bluuebunny/crossref_metadata_2025_split huggingface dataset:
Resumption of Sexual Activity After Voluntary Medical Male Circumcision: Data from a Population Based Cohort in Rakai, Uganda, 2013 to 2020
Authors: Daama Alex , Nalugoda Fred , Kankaka Edward , Kasango Asani , Nantume Betty , Kigozi Grace Nalwoga , Ssekubugu Robert , Namutundu Juliana , Ssettuba Absalom , Lutalo Tom , Kagaayi Joseph , Nakigozi Gertrude , Alamo Stella , Mills Lisa A. , Kabuye Geoffrey , Gray Ron , Wawer Maria , Serwadda David , Sewankambo Nelson , Kigozi Godfrey 
Published: January 2024

AbstractIntroductionVoluntary medical male circumcision (VMMC) reduces the risk of heterosexual acquisition of HIV by 50%–60%. The Uganda Ministry of Health recommends abstinence for 42 days after VMMC to allow complete wound healing. However, some men resume sex early before the recommended period. We estimated trends in prevalence and risk factors of early sex resumption (ESR) among VMMC clients in Rakai, Uganda, from 2013-2020.MethodsData from the Rakai Community Cohort Study, a cross-sectional study were analyzed. Data included consenting men aged 15–49 years in who self-reported having received VMMC in one of four successive surveys, (June 2013 to January 2015), (February 2015 to September 2016), (October 2016 to May 2018), and (June 2018 to October 2020). ESR prevalence and associated risk factors using modified Poisson regression to estimate adjusted prevalence ratios (aPR) were estimated.ResultsOverall, 1,832 men participated in the study. ESR decreased from 45.1% in 2013 to 14.9% in 2020 (p<0.001). Across the three surveys, ESR prevalence was consistently higher among married than never married men, aPR=1.83, 95% CI: [1.30,2.57]; aPR=2.46, 95% CI: [1.50,4.06]; aPR=2.22, 95% CI: [1.22,4.03]. ESR prevalence was higher among men who reported more than one sexual partner than men with one partner, aPR=1.59, 95% CI: [1.16,2.20]. In the fourth survey (2018-2020), ESR prevalence was significantly higher among men with primary education than men with post-primary, aPR=2.38, 95% CI: [1.31, 4.30] while ESR prevalence was lower among men aged at least 45 men with no sexual relationship in the past 12 months but self-reported to have resumed sex activities, aPR= 0, 95% CI: [1.86-07, 2.69-06] and aPR=0, 95% CI: [3.61e-07, 2.12e-06], respectively. Overall, men who reported primary school as their highest level of education reported ESR more often than those with post-primary education aPR=2.38, 95% CI: [1.31, 4.30]. Occupation and known HIV status were not associated with ESR.ConclusionsSelf-reported ESR after VMMC declined between 2013 and 2020. Targeted efforts for counseling focusing on married men, men who had multiple sex partners, and men with lower levels of education can help decrease post-VMMC ESR.
Benchmarking Mendelian Randomization methods for causal inference using genome-wide association study summary statistics
Authors: Hu Xianghong , Cai Mingxuan , Xiao Jiashun , Wan Xiaomeng , Wang Zhiwei , Zhao Hongyu , Yang Can 
Published: January 2024

AbstractMendelian Randomization (MR), which utilizes genetic variants as instrumental variables (IVs), has gained popularity as a method for causal inference between phenotypes using genetic data. While efforts have been made to relax IV assumptions and develop new methods for causal inference in the presence of invalid IVs due to confounding, the reliability of MR methods in real-world applications remains uncertain. To bridge this gap, we conducted a benchmark study evaluating 15 MR methods using real-world genetic datasets. Our study focused on three crucial aspects: type I error control in the presence of various confounding scenarios (e.g., population stratification, pleiotropy, and assortative mating), the accuracy of causal effect estimates, replicability and power. By comprehensively evaluating the performance of compared methods over one thousand pairs of exposure-outcome traits, our study not only provides valuable insights into the performance and limitations of the compared methods but also offers practical guidance for researchers to choose appropriate MR methods for causal inference.
Human bronchopulmonary disposition and plasma pharmacokinetics of oral bemnifosbuvir (AT-527), an experimental guanosine nucleotide prodrug for COVID-19
Authors: Zhou Xiao-Jian , Horga Arantxa , Puri Adeep , Winchester Lee , Montrond Maureen , Pietropaolo Keith , Belanger Bruce , Fletcher Courtney V. , Hammond Janet 
Published: January 2024

