bluuebunny/crossref_metadata_2025_split huggingface dataset:
SAFER brief community intervention: a primary suicide prevention strategy to improve firearm and medication storage behaviour
Authors: Stuber Jennifer Paige , Massey Anne , Meadows Morgan , Bass Brett , Rowhani-Rahbar Ali 
Published: October 2020

ObjectiveTo determine if a brief intervention, called Signpost, Assess, Facts, Emotion, Recommend (SAFER), designed to motivate changes in behaviour to secure firearms and medications to prevent future suicide is feasible to implement in community-based settings such as gun shows, acceptable to participants at higher risk for suicide including veterans and men in the middles years (35–64) and improves firearm and medication locking behaviours.Methods1175 people received SAFER over a 12-month period at 18 gun shows and community events in 2019 and completed a preassessment measuring firearms ownership, storage practices, knowledge about suicide as the leading type of firearm fatality and attitudes about suicide prevention. 372 responded to a brief postassessment using comparable measures.Results85% of participants reported keeping firearms at home. 43.7% reported current or prior military service. 53.2% were males between the ages of 35 and 64. Among those who responded to the postassessment, 61% of participants reported SAFER to be highly valuable. Safe firearms storage improved among participants who completed the preassessment and postassessment (51.2% pre, 66.0% post; p<0.01) as did safe medication storage (14.8% pre, 21.6% post; p=0.01). Knowledge that most firearm fatalities are suicides (33.4% pre, 45.8% post; p<0.01) also improved.ConclusionsIt is feasible, acceptable and effective to reach groups at elevated risk for suicide using a brief intervention strategy in unconventional settings. Community-based interventions to improve safe storage motivated by suicide prevention messaging should be prioritised because men in the middle years are less likely to use mental health services.
Factors associated with reporting antibiotic use as STI prophylaxis among HIV PrEP users: findings from a cross-sectional online community survey, May–July 2019, UK
Authors: O'Halloran Charlotte , Croxford Sara , Mohammed Hamish , Gill Owen Noel , Hughes Gwenda , Fifer Helen , Allen Hester , Owen Greg , Nutland Will , Delpech Valerie , Saunders John Michael 
Published: October 2020

ObjectivesThe use of antibiotics as pre-exposure or postexposure prophylaxis for sexually transmitted infection (STI) prevention (STI prophylaxis) is not currently recommended in the UK, but there is evidence that self-prescribing occurs among those at greatest risk. We present the prevalence and factors associated with STI prophylaxis among a community sample of HIV pre-exposure prophylaxis (PrEP) users.MethodsThe 2019 online PrEP User Survey ran between 17 May and 1 July. Eligible participants included UK residents reporting HIV PrEP use or having tried to obtain HIV PrEP since January 2017. STI prophylaxis use was defined as reporting buying antibiotics to prevent STIs, either privately or through the internet; this question was only asked to HIV PrEP users. Factors associated with STI prophylaxis use were assessed using univariable and multivariable logistic regression.ResultsOverall, 9% (167/1856) of HIV PrEP users reported STI prophylaxis use; 97% were gay or bisexual men, 84% reported white ethnicity, 55% resided in London and 69% were aged ≥35 years. Factors associated with STI prophylaxis included: reporting ≥5 compared with 1–4 condomless sex partners in the past 6 months (12% vs 5.6%, adjusted odds ratio (aOR)=1.80; 95% CI 1.22 to 2.64), reporting chemsex drug use compared with no sexualised drug use in the past 12 months (13% vs 6.0%, aOR=1.88; 95% CI 1.20 to 2.93) and reporting an STI diagnosis in the past 12 months (12% vs 6.6%, aOR=1.54; 95% CI 1.08 to 2.18). Variables not significant in multivariable analyses included: ethnicity, age, residence and HIV PrEP sourcing.ConclusionsApproximately 1 in 10 HIV PrEP users from this community sample reported self-prescribed STI prophylaxis. STI prophylaxis was associated with sexual behaviour known to facilitate STI transmission and with a history of recent STIs acquisition. Given the potential risk of antimicrobial resistance, sexual health clinicians should consider asking attendees, especially HIV PrEP users, about the use of antibiotics as STI prophylaxis, to inform appropriate counselling, testing and management.
International Sexual Health And REproductive health (I-SHARE) survey during COVID-19: study protocol for online national surveys and global comparative analyses
Authors: Michielsen Kristien , Larrson Elin C , Kågesten Anna , Erausquin Jennifer Toller , Griffin Sally , Van de Velde Sarah , Tucker Joseph D 
Published: October 2020

