bluuebunny/crossref_metadata_2025_split huggingface dataset:
State handgun purchase age minimums in the US and adolescent suicide rates: regression discontinuity and difference-in-differences analyses
Authors: Raifman Julia , Larson Elysia , Barry Colleen L , Siegel Michael , Ulrich Michael , Knopov Anita , Galea Sandro 
Published: July 2020

AbstractObjectiveTo evaluate the association between US state policies that establish age 18 or 21 years as the minimum purchaser age for the sale of handguns and adolescent suicide rate.DesignRegression discontinuity and difference-in-differences analyses.Setting46 US states without policy changes between 2001 and 2017; Missouri and South Carolina, which lowered the age for handgun sales in 2007 and 2008, respectively; and West Virginia and Wyoming, which increased the age for handgun sales in 2010.ParticipantsAdolescents aged 13 to 20 years(554 461 961 from 2001 to 2017) in the regression discontinuity analysis, and adolescents aged 18 to 20 years (168 934 041 from 2002 to 2014) in the main difference-in-differences analysis.Main outcome measureSuicide rate per 100 000 adolescents.ResultsIn the regression discontinuity analysis, state policies that limited the sale of handguns to those aged 18 or older (relative to 21 or older) were associated with an increase in suicide rate among adolescents aged 18 to 20 years equivalent to 344 additional suicides in each state where they were in place between 2001 and 2017. In the difference-in-differences analysis, state policies that limited the sale of handguns to those aged 21 or older were associated with 1.91 fewer suicides per 100 000 adolescents aged 18 to 20 years (95% confidence interval −3.13 to −0.70, permutation adjusted P=0.025). In the difference-in-differences analysis, there were 1.83 fewer firearm related suicides per 100 000 adolescents (−2.66 to −1.00, permutation adjusted P=0.002), with no association between age 21 handgun sales policies and non-firearm related suicides. Separate event study estimates indicated increases in suicide rates in states that lowered the age of handgun sales, with no association in states that increased the age of handgun sales.ConclusionsA clear discontinuity was shown in the suicide rate by age at age 18 in states that limited the sale of handguns to individuals aged 18 or older. State policies to limit the sale of handguns to individuals aged 21 or older were associated with a reduction in suicide rates among adolescents. Increases in suicide rates were observed after states lowered the age of handgun sales, but no effect was found in states that increased the age of handgun sales.
Interaction between sex and rurality on the prevalence of diabetes in Guyana: a nationally representative study
Authors: Ke Calvin , Persaud Shamdeo , Singh Kavita , Ostrow Brian , Lebovic Gerald , Hincapié Cesar , Lowe Julia 
Published: July 2020

IntroductionDiabetes prevalence has never been measured in Guyana. We conducted a nationally representative cross-sectional study to estimate the prevalence of diabetes and pre-diabetes, and the association between sex and diabetes.Research design and methodsIn 2016, the Ministry of Public Health led Guyana’s first national STEPS survey among adults aged 18–69 years. Half of the participants were randomly selected for hemoglobin A1cand fasting blood glucose testing. We estimated the prevalence of diabetes and pre-diabetes and measured the association between sex and diabetes prevalence using logistic regression to compute adjusted ORs.ResultsWe included 805 adults (511 women, 294 men, mean age 41.8 (SD 14.4) years). The national prevalence of diabetes was 18.1% (95% CI: 15.4% to 20.8%), with higher rates among women (21.4%, 95% CI: 18.0% to 24.7%) than men (15.1%, 95% CI: 10.9% to 19.3%). Sex-specific diabetes prevalence varied significantly across urban and rural areas (p=0.002 for interaction). In rural areas, diabetes was twice as common among women (24.1%, 95% CI: 20.1% to 28.2%) compared with men (11.8%, 95% CI: 7.7% to 15.9%). After adjusting for prespecified covariates, rural women had double the odds of diabetes compared with rural men (OR 2.1, 95% CI: 1.20 to 3.82). This prevalence pattern was reversed in urban areas (diabetes prevalence, women: 13.9%, 95% CI: 8.7% to 19.0%; men: 22.0%, 95% CI: 12.9% to 31.1%), with urban women having half the odds of diabetes compared with urban men (OR 0.4, 95% CI: 0.20 to 0.99). We estimated that nearly one-third of women and over a quarter of men had diabetes or pre-diabetes.ConclusionsThe burden of diabetes in Guyana is considerably higher than previously estimated, with an unexpectedly high prevalence among women—particularly in rural areas.
Clinical characterization of data-driven diabetes subgroups in Mexicans using a reproducible machine learning approach
Authors: Bello-Chavolla Omar Yaxmehen , Bahena-López Jessica Paola , Vargas-Vázquez Arsenio , Antonio-Villa Neftali Eduardo , Márquez-Salinas Alejandro , Fermín-Martínez Carlos A , Rojas Rosalba , Mehta Roopa , Cruz-Bautista Ivette , Hernández-Jiménez Sergio , García-Ulloa Ana Cristina , Almeda-Valdes Paloma , Aguilar-Salinas Carlos Alberto ,   the Metabolic Syndrome Study Group
Published: July 2020

IntroductionPrevious reports in European populations demonstrated the existence of five data-driven adult-onset diabetes subgroups. Here, we use self-normalizing neural networks (SNNN) to improve reproducibility of these data-driven diabetes subgroups in Mexican cohorts to extend its application to more diverse settings.Research design and methodsWe trained SNNN and compared it with k-means clustering to classify diabetes subgroups in a multiethnic and representative population-based National Health and Nutrition Examination Survey (NHANES) datasets with all available measures (training sample: NHANES-III, n=1132; validation sample: NHANES 1999–2006, n=626). SNNN models were then applied to four Mexican cohorts (SIGMA-UIEM, n=1521; Metabolic Syndrome cohort, n=6144; ENSANUT 2016, n=614 and CAIPaDi, n=1608) to characterize diabetes subgroups in Mexicans according to treatment response, risk for chronic complications and risk factors for the incidence of each subgroup.ResultsSNNN yielded four reproducible clinical profiles (obesity related, insulin deficient, insulin resistant, age related) in NHANES and Mexican cohorts even without C-peptide measurements. We observed in a population-based survey a high prevalence of the insulin-deficient form (41.25%, 95% CI 41.02% to 41.48%), followed by obesity-related (33.60%, 95% CI 33.40% to 33.79%), age-related (14.72%, 95% CI 14.63% to 14.82%) and severe insulin-resistant groups. A significant association was found between the SLC16A11 diabetes risk variant and the obesity-related subgroup (OR 1.42, 95% CI 1.10 to 1.83, p=0.008). Among incident cases, we observed a greater incidence of mild obesity-related diabetes (n=149, 45.0%). In a diabetes outpatient clinic cohort, we observed increased 1-year risk (HR 1.59, 95% CI 1.01 to 2.51) and 2-year risk (HR 1.94, 95% CI 1.13 to 3.31) for incident retinopathy in the insulin-deficient group and decreased 2-year diabetic retinopathy risk for the obesity-related subgroup (HR 0.49, 95% CI 0.27 to 0.89).ConclusionsDiabetes subgroup phenotypes are reproducible using SNNN; our algorithm is available as web-based tool. Application of these models allowed for better characterization of diabetes subgroups and risk factors in Mexicans that could have clinical applications.
Globo H-KLH vaccine adagloxad simolenin (OBI-822)/OBI-821 in patients with metastatic breast cancer: phase II randomized, placebo-controlled study
Authors: Huang Chiun-Sheng , Yu Alice L , Tseng Ling-Ming , Chow Louis W C , Hou Ming-Feng , Hurvitz Sara A , Schwab Richard B , L Murray James , Chang Hsien-Kun , Chang Hong-Tai , Chen Shin-Cheh , Kim Sung-Bae , Hung Jung-Tung , Ueng Shir-Hwa , Lee Su-Hua , Chen Chwen-Cheng , Rugo Hope S 
Published: July 2020

PurposeThis randomized, double-blind, placebo-controlled, parallel-group, phase II trial assessed the efficacy and safety of adagloxad simolenin (OBI-822; a Globo H epitope covalently linked to keyhole limpet hemocyanin (KLH)) with adjuvant OBI-821 in metastatic breast cancer (MBC).MethodsAt 40 sites in Taiwan, USA, Korea, India, and Hong Kong, patients with MBC of any molecular subtype and ≤2 prior progressive disease events with stable/responding disease after the last anticancer regimen were randomized (2:1) to adagloxad simolenin (AS/OBI-821) or placebo, subcutaneously for nine doses with low-dose cyclophosphamide. The primary endpoint was progression-free survival (PFS). Secondary endpoints included overall survival, correlation of clinical outcome with humoral immune response and Globo H expression, and safety.ResultsOf 349 patients randomized, 348 received study drug. Patients with the following breast cancer subtypes were included: hormone receptor-positive (HR+)/human epidermal growth factor receptor 2-negative (HER2–) (70.4%), triple negative (12.9%), and HER2+ (16.7%), similarly distributed between treatment arms. Median PFS was 7.6 months (95% CI: 6.5–10.9) with AS/OBI-821 (n=224) and 9.2 months (95% CI: 7.3–11.3) with placebo (n=124) (HR=0.96; 95% CI: 0.74–1.25; p=0.77), with no difference by breast cancer subtype. AS/OBI-821 recipients with anti-Globo H IgG titer ≥1:160 had significantly longer median PFS (11.1 months (95% CI: 9.3–17.6)) versus those with titers <1:160 (5.5 months (95% CI: 3.7–5.6); HR=0.52; p<0.0001) and placebo recipients (HR=0.71; p=0.03). Anti-KLH immune responses were similar at week 40 between AS/OBI-821 recipients with anti-Globo IgG titer ≥1:160 and those with anti-Globo IgG titer <1:160. The most common adverse events with AS/OBI-821 were grade 1 or 2 injection site reactions (56.7%; placebo, 8.9%) and fever (20.1%; placebo, 6.5%).ConclusionAS/OBI-821 did not improve PFS in patients with previously treated MBC. However, humoral immune response to Globo H correlated with improved PFS in AS/OBI-821 recipients, leading the way to further marker-driven studies. Treatment was well tolerated.NCT01516307.
No-reflow phenomenon and comparison to the normal-flow population postprimary percutaneous coronary intervention for ST elevation myocardial infarction: case–control study (NORM PPCI)
Authors: Rossington Jennifer Ann , Sol Eirini , Masoura Konstantina , Aznaouridis Konstantinos , Chelliah Raj , Cunnington Michael , Davison Benjamin , John Joseph , Oliver Richard , Hoye Angela 
Published: July 2020

IntroductionNo-reflow (NR) phenomenon is characterised by the failure of myocardial reperfusion despite the absence of mechanical coronary obstruction. NR negatively affects patient outcomes, emphasising the importance of prediction and management. The objective was to evaluate the incidence and independent predictors of NR in patients presenting with ST-elevation myocardial infarction (STEMI).MethodsThis was a single-centre prospective case–control study. Cases were subjects who suffered NR, and the control comparators were those who did not. Clinical outcomes were documented. Salient variables relating to the patients and their presentation, history and angiographical findings were compared using one-way analysis of variance or χ2test. Multiple regression determined the independent predictors, and a risk score was established based on the β coefficient.ResultsOf 173 consecutive patients, 24 (13.9%) suffered from NR, with 46% occurring post stent implantation. Patients with NR had increased risk of in-hospital death (OR 7.0, 95% CI 1.3 to 36.7, p=0.022). From baseline variables available prior to percutaneous coronary intervention, the independent predictors of NR were increased lesion complexity, admission systolic hypertension, weight of <78 kg and history of hypertension. Continuous data were transformed into best-fit binary variables, and a risk score was defined. Significant difference was demonstrated between the risk score of patients with NR (4.1±1) compared with controls (2.6±1) (p<0.001), and the risk score was considered a good test (area under the curve=0.823). A score of ≥4 had 75% sensitivity and 76.5% specificity.ConclusionPatients with NR have a higher rate of mortality following STEMI. Predictors of NR include lesion complexity, systolic hypertension and low weight. Further validation of this risk model is required.
Compliance with the smoking ban in enclosed, semiopen and open areas of workplaces and public places in Chile
Authors: Peruga Armando , Molina Xaviera , Delgado Iris , Matute Isabel , Olea Andrea , Hirmas Macarena , González Claudia , Aguilera Ximena 
Published: July 2020

ObjectiveTo assess the national level of compliance with the Chilean comprehensive smoke-free legislation by observing healthcare facilities, education centres, government offices, hospitality venues and private workplaces, by type of area within workplaces and public places: enclosed, semiopen and open.MethodologyIn this cross-sectional observational study, we studied a national representative sample of 3253 venues obtained through a two-stage cluster sampling design. First, 57 municipalities were randomly selected, proportionally to the total number of venues of interest. Second, within each selected municipality, a maximum of 12 venues of each sector was selected systematically from a list of existing sites. We determined the non-compliance level by estimating the percentage of the visited venues where smoking was observed or suspected in banned areas of the premises.ResultsSmoking or suspicion thereof was not observed in any enclosed area of any establishment. However, smoking violations were observed in semiopen areas ranging from less than 0.5% of schools and healthcare centres to around 10% of hospitality venues or 23.0% of higher education centres. Smoking violations were also observed in outdoor areas of 6.7% and 1.6% of the health centres and schools, respectively.DiscussionThe stark contrast in compliance with the smoking ban between the enclosed areas and the semiopen areas may be a consequence of the complex definition of semiopen areas in the regulations. The study also reflects the need to improve the overall enforcement of the smoke-free law, particularly in universities and hospitality venues.
A study of New Physics searches with tritium and similar molecules
Authors: Hollik Wolfgang Gregor , Linster Matthias , Tabet Mustafa 
Published: July 2020

AbstractSearches for New Physics focus either on the direct production of new particles at colliders or at deviations from known observables at low energies. In order to discover New Physics in precision measurements, both experimental and theoretical uncertainties must be under full control. Laser spectroscopy nowadays offers a tool to measure transition frequencies very precisely. For certain molecular and atomic transitions the experimental technique permits a clean study of possible deviations. Theoretical progress in recent years allows us to compare ab initio calculations with experimental data. We study the impact of a variety of New Physics scenarios on these observables and derive novel constraints on many popular generic Standard Model extensions. As a result, we find that molecular spectroscopy is not competitive with atomic spectroscopy and neutron scattering to probe new electron-nucleus and nucleus-nucleus interactions, respectively. Molecular and atomic spectroscopy give similar bounds on new electron-electron couplings, for which, however, stronger bounds can be derived from the magnetic moment of the electron. In most of the parameter space H$$_2$$2 molecules give stronger constraints than T$$_2$$2 or other isotopologues.
The Butterfly “Affect”: impact of development practices on cryptocurrency prices
Authors: Bartolucci Silvia , Destefanis Giuseppe , Ortu Marco , Uras Nicola , Marchesi Michele , Tonelli Roberto 
Published: July 2020

AbstractThe network of developers in distributed ledgers and blockchains open source projects is essential to maintaining the platform: understanding the structure of their exchanges, analysing their activity and its quality (e.g. issues resolution times, politeness in comments) is important to determine how “healthy” and efficient a project is. The quality of a project affects the trust in the platform, and therefore the value of the digital tokens exchanged over it.In this paper, we investigate whether developers’ emotions can effectively provide insights that can improve the prediction of the price of tokens. We consider developers’ comments and activity for two major blockchain projects, namely Ethereum and Bitcoin, extracted from Github. We measure sentiment and emotions (joy, love, anger, etc.) of the developers’ comments over time, and test the corresponding time series (i.e. the affect time series) for correlations and causality with the Bitcoin/Ethereum time series of prices. Our analysis shows the existence of a Granger-causality between the time series of developers’ emotions and Bitcoin/Ethereum price. Moreover, using an artificial recurrent neural network (LSTM), we can show that the Root Mean Square Error (RMSE)—associated with the prediction of the prices of cryptocurrencies—significantly decreases when including the affect time series.
Combining Biomarkers and Imaging for Short‐Term Assessment of Cardiovascular Disease Risk in Apparently Healthy Adults
Authors: Gore Maria Odette , Ayers Colby R. , Khera Amit , deFilippi Christopher R. , Wang Thomas J. , Seliger Stephen L. , Nambi Vijay , Selvin Elizabeth , Berry Jarett D. , Hundley W. Gregory , Budoff Matthew , Greenland Philip , Drazner Mark H. , Ballantyne Christie M. , Levine Benjamin D. , de Lemos James A. 
Published: July 2020

Background

Current strategies for cardiovascular disease (
CVD
) risk assessment focus on 10‐year or longer timeframes. Shorter‐term
CVD
risk is also clinically relevant, particularly for high‐risk occupations, but is under‐investigated.

Methods and Results

We pooled data from participants in the ARIC (Atherosclerosis Risk in Communities study), MESA (Multi‐Ethnic Study of Atherosclerosis), and DHS (Dallas Heart Study), free from
CVD
at baseline (N=16 581). Measurements included N‐terminal pro‐B‐type natriuretic peptide (>100 pg/mL prospectively defined as abnormal); high‐sensitivity cardiac troponin T (abnormal >5 ng/L); high‐sensitivity C‐reactive protein (abnormal >3 mg/L); left ventricular hypertrophy by
ECG
(abnormal if present); carotid intima‐media thickness, and plaque (abnormal >75th percentile for age and sex or presence of plaque); and coronary artery calcium (abnormal >10 Agatston U). Each abnormal test result except left ventricular hypertrophy by
ECG
was independently associated with increased 3‐year risk of global
CVD
(myocardial infarction, stroke, coronary revascularization, incident heart failure, or atrial fibrillation), even after adjustment for traditional
CVD
risk factors and the other test results. When a simple integer score counting the number of abnormal tests was used, 3‐year multivariable‐adjusted global
CVD
risk was increased among participants with integer scores of 1, 2, 3, and 4, by ≈2‐, 3‐, 4.5‐ and 8‐fold, respectively, when compared with those with a score of 0. Qualitatively similar results were obtained for atherosclerotic
CVD
(fatal or non‐fatal myocardial infarction or stroke).

Conclusions

A strategy incorporating multiple biomarkers and atherosclerosis imaging improved assessment of 3‐year global and atherosclerotic
CVD
risk compared with a standard approach using traditional risk factors.
Transition from Geostrophic Flows to Inertia–Gravity Waves in the Spectrum of a Differentially Heated Rotating Annulus Experiment
Authors: Rodda Costanza , Harlander Uwe 
Published: July 2020

Abstract
Inertia–gravity waves (IGWs) play an essential role in the terrestrial atmospheric dynamics as they can lead to energy and momentum flux when propagating upward. An open question is to what extent IGWs contribute to the total energy and to the flattening of the energy spectrum observed at the mesoscale. In this work, we present an experimental investigation of the energy distribution between the large-scale balanced flow and the small-scale imbalanced flow. Weakly nonlinear IGWs emitted from baroclinic jets are observed in the differentially heated rotating annulus experiment. Similar to the atmospheric spectra, the experimental kinetic energy spectra reveal the typical subdivision into two distinct regimes with slopes k−3 for the large scales and k−5/3 for the small scales. By separating the spectra into the vortex and wave components, it emerges that at the large-scale end of the mesoscale the gravity waves observed in the experiment cause a flattening of the spectra and provide most of the energy. At smaller scales, our data analysis suggests a transition toward a turbulent regime with a forward energy cascade up to where dissipation by diffusive processes occurs.
Rationing Rotational Magnet Cochlear Implant Technology in a Single Payer Healthcare System
Authors: Pisa Justyn , Andrews Colin , Hochman Jordan B. 
Published: July 2020

Introduction: In a publicly funded health care system, fiscally responsible management of any program is required. This is especially pertinent as evolving technology and associated incremental costs, places pressure on device availability within a fixed funding envelope. The application of rotational magnet technology and associated escalating surgical wait times must be justified to patients and the single-payer system. We present a single cochlear implant center’s attempt at a rationing schema for magnetic resonance compatible cochlear implantation. Contrasting approaches to rationing care are evaluated and deliberated. Methods: Based on a comparison of magnetic resonance imaging (MRI) rates within the general population to our cochlear implant (CI) cohort, we attempt the development of a decision-making schema that maximizes the number of patients to receive a CI while rationing the distribution of a rotational magnet technology to similarly situated individuals most likely to benefit. Results: We elect to provide rotational magnet technology to select patient cohorts. This is based on the dominant imaging needs of these populations and the probability of requiring recurrent imaging studies. We consider this an ethical approach grounded in the egalitarian principle of equality of opportunity within cohorts of patients. Conclusion: Given finite resources, increasing per unit cost will unavoidably extend wait times for adult patients. Our approach does not afford similar implant devices for all patients, but rather all similarly situated individuals. Therefore, access to a scare medical resource requires program rigor and a formalized policy around candidacy for emergent technology.