bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of virological failure among adults on first-line highly active antiretroviral therapy at public health facilities in Kombolcha town, Northeast, Ethiopia: a case–control study
Authors: Meshesha Habtamu Mengist , Nigussie Zelalem Mehari , Asrat Anemaw , Mulatu Kebadnew 
Published: July 2020

ObjectiveTo identify determinants of virological failure among HIV-infected adults on first-line highly active antiretroviral therapy at public health facilities in Kombolcha town, Northeast, Ethiopia, in 2019.MethodsAn unmatched case–control study was conducted from April to May 2019. About 130 cases and 259 controls were selected by simple random sampling. Data were extracted from charts of patients using a structured checklist. Multiple logistic regression analysis was performed to identify possible factors. Hosmer-Lemeshow goodness of fit test was used to check the model. Finally, independent predictor variables of virological failure were identified based on adjusted OR (AOR) with 95% CI and a p value of 0.05.ResultsThe odds of virological failure were 2.4-fold (AOR=2.44, 95% CI 1.353 to 4.411) higher in clients aged <35 years compared with older clients, fivefold (AOR=5.00, 95% CI 2.60 to 9.63) higher in clients who did not disclose their HIV status, threefold (AOR=2.99, 95% CI 1.33 to 6.73) higher in clients with poor adherence, and 7.5-fold (AOR=7.51, 95% CI 3.98 to 14.14) higher in clients who had recent CD4 count of ≤250 cells/mm3.Conclusion and recommendationThis study revealed that age, marital status, occupation, disclosure status, baseline functional status, missed clinic visit, current antiretroviral therapy regimen, adherence to treatment and recent CD4 count were significantly associated with virological failure. Therefore, adherence support should be strengthened among clients. Missed clinic visits should also be reduced, as it could help clients better adhere to treatment, and therefore boost their immunity and suppress viral replication.
Self-directed multimedia process for delivering participant informed consent
Authors: Chapman Niamh , McWhirter Rebekah , Armstrong Matthew K , Fonseca Ricardo , Campbell Julie A , Nelson Mark , Schultz Martin G , Sharman James E 
Published: July 2020

ObjectiveObtaining informed consent is a cornerstone requirement of conducting ethical research. Traditional paper-based consent is often excessively lengthy and may fail to achieve the desired participant understanding of study requirements. Multimedia tools including video and audio may be a useful alternative. This study aimed to determine the efficacy, usability and acceptability of self-directed multimedia delivery of participant consent.DesignIt is a single-centre, randomised, prospective study to determine the efficacy, usability and acceptability of a self-directed multimedia consent process (intervention) compared with the traditional paper-based approach (control). The intervention was free of research staff, with computer-based finger-signed consent.SettingPathology blood collection services in Tasmania, Australia.Participants298 participants (63±8 years; 51% female individuals) referred from general practice were randomised to intervention (n=146) and control (n=152).Outcome measuresEfficacy, usability and acceptability of the allocated consent process were assessed by a questionnaire.ResultsAll participants successfully completed the allocated interventions. Efficacy parameters were higher among intervention participants, including a better understanding of study requirements compared with controls (p<0.05 all). Intervention participants were more likely to engage with the study information and spend more time on the consent process (p=<0.001 and p=0.006, respectively). Both groups reported similar levels of acceptability, although more control participants reported that the study information was too long (24% vs 14%; p=0.020).ConclusionA self-directed multimedia consent process is effective for achieving participant understanding and obtaining consent free of research staff. Thus, multimedia represents a viable method to reduce the burden on researchers, meet participant needs and achieve informed consent in clinical research.
General practice nurses and physicians and end of life: a systematic review of models of care
Authors: Mitchell Geoffrey , Aubin Michèle , Senior Hugh , Johnson Claire , Fallon-Ferguson Julia , Williams Briony , Monterosso Leanne , Rhee Joel J , McVey Peta , Grant Matthew , Nwachukwu Harriet , Yates Patsy 
Published: July 2020