ABSTRACTBemnifosbuvir (BEM, AT-527) is a novel oral guanosine nucleotide antiviral drug for the treatment of patients with COVID-19. Direct assessment of drug disposition in the lungs, via bronchoalveolar lavage, is necessary to ensure antiviral drug levels at the primary site of SARS-CoV-2 infection are achieved. We conducted a Phase 1 study in healthy subjects to assess the bronchopulmonary pharmacokinetics, safety, and tolerability of repeated doses of BEM. A total of 24 subjects were assigned to receive twice-daily (BID) BEM at doses of 275, 550, or 825 mg for up to 3.5 days. AT-511, the free base of BEM, was largely eliminated from the plasma within 6 h post dose in all dosing groups. Antiviral drug levels of BEM were consistently achieved in the lungs with BEM 550 mg BID. The mean level of the guanosine nucleoside metabolite AT-273, the surrogate of the active triphosphate metabolite of the drug, measured in the epithelial lining fluid of the lungs was 0.62 µM at 4–5 h post dose. This exceeded the targetin vitro90% effective concentration (EC90) of 0.5 µM for antiviral drug exposure against SARS-CoV-2 replication in human airway epithelial cells. BEM was well tolerated across all doses tested, and most treatment-emergent adverse events reported were mild in severity and resolved. The favorable pharmacokinetics and safety profile of BEM demonstrates its potential as an oral antiviral treatment for COVID-19, with 550 mg BEM BID currently under further clinical evaluation in patients with COVID-19.
Substance Use and Overdose in Pennsylvania Libraries, 2019
Authors: Feuerstein-Simon Rachel , Lowenstein Margaret , Szapary Claire , Torres Omaya , Dolan Abby , Jalloh Aminata , Meisel Zachary F. , Cannuscio Carolyn C. 
Published: January 2024

AbstractThis study examines the implementation of naloxone distribution initiatives in Pennsylvania public libraries following a nationwide program offering free Narcan. We conducted a cross-sectional telephone survey with a random sample of Pennsylvania public libraries (n=352). Overall, nearly one-quarter of respondents reported stocking naloxone (23.9%), and over one in ten libraries reported a previous on-site overdose (11.9%). Nearly 30% of respondents had received naloxone training. Significant predictors of on-site overdoses included the library’s county urbanization status and higher county-level overdose mortality rates. Among libraries that stocked naloxone, 73% obtained the medication from local health departments or community-based organizations. This study underscores the role of public libraries in opioid overdose crisis response and the need for tailored strategies to enhance naloxone accessibility, especially in high-risk urban areas. Collaboration between libraries, public health entities, and pharmaceutical companies is crucial to amplify naloxone distribution efforts and address the escalating opioid overdose crisis.
Detecting Goals of Care Conversations in Clinical Notes with Active Learning
Authors: Weissenbacher Davy , Courtright Katherine , Rawal Siddharth , Crane-Droesch Andrew , O’Connor Karen , Kuhl Nicholas , Merlino Corinne , Foxwell Anessa , Haines Lindsay , Puhl Joseph , Gonzalez-Hernandez Graciela 
Published: January 2024