Background
COVID-19 may have a profound impact on sexual health, reproductive health and social life across the world. Shelter in place regulations that have extended across the globe may influence condomless sex, exacerbate intimate partner violence and reduce access to essential reproductive health services. Population representative research is challenging during shelter in place, leaving major gaps in our understanding of sexual and reproductive health during COVID-19. This International Sexual Health And ReproductivE health (I-SHARE) study protocol manuscript describes a common plan for online national surveys and global comparative analyses.

Methods
The purpose of this cross-sectional study is to better understand sexual and reproductive health in selected countries during the COVID-19 pandemic and facilitate multinational comparisons. Participants will be recruited through an online survey link disseminated through local, regional and national networks. In each country, a lead organisation will be responsible for organising ethical review, translation and survey administration. The consortium network provides support for national studies, coordination and multinational comparison. We will use multilevel modelling to determine the relationship between COVID-19 and condomless sex, intimate partner violence, access to reproductive health services, HIV testing and other key items. This study protocol defines primary outcomes, prespecified subanalyses and analysis plans.

Conclusion
The I-SHARE study examines sexual and reproductive health at the national and global level during the COVID-19 pandemic. We will use multilevel modelling to investigate country-level variables associated with outcomes of interest. This will provide a foundation for subsequent online multicountry comparison using more robust sampling methodologies.
Physical activity energy expenditure and fat-free mass: relationship with metabolic syndrome in overweight or obese postmenopausal women
Authors: Maréchal René , Ghachem Ahmed , Prud’homme Denis , Rabasa-Lhoret Rémi , Dionne Isabelle J. , Brochu Martin 
Published: October 2020

Menopause transition is associated with detrimental changes in physical activity, body composition, and metabolic profile. Although physical activity energy expenditure (PAEE) is inversely associated with metabolic syndrome (MetS) in individuals at higher risk of cardiovascular disease, the association is unknown in low-risk individuals. The aim of the study was to investigate the association between PAEE and MetS (prevalence and severity) in inactive overweight or obese postmenopausal women with a low Framingham Risk Score (<10%). Cross-sectional data of 126 participants were divided into quartiles based on PAEE (Quartile (Q)1 = lowest PAEE) while fat-free mass (FFM) and fat mass were measured by dual-energy X-ray absorptiometry. MetS prevalence was significantly different between Q1 and Q4 (37.9% vs 13.3%, p = 0.03). After controlling for potential confounders, MetS severity was negatively associated with PAEE (B = −0.057, p < 0.01) and positively with FFM (B = 0.038, p < 0.001). Moderation analyses indicated that a greater FFM exacerbated the association between PAEE and MetS severity in Q1 and Q2 (PAEE × FFM; B = −0.004; p = 0.1). Our results suggest that displaying a low FRS and lower PAEE increase MetS prevalence and severity. In addition, greater FFM interacts with lower PAEE to worsens MetS severity, while higher PAEE lessened this effect. Novelty: Inactive individuals displaying higher daily PAEE also have a lower MetS prevalence. Greater FFM is associated with a worse MetS severity where a higher PAEE mitigated this deleterious effect in our cohort.
The influence of human population change and aquatic invasive species establishment on future recreational fishing activities to the Canadian portion of the Laurentian Great Lakes
Authors: Hunt Len M. , Phaneuf Daniel J. , Abbott Joshua K. , Fenichel Eli P. , Rodgers Jennifer A. , Buckley Jeffrey D. , Drake D. Andrew R. , Johnson Timothy B. 
Published: October 2020