BackgroundGeneral practitioners (GPs) and general practice nurses (GPNs) face increasing demands to provide palliative care (PC) or end-of-life care (EoLC) as the population ages. In order to maximise the impact of GPs and GPNs, the impact of different models of care that have been developed to support their practice of EoLC needs to be understood.ObjectiveTo examine published models of EoLC that incorporate or support GP and GPN practice, and their impact on patients, families and the health system.MethodSystematic literature review. Data included papers (2000 to 2017) sought from Medline, Psychinfo, Embase, Joanna Briggs Institute and Cochrane databases.ResultsFrom 6209 journal articles, 13 papers reported models of care supporting the GP and GPN’s role in EoLC or PC practice. Services and guidelines for clinical issues have mixed impact on improving symptoms, but improved adherence to clinical guidelines. National Frameworks facilitated patients being able to die in their preferred place. A single specialist PC-GP case conference reduced hospitalisations, better maintained functional capacity and improved quality of life parameters in both patients with cancer and without cancer. No studies examined models of care aimed at supporting GPNs.ConclusionsPrimary care practitioners have a natural role to play in EoLC, and most patient and health system outcomes are substantially improved with their involvement. Successful integrative models need to be tested, particularly in non-malignant diseases. Such models need to be explored further. More work is required on the role of GPNs and how to support them in this role.
Women’s age and total motile normal morphology sperm count predict fecundability: a prospective cohort study
Authors: Lam Mei Ting , Li Hang Wun Raymond , Wong Ching Yin Grace , Yeung William Shu Biu , Ho Pak Chung , Ng Ernest Hung Yu 
Published: July 2020

ObjectiveThis study investigated the role of women’s age, serum anti-Müllerian hormone (AMH) level and semen parameters in predicting fecundability.MethodsThis was a prospective cohort study on couples attending for preconceptional health check. Occurrence of conception at 1 year after ceasing contraception and time to pregnancy were noted by telephone follow-up. The women’s age, serum AMH level and total motile normal morphology sperm count (TMNC) were compared between those who conceived and those who did not after 1 year; their independent predictive value on conception at 1 year was analysed by logistic regression. Among those conceiving within 1 year, Spearman’s correlations between time to pregnancy and the clinical parameters were studied.ResultsOf the 100 couples analysed, we found younger age of the women (p=0.008), higher serum AMH level (p=0.038) and higher TMNC (p=0.015) in those that conceived within 1 year. Multivariate logistic regression found that women’s age (OR 0.867, 95% CI 0.761 to 0.988, p=0.032) and TMNC (OR 1.089, 95% 1.001–1.185, p=0.047), but not serum AMH level, significantly predicted conception within 1 year. Among those that conceived within 1 year, none of the parameters analysed were correlated with time to pregnancy within 1 year.ConclusionsWomen’s age and TNMC are significant independent predictors of conception within 1 year. No parameter was shown to predict the time to pregnancy within 1 year. This finding can aid preconceptional counselling of couples who are planning for pregnancy.
Mutation spectrum and erythrocyte indices characterisation of α-thalassaemia and β-thalassaemia in Sichuan women in China: a thalassaemia screening survey of 42 155 women
Authors: Li Bei , Han Xiao , Ma Jian , Yang Dan 
Published: July 2020

AimsThe present study aims to investigate the mutation spectrum of thalassaemia, and characterise the erythrocyte indices of thalassaemia in a large cohort in Sichuan, which is a province with a high prevalence of thalassaemia in southern China.MethodsThe present study was conducted from July 2017 to July 2019. A total of 42 155 women screened for thalassaemia were enrolled. The thalassaemia carriers were screened by erythrocyte analysis and haemoglobin electrophoresis. Then, the screening test results and genetic results were collected.ResultsA total of 1109 individuals had thalassaemia gene defects. Among these individuals, 69.7% were α-thalassaemia (α-thal) and 28.6% were β-thalassaemia (β-thal). For α-thal defects, carriers with--SEAhad the lowest mean corpuscular volume (MCV) and mean corpuscular haemoglobin (MCH) values. For β-thal defects, carriers with heterozygous haemoglobin E and −28 had the highest MCV and MCH values. In addition, an MCV cut-off of 80 fl and an MCH cut-off of 27 pg was able to detect 99.1% α0 thalassaemia and 99.7% β0/β+ thalassaemia; however, that criterion could result in a great number of false-negative results in α+ carriers.ConclusionA criterion of MCV <80 fl and MCH <27 pg is recommended for detecting –SEA carriers and β0/β+ carriers, while higher cut-offs are needed to detect α+ carriers.
Comprehensive characteristics of somatic mutations in the normal tissues of patients with cancer and existence of somatic mutant clones linked to cancer development
Authors: Oh Ji-Hye , Sung Chang Ohk 
Published: July 2020