AbstractObjectiveGoals Of Care (GOC) discussions are an increasingly used quality metric in serious illness care and research. Wide variation in documentation practices within the Electronic Health Record (EHR) presents challenges for reliable measurement of GOC discussions. Novel natural language processing approaches are needed to capture GOC discussions documented in real-world samples of seriously ill hospitalized patients’ EHR notes, a corpus with a very low event prevalence.MethodsTo automatically detect utterances documenting GOC discussions outside of dedicated GOC note types, we proposed an ensemble of classifiers aggregating the predictions of rule-based, feature-based, and three transformers-based classifiers. We trained our classifier on 600 manually annotated EHR notes among patients with serious illnesses. Our corpus exhibited an extremely imbalanced ratio between utterances discussing GOC and utterances that do not. This ratio challenges standard supervision methods to train a classifier. Therefore, we trained our classifier with active learning.ResultsUsing active learning, we reduced the annotation cost to fine-tune our ensemble by 70% while improving its performance in our test set of 176 EHR notes, with 0.557 F1-score for utterance classification and 0.629 for note classification.ConclusionWhen classifying notes, with a true positive rate of 72% (13/18) and false positive rate of 8% (13/158), our performance may be sufficient for deploying our classifier in the EHR to facilitate point-of-care access to GOC conversations documented outside of dedicated notes types, without overburdening clinicians with false positives. Improvements are needed before using it to enrich trial populations or as an outcome measure.
Trends in types of revision for prosthetic joint infection and risk of a second revision from 1995 to 2022: A descriptive cohort study from the Danish Hip Arthroplasty Registry
Authors: Lundsgaard Daniel , Abedi Armita Armina , Overgaard Søren , Laigaard Jens Holm 
Published: January 2024

AbstractThis protocol outlines a register-based cohort study utilizing Danish Hip Arthroplasty Register data from 1995 to 2022. Focusing on adult patients undergoing primary total hip arthroplasty (THA), the study categorizes revisions, particularly periprosthetic joint infections (PJI), into Debridement, antibiotics, and implant retention (DAIR), one-stage, and two-stage approaches. Annual revision numbers and the risk of a second revision after each primary type will be analyzed. The study’s strengths lie in its comprehensive examination of various PJI revision methods and an extended recording period, leveraging the DHR’s high completeness rates. While acknowledging potential uncertainties, the study offers valuable insights into THA revision trends, aiding in clinical practice optimization and improving patient outcomes.Study registrationPrivacy identifier p-2023-14990Protocol uploaded to OSF: Not yet uploadedBudgetThe costs of the study are limited to the salary of the investigators, which is paid by the orthopedic department.
Shayona@SMM4H’23: COVID-19 Self diagnosis classification using BERT and LightGBM models
Authors: Chavda Rushi , Makwana Darshan , Patel Vraj , Shukla Anupam 
Published: January 2024

AbstractThis paper describes approaches and results for shared Task 1 and 4 of SMMH4-23 by Team Shayona. Shared Task-1 was binary classification of english tweets self-reporting a COVID-19 diagnosis, and Shared Task-4 was Binary classification of English Reddit posts self-reporting a social anxiety disorder diagnosis. Our team has achieved the highest f1-score 0.94 in Task-1 among all participants. We have leveraged the Transformer model (BERT) in combination with the LightGBM model for both tasks.
Safety and effectiveness of SGLT2-inhibitors in people with type 2 diabetes over 70: UK population-based study using an Instrumental Variable approach
Authors: Güdemann Laura Maria , Young Katie G. , Thomas Nicholas J. M. , Hopkins Rhian , Challen Robert , Jones Angus G. , Hattersley Andrew T. , Pearson Ewan R , Shields Beverley M. , Bowden Jack , Dennis John M. , McGovern Andrew P. ,   the Mastermind consortium
Published: January 2024

AbstractObjectiveOlder adults are underrepresented in trials, meaning the benefits and risks of glucose lowering agents in this age group are unclear. We applied causal analysis to assess the safety and effectiveness of SGLT2-inhibitors in people with type 2 diabetes (T2D) over 70.Research Design and MethodsHospital-linked UK primary care data (Clinical Practice Research Datalink, 2013-2020) were used to compare adverse events and effectiveness in individuals initiating SGLT2-inhibitors compared to DPP4-inhibitors. Analysis was age-stratified: <70 years (SGLT2-inhibitors n=66810, DPP4-inhibitors n=76172), ≥70 years (SGLT2-inhibitors n=10419, DPP4-inhibitors n=33434). Outcomes were assessed using the Instrumental Variable causal inference method and prescriber preference as instrument.ResultsRisk of DKA was increased with SGLT2-inhibitors in those aged ≥70 (Incidence risk ratio compared to DPP4i: 3.82 [95%CI 1.12,13.03]), but not in those <70 (1.12 [95%CI 0.41,3.04]). However incidence rates with SGLT2-inhibitors in those ≥70 was low (29.6 [95%CI 29.5,29.7]) per 10000 person-years. SGLT2-inhibitors were associated with similarly increased risk of genital infection in both age groups (IRR <70 2.27 [2.03,2.53]; ≥70 2.16 [1.77,2.63]). There was no evidence of an increased risk of volume depletion, poor micturition control, urinary frequency, falls or amputation with SGLT2-inhibitors in either age group. In those ≥70, HbA1c reduction was similar with SGLT2-inhibitors and DPP4-inhibitors (−0.3 mmol/mol [−1.6,1.1], −0.02% [0.1,0.1]), but in those <70 SGLT2-inhibitors were more effective (−4 mmol/mol [4.8,−3.1], −0.4% [−0.4,−0.3]).ConclusionsCausal analysis suggests SGLT2-inhibitors are effective in adults ≥70, but increase risk for genital infections and DKA. Our study extends RCT evidence to older adults with T2D.Article HighlightsWhy did we undertake this study?–Current guidelines for type 2 diabetes recommend an individualised approach to treatment, but evidence for older adults is limited.What is the specific question(s) we wanted to answer?–To assess the safety and effectiveness of SGLT2-inhibitors in older adults by applying a causal inference framework to address potential confounding bias in observational data.What did we find?–SGLT2-inhibitors are effective in reducing HbA1c and weight and generally safe for older adults. Adverse events in this older group include genital infections and a small increase in DKA.What are the implications of our findings?–SGLT2-inhibitors are effective and safe for older adults, but clinicians should be aware of the risks for genital infections and DKA.
Time to publication in medical education journals: An analysis of publication timelines during COVID-19 (2019-2022)
Authors: Maggio L.A. , Costello J.A. , Brown K. R. , Artino A.R. , Durning S.J , Ma T. 
Published: January 2024

IntroductionCOVID-19 changed scholarly publishing. Yet, its impact on medical education publishing is unstudied. Because journal articles and their corresponding publication timelines can influence academic success, the field needs updated publication timelines to set evidence-based expectations for academic productivity. This study attempts to answer the following research questions: did publication timelines significantly change around the time of COVID-19 and, if so, how?MethodsWe conducted a bibliometric study; our sample included articles published between January 2018, and December 2022, that appeared in the Medical Education Journals List-24 (MEJ-24). We clustered articles into three time-based groups (pre-COVID, COVID-overlap, and COVID-endemic), and two subject-based groups (about COVID-19 and not about COVID-19). We downloaded each article’s metadata from the National Library of Medicine and analyzed data using descriptive statistics, analysis of variance, and post-hoc tests to compare mean time differences across groups.ResultsOverall, time to publish averaged 300.8 days (SD= 200.8). One-way between-groups ANOVA showed significant differences between the three time-based groupsF(2, 7473) = 2150.7,p<.001. The post-hoc comparisons indicated that COVID-overlap articles took significantly longer (n= 1470,M= 539;SD= 210.6) as compared to pre-COVID (n= 1281;M= 302;SD= 172.5) and COVID-endemic articles (n= 4725;M= 226;SD= 136.5). Notably, COVID-endemic articles were published in significantly less time than pre-pandemic articles,p< .001.DiscussionLonger publication time was most pronounced for COVID-overlap articles. Publication timelines for COVID-endemic articles have shortened. Future