We project how human population change (2018 to 2046) and aquatic invasive species (AIS) establishment events of bigheaded carps (Hypophthalmichthys spp.) and grass carp (Ctenopharyngodon idella) might combine to affect future Canadian recreational fishing activity for the Laurentian Great Lakes. Human population change is expected to affect the total number of fishing trips (increase of about 143 000 trips or 11.4%) more than any of the AIS establishment events (maximum decrease of about 44 000 trips or 3.5%). The projected 11.4% increase to the number of fishing trips from human population change, however, lags the 38% projected increase to Ontario, Canada’s population from 2018 to 2046. Increasing urbanization and an aging population, which are associated with reduced rates of fishing participation, were responsible for this difference. The combined effects of human population change and AIS establishment illustrate the importance of accounting for human population change as it reverses the conclusions and results in a projected net increase of between 92 000 and 125 000 in the number of fishing trips. The combined model also identifies potential growth areas for fishing such as shore fishing by urbanites on the western portion of Lake Ontario.
Wormhole modeling in f(R,T) gravity with minimally-coupled massless scalar field
Authors: Godani Nisha , Samanta Gauranga C. 
Published: October 2020

In this paper, the strong gravitational lensing is explored for traversable wormholes in [Formula: see text] theory of gravity with minimally-coupled massless scalar field. First, the effective wormhole solutions are obtained using the model [Formula: see text], where [Formula: see text] is constant, [Formula: see text] is scalar curvature and [Formula: see text] is the trace of stress-energy tensor. Furthermore, three different shape functions namely, [Formula: see text] (Ref. 36), [Formula: see text] (Refs. 35 and 37) and [Formula: see text], [Formula: see text] (Refs. 34, 35, 39, 73) are considered and studied their qualitative behavior for the construction of wormhole geometry respectively. Subsequently, gravitational lensing effect is implemented to detect the existence of photon spheres at or outside the throat of wormholes.
Clinical Characteristics of Patients with Different N-Terminal Probrain Natriuretic Peptide Levels after Hematopoietic Stem Cell Transplantation
Authors: Se Zhen , Zhou Haobin , Li Hanlin , Sun Jing , Zhan Qiong , Zeng Qingchun , Liu Qifa , Xu Dingli 
Published: October 2020

Heart failure (HF) is not uncommon among patients with hematologic malignancies (HM) undergoing hematopoietic stem cell transplantation (HSCT) and is associated with an increased mortality. Among HSCT patients without signs or symptoms of HF, groups with elevated and normal N-terminal probrain natriuretic peptide (NT-proBNP) levels have been poorly characterized in previous literature. Herein, we reviewed consecutive admissions for HM undergoing HSCT (

n
=
301

). Based on NT-proBNP levels and clinical signs or symptoms of HF at follow-up (one month after HSCT), patients were grouped into ENPH (elevated

N
T
‐
proBNP
>
125

pg
/
mL

, presence of HF symptoms or signs), ENAH (elevated

N
T
‐
proBNP
>
125

pg
/
mL

, absence of HF symptoms or signs), and NN (normal

N
T
‐
proBNP
<
125

pg
/
mL

). ENPH, ENAH, and NN were observed in 22.9%, 54.5%, and 22.6% of patients, respectively. ENPH patients had a significantly higher baseline NT-proBNP level, followed by the ENAH and NN groups, respectively (

P
<
0.001

). Frequencies of HLA partially matched related donors, stem cell source (bone marrow+peripheral blood), and utilization of graft-versus-host disease prophylaxis regimens (ciclosporin+methotrexate+antithymocyte globulin±mycophenolate mofetil) were also the highest in the ENPH group, followed by ENAH and NN groups, respectively (all

P
<
0.05

). Uric acid and hemoglobin levels, transplant type, and cyclophosphamide-based conditioning regimens utilized were similar between the ENAH and ENPH groups. We found that ENPH and ENAH are commonly observed in HM hospitalized for HSCT. Serum NT-proBNP levels may allow for earlier identification of HSCT patients at high risk of developing cardiac dysfunction.
Social Inequalities in Cancer Survival in Belgium: A Population-Based Cohort Study
Authors: Rosskamp Michael , Verbeeck Julie , Sass Victoria , Gadeyne Sylvie , Verdoodt Freija , De Schutter Harlinde 
Published: October 2020

Abstract

Background:
Socioeconomic status (SES) is an important factor in cancer survival; however, results are heterogeneous and linked to characteristics of the study population and health care system. This population-based cohort study evaluates the association between individual-level socioeconomic and demographic factors and cancer survival for the first time in Belgium.