BackgroundSomatic mutations are a major driver of cancer development and many have now been identified in various cancer types, but the comprehensive somatic mutation status of the normal tissues matched to tumours has not been revealed.MethodWe analysed the somatic mutations of whole exome sequencing data in 392 patient tumour and normal tissue pairs based on the corresponding blood samples across 10 tumour types.ResultsMany of the mutations involved in oncogenic pathways such as PI3K, NOTCH and TP53, were identified in the normal tissues. The ageing-related mutational signature was the most prominent contributing signature found and the mutations in the normal tissues were frequently in genes involved in late replication time (p<0.0001). Variants were rarely overlapping across tissue types but shared variants between normal and matched tumour tissue were present. These shared variants were frequently pathogenic when compared with non-shared variants (p=0.001) and showed a higher variant-allele-fraction (p<0.0001). Normal tissue-specific mutated genes were frequently non-cancer-associated (p=0.009).PIK3CAmutations were identified in 6 normal tissues and were harboured by all of the matched cancer tissues. Multiple types ofPIK3CAmutations were found in normal breast and matched cancer tissues. ThePIK3CAmutations exclusively present in normal tissue may indicate clonal expansions unrelated to the tumour. In addition,PIK3CAmutation was appeared that they arose before the occurrence of the allelic imbalance.ConclusionOur current results suggest that somatic mutant clones exist in normal tissues and that their clonal expansion could be linked to cancer development.
Effects on time to lapse of switching menthol smokers to non-menthol cigarettes prior to a cessation attempt: a pilot study
Authors: Kotlyar Michael , Shanley Ryan , Dufresne Sheena R , Corcoran Gretchen A , Okuyemi Kolawole S , Mills Anne M , Hatsukami Dorothy K 
Published: July 2020

IntroductionMenthol smokers (particularly African-Americans) have lower cessation success rates than non-menthol smokers. With bans being considered on characterising menthol flavour in cigarettes, data are needed regarding how switching to non-menthol cigarettes impacts cessation measures.MethodsIn this randomised pilot study, African-American menthol cigarette smokers interested in quitting smoking either continued smoking menthol cigarettes (n=60) or switched to non-menthol cigarettes (n=62) for a 1-month period prior to a cessation attempt. The primary endpoint was time to smoking lapse (ie, time from quitting until any smoking). Additional endpoints included time to smoking relapse (ie, number of days from quitting until the first of seven consecutive smoking days) and difference between groups in subjective measures.ResultsAfter attempting to quit, the non-menthol cigarette group had indications of delayed time to lapse (HR 0.82; 95% CI 0.55 to 1.22; p=0.33) and time to relapse (HR 0.67; 95% CI 0.42 to 1.06; p=0.09), although these were not statistically significant. Post hoc analyses suggest that observed differences were largely due to a smaller proportion of participants in the non-menthol group relapsing within the first day of quitting (21% vs 40%; p=0.05). Values of other measures assessed postcessation were largely similar between groups.ConclusionsThese data suggest that among African-American smokers, a menthol cigarette ban would not undermine short-term cessation measures and may result in some benefits. Future research is needed to assess longer term cessation rates and to identify interventions to maximise cessation success in the event of a menthol ban.Trial registration numberNCT02342327.
Some remarks about the maximal perimeter of convex sets with respect to probability measures
Authors: Livshyts Galyna V. 
Published: July 2020

In this note, we study the maximal perimeter of a convex set in [Formula: see text] with respect to various classes of measures. Firstly, we show that for a probability measure [Formula: see text] on [Formula: see text], satisfying very mild assumptions, there exists a convex set of [Formula: see text]-perimeter at least [Formula: see text] This implies, in particular, that for any isotropic log-concave measure [Formula: see text], one may find a convex set of [Formula: see text]-perimeter of order [Formula: see text]. Secondly, we derive a general upper bound of [Formula: see text] on the maximal perimeter of a convex set with respect to any log-concave measure with density [Formula: see text] in an appropriate position. Our lower bound is attained for a class of distributions including the standard normal distribution. Our upper bound is attained, say, for a uniform measure on the cube. In addition, for isotropic log-concave measures, we prove an upper bound of order [Formula: see text] for the maximal [Formula: see text]-perimeter of a convex set.
Breast Cancer Risk and Use of Nonsteroidal Anti-inflammatory Agents After a Benign Breast Biopsy
Authors: Sherman Mark E. , Vierkant Robert A. , Kaggal Suneetha , Hoskin Tanya L. , Frost Marlene H. , Denison Lori , Visscher Daniel W. , Carter Jodi M. , Winham Stacey J. , Jensen Matthew R. , Radisky Derek C. , Vachon Celine M. , Degnim Amy C. 
Published: July 2020

