipulacje i pasywnych istot. Celem artykułu jest rozwinięcie tej opowieści w postaci dwóch narracji: o człowieku jako istocie kreatywnej, tworzącej dobre warunki dla rozwoju niektórych roślin; oraz o porządku ludzkim jako kruchym i podatnym na zaburzenie. Pierwsza z nich opisywana jest na przykładzie wszędobylskiej i nieuchronnej obecności roślin w mieście, druga wskazuje, że praktyki ciągłego odgradzania sfery kontrolowanej przez człowieka od samoistności przyrodniczej mają swoje ograniczenia i nie mogą być w pełni realizowane. Obie te historie zaproponowane są po to, aby spojrzeć na relacje ludzko-roślinne w inny sposób niż poprzez pryzmat obrazu człowieka jako destruktywnej siły wrogiej życiu i bioróżnorodności. Rośliny są dzięki temu ukazane jako nieodłączna i aktywna część życia społecznego. W podsumowaniu artykułu zaproponowano ideę normatywną „dawania się zarastać”, która postuluje koniczność płynnego traktowania granic między tym, co ludzkie, a tym, co roślinne.
Retrofitting GDPR compliance onto legacy databases
Authors: Agarwal Archita , George Marilyn , Jeyaraj Aaron , Schwarzkopf Malte 
Published: April 2022

New privacy laws like the European Union's General Data Protection Regulation (GDPR) require database administrators (DBAs) to identify all information related to an individual on request,
e.g.
, to return or delete it. This requires time-consuming manual labor today, particularly for legacy schemas and applications.

In this paper, we investigate what it takes to provide mostly-automated tools that assist DBAs in GDPR-compliant data extraction for legacy databases. We find that a combination of techniques is needed to realize a tool that works for the databases of real-world applications, such as web applications, which may violate strict normal forms or encode data relationships in bespoke ways. Our tool, GDPRizer, relies on foreign keys, query logs that identify implied relationships, data-driven methods, and coarse-grained annotations provided by the DBA to extract an individual's data.
In a case study with three popular web applications, GDPRizer achieves 100% precision and 96--100% recall. GDPRizer saves work compared to hand-written queries, and while manual verification of its outputs is required, GDPRizer simplifies privacy compliance.