Methods:
From the Belgian Cancer Registry, we identified 109,591 patients diagnosed between 2006 and 2013 with one of eight common cancer types. Information on treatment, socioeconomic parameters, and vital status were retrieved from multiple data sources and linked using a unique personal identification number. The outcome was 5-year observed survival. Associations between survival and socioeconomic and demographic factors were assessed using multivariable Cox proportional–hazard regression models.

Results:
Lower income, unemployment, and living alone were all associated with worse cancer survival. These associations were most pronounced for certain lifestyle-related cancer types (e.g., head and neck cancers) and those with good to moderate prognosis (e.g., colorectal and female breast cancer).

Conclusions:
These results indicate that, despite a comprehensive and nationwide health insurance program in which equity in rights and access to health care are pursued, SES is associated with disparities in cancer survival in Belgium.

Impact:
This population-based study with individual-level socioeconomic information of more than 100,000 patients with cancer identifies patient groups that may be at highest risk for socioeconomic disparities in cancer survival. Reasons behind the observed disparities are multiple and complex and should be further examined. Health policy interventions should consider the observed deprivation gap to plan targeted actions.
Lessons Learned from Setting Up a Prospective, Longitudinal, Multicenter Study with Women at High Risk for Breast Cancer
Authors: Patuleia Susana I.S. , Hagenaars Sophie C. , Moelans Cathy B. , Ausems Margreet G.E.M. , van Gils Carla H. , Tollenaar Rob A.E.M. , van Diest Paul J. , Mesker Wilma E. , van der Wall Elsken 
Published: October 2020

Abstract
Women identified with an increased risk of breast cancer due to mutations in cancer susceptibility genes or a familial history of breast cancer undergo tailored screening with the goal of detecting tumors earlier, when potential curative interventions are still possible. Ideally, screening would identify signs of carcinogenesis even before a tumor is detectable by imaging. This could be achieved by timely signaling of altered biomarker levels for precancerous processes in liquid biopsies. Currently, the Nipple Aspirate Fluid (NAF) and the Trial Early Serum Test BREAST cancer (TESTBREAST), both ongoing, prospective, multicenter studies, are investigating biomarkers in liquid biopsies to improve breast cancer screening in high-risk women. The NAF study focuses on changes over time in miRNA expression levels both in blood and NAF samples, whereas the TESTBREAST study analyzes changes in protein levels in blood samples at sequential interval timepoints. These within-subject changes are studied in relation to later occurrence of breast cancer using a nested case–control design. These longitudinal studies face their own challenges in execution, such as hindrances in logistics and in sample processing that were difficult to anticipate. This article offers insight into those challenges and concurrently aims to provide useful strategies for the set-up of similar studies.
See related commentary by Sauter, p. 429
Assessing Impact of HPV Vaccination on Cervical Cancer Incidence among Women Aged 15–29 Years in the United States, 1999–2017: An Ecologic Study
Authors: Mix Jacqueline M. , Van Dyne Elizabeth A. , Saraiya Mona , Hallowell Benjamin D. , Thomas Cheryll C. 
Published: October 2020

Abstract

Background:
To date, the impact of the human papillomavirus (HPV) vaccine on invasive cervical cancers in the United States has not been documented due, in part, to the time needed for cancer to develop and to recent changes to cervical cancer screening guidelines and recommendations, which complicate data interpretation.

Methods:
We examined incidence rates of cervical squamous cell carcinoma (SCC) and adenocarcinoma (AC) among women aged 15–29 years diagnosed during 1999–2017 using population-based cancer registry data covering 97.8% of the U.S. population. Trends were stratified by age and histology. The annual percent change in cervical cancer incidence per year was calculated using joinpoint regression.

Results:
During 1999–2017, SCC rates decreased 12.7% per year among women aged 15–20 years, 5.5% among women aged 21–24 years, and 2.3% among women aged 25–29 years. The declines in SCC rates were largest among women aged 15–20 years during 2010–2017, with a decrease of 22.5% per year. Overall, AC rates decreased 4.1% per year among women aged 15–20 years, 3.6% per year among women aged 21–24 years, and 1.6% per year among women aged 25–29 years. AC rates declined the most among women aged 15–20 years during 2006–2017, decreasing 9.4% per year.

Conclusions:
Since HPV vaccine introduction, both SCC and AC incidence rates declined among women aged 15–20 years, a group not typically screened for cervical cancer, which may suggest HPV vaccine impact.

Impact:
Timely vaccination and improved screening and follow-up among recommended age groups could result in further reductions in invasive cervical cancer.
Improved Assessment of Response Status in Patients with Pancreatic Cancer Treated with Neoadjuvant Therapy using Somatic Mutations and Liquid Biopsy Analysis
Authors: Yin Lingdi , Pu Ning , Thompson Elizabeth , Miao Yi , Wolfgang Christopher , Yu Jun 
Published: October 2020

Abstract

Purpose:
To evaluate somatic mutations, circulating tumor cells (CTCs) and circulating tumor DNA (ctDNA) in patients with Pancreatic ductal adenocarcinoma (PDAC) with pathologic complete response (pCR) to neoadjuvant therapy (NAT) and find their associations with outcome.

Experimental Design:
Thirty-six patients with PDAC with pCR were identified from 2009 to 2017. Macrodissection was performed on resected specimens to isolate DNA from 332 regions of interest including fibrosis, normal duct, normal parenchyma, and undefined ductal cells (UDCs). Cell-free DNA and CTCs were also extracted. Next-generation sequencing was used to detect mutations of KRAS, CDKN2A, SMAD4, TP53, GNAS, and BRAF.

Results:
KRAS mutation was detected in UDCs and fibrosis while SMAD4, TP53, and GNAS were only seen in UDCs. Patients with TP53 mutation showed relatively worse overall survival (HR, 3.596, 95% CI, 0.855–15.130; P = 0.081). Five patients available for CTCs data were all positive for CTCs and seven of 16 patients with pCR were detected with ctDNA at surgery. We proposed a new concept of regression assessment combining genomic analysis of resected specimens and liquid biopsy data for PDAC, namely, molecular complete response (mCR). Three of six patients with mCR recurred as compared with six in 15 non-mCR patients. Seven of 15 non-mCR patients died during follow-up, while there was only one in six patients with mCR.

Conclusions:
This study first reports that somatic mutations, CTCs, and ctDNA existed even in patients with PDAC with pCR to NAT, which could possibly predict early recurrence and reduced survival. The current regression evaluation system of PDAC needs to be reassessed at a molecular level.
Early 3+3 Trial Dose-Escalation Phase I Clinical Trial Design and Suitability for Immune Checkpoint Inhibitors
Authors: Rahma Osama E. , Reuss Joshua E. , Giobbie-Hurder Anita , Shoja E Razavi Ghazaleh , Abu-Shawer Osama , Mehra Pooja , Gupta Seema , Simon Richard , Khleif Samir N. 
Published: October 2020

Abstract

Purpose:
Despite the expansion of immune checkpoint inhibitor (ICI) indications, the relationship between ICI dose and toxicity or response is not well established. To understand this correlation, we performed a meta-analysis of ICI trials that used dose escalation.

Experimental Design:
We searched PubMed and abstracts presented at (inter)national meetings for trials using FDA-approved ICIs. The reported rates of grade 3–5 adverse events (G3–5 AE), immune-related adverse events (irAE), and response were correlated with doses within each ICI using marginal exact generalized linear models.

Results:
A total of 74 trials (7,469 patients) published between January 2010 and January 2017 were included. For ipilimumab, the incidence of G3–5 AEs was 34% with a significant 27% reduced risk in lower doses (P = 0.002). However, no relationship was observed between dose and irAEs or response. For nivolumab, the incidence of G3–5 AEs was 20.1% which was lower in non–small cell lung cancer (NSCLC) compared with renal cell carcinoma (RCC) or melanoma (P ≤ 0.05) with no dose-toxicity relationship. In melanoma and NSCLC, a dose–response association was observed, which was not observed in RCC. For pembrolizumab, the incidence of G3–5 AEs was 13.3%, which was lower in melanoma compared with NSCLC (P = 0.03) with no dose-toxicity relationship. In melanoma, lower dose levels correlated with decreased odds of response (P = 0.01), a relationship that was not observed in NSCLC.

Conclusions:
Our analysis shows a lack of consistent dose-toxicity or dose–response correlation with ICIs. Therefore, dose escalation is not an appropriate design to conduct ICI studies. Here we present an innovative trial design for immune-modulating agents.