Abstract
Over one million women in the United States receive biopsy diagnoses of benign breast disease (BBD) each year, which confer a 1.5–4.0-fold increase in breast cancer risk. Studies in the general population suggest that nonsteroidal anti-inflammatory agents (NSAID) lower breast cancer risk; however, associations among women with BBD are unknown. We assessed whether NSAID use among women diagnosed with BBD is associated with lower breast cancer risk. Participants included 3,080 women (mean age = 50.3 ± 13.5 years) in the Mayo BBD surgical biopsy cohort diagnosed between January 1, 1992 and December 31, 2001 who completed breast cancer risk factor questionnaires that assessed NSAID use, and whose biopsies underwent detailed pathology review, masked to outcome. Women were followed from date of BBD biopsy to breast cancer diagnosis (main outcome) or censoring (death, prophylactic mastectomy, reduction mammoplasty, lobular carcinoma in situ or last contact). Median follow-up time was 16.4 ± 6.0 years. Incident breast cancer was diagnosed among 312 women over a median follow-up of 9.9 years. Regular non-aspirin NSAID use was associated with lower breast cancer risk [HR = 0.63; 95% confidence interval (CI) = 0.46–0.85; P = 0.002] with trends of lower risk (highest tertiles of use vs. nonuse) for greater number of years used [HR = 0.55; 95% CI = 0.31–0.97; Ptrend = 0.003), days used per month (HR = 0.51; 95% CI = 0.33–0.80; Ptrend = 0.001) and lifetime number of doses taken (HR = 0.53; 95% CI = 0.31–0.89; Ptrend = 0.003). We conclude that nonaspirin NSAID use is associated with statistically significant lower breast cancer risk after a BBD biopsy, including a dose–response effect, suggesting a potential role for NSAIDs in breast cancer prevention among patients with BBD.
Cardio‐Oncology in the Era of the COVID‐19 Pandemic and Beyond
Authors: Addison Daniel , Campbell Courtney M. , Guha Avirup , Ghosh Arjun K. , Dent Susan F. , Jneid Hani 
Published: July 2020

Abstract
Coronavirus disease 2019 (COVID‐19) has emerged as a global pandemic and public health crisis. Increasing waves of intermittent infectious outbreaks have dramatically influenced care among broad populations. Over the past 2 decades, there has been a rapid increase in cancer survival, with >400 000 new survivors each year. The increasingly common presence of cardiovascular disease in patients during or after cancer treatment led to the rapid growth of the field of cardio‐oncology with a mandate of identifying, treating, and preventing the various forms of cardiovascular disease seen among this population. This review evaluates the implications of the pandemic on the practice and study of cardio‐oncology. The evolving understanding of the relationship between comorbid disease and clinical outcomes among this population is assessed. With the impetus of the pandemic, cardio‐oncology can be deliberate in embracing changes to cardiac screening, monitoring, and intervention during oncology care. Bridging 2 specialties, consideration of the lessons learned in cancer and cardiovascular may pivotally inform ongoing therapeutic efforts. Further, the development of multicenter registries focused on understanding and optimizing outcomes among these patients should be considered. Together, these insights may critically inform strategies for the care of cardio‐oncology patients in future phases of the COVID‐19 pandemic and beyond.
Combining Emergent Constraints for Climate Sensitivity
Authors: Bretherton Christopher S. , Caldwell Peter M. 
Published: July 2020

AbstractA method is proposed for combining information from several emergent constraints into a probabilistic estimate for a climate sensitivity proxy Y such as equilibrium climate sensitivity (ECS). The method is based on fitting a multivariate Gaussian PDF for Y and the emergent constraints using an ensemble of global climate models (GCMs); it can be viewed as a form of multiple linear regression of Y on the constraints. The method accounts for uncertainties in sampling this multidimensional PDF with a small number of models, for observational uncertainties in the constraints, and for overconfidence about the correlation of the constraints with the climate sensitivity. Its general form (Method C) accounts for correlations between the constraints. Method C becomes less robust when some constraints are too strongly related to each other; this can be mitigated using regularization approaches such as ridge regression. An illuminating special case, Method U, neglects any correlations between constraints except through their mutual relationship to the climate proxy; it is more robust to small GCM sample size and is appealingly interpretable. These methods are applied to ECS and the climate feedback parameter using a previously published set of 11 possible emergent constraints derived from climate models in the Coupled Model Intercomparison Project (CMIP). The ±2σ posterior range of ECS for Method C with no overconfidence adjustment is 4.3 ± 0.7 K. For Method U with a large overconfidence adjustment, it is 4.0 ± 1.3 K. This study adds confidence to past findings that most constraints predict higher climate sensitivity than the CMIP mean.
Evaluation on the Capability of Revealing Ocean Swells from Sentinel-1A Wave Spectra Measurements
Authors: Wang Xuan , Husson Romain , Jiang Haoyu , Chen Ge , Gao Guoping 
Published: July 2020

AbstractWave measurements retrieved bySentinel-1Alevel-2 ocean (OCN) products are sensitive to swells other than wind seas, and are considered to provide a finer resolution of ocean swells. To assess the capability of swell retrieval globally, OCN products are validated against WAVEWATCH III (WW3) wave spectra for two available incidence angles [“wave mode” (WV); WV1: 23°; WV2: 36°], focused on the integral wave parameters and most energetic wave system ofSentinel-1A. The wave parameter difference betweenSentinel-1Aand WW3 along antenna look angles for WV1 demonstrates the obvious impact of the nonlinearity influence in the azimuth direction, resulting in an unrealistically high wave height at the low wave frequency, and the spurious split of wave systems in the range direction, due to the vanishing of velocity bunching modulation. WV2 is less pronounced in these two aspects, but tends to shift wave energy to a higher wave frequency in the range direction. The inside discrepancy of wave energy has two noticeable features: the difference in peak wavelengths in the wave spectrum is positively clustered in the azimuth direction and negatively clustered in the range direction; some of the most energetic partitions derived fromSentinel-1Aare difficult to assign to any wave systems in WW3. This phenomenon could be related to wind-wave coupling as the azimuth cutoff/WW3 peak wavelength is confined to a ratio below 0.5 for the negative difference betweenSentinel-1Aand WW3 peak wavelengths and the spectral distance of most energetic wave system inSentinel-1Ahighly resembles “swell pools.”
Assessment of tacrolimus and creatinine concentration collected using Mitra microsampling devices
Authors: Marshall David J , Kim Jon Jin , Brand Sarah , Bryne Catherine , Keevil Brian G 
Published: July 2020

Background Current practice requires regular venous blood samples for monitoring of tacrolimus concentrations post renal transplant requiring regular hospital visits. Mitra devices use volumetric absorptive microsampling technology and absorb a fixed amount of blood (10  μL) from a capillary blood sample. They are a viable volumetric alternative to dried blood spots and are able to be posted to the laboratory for analysis. Objective The aim was to develop and validate liquid chromatography-tandem mass spectrometry (LC-MS/MS) assays for tacrolimus and creatinine analysis using Mitra devices. The usefulness of this approach was assessed in renal transplant patients routinely monitored for tacrolimus and creatinine. Method Routine tacrolimus samples were used to assess the utility and reliability of Mitra sampling. Shared sample preparation for both tacrolimus and creatinine was carried out in a 96-deep well plate; mass spectrometric analysis was then undertaken for tacrolimus followed by re-injection for creatinine analysis. Results Comparison of 131 Mitra samples with a routine LC-MS/MS assay for tacrolimus showed a minimal bias –5.6% (95% CI –8.5 to –2.7%). Comparison of 135 serum and Mitra samples for creatinine using a fully validated LC-MS/MS assay showed a bias –6.5% (95% CI –8.5 to –4.5%). Discussion We have developed assays for tacrolimus and creatinine on fingerprick blood using the Mitra device and believe this approach provides a viable alternative to repeated venepuncture for therapeutic drug monitoring. This method could open up the opportunity for patients to perform tacrolimus and kidney function monitoring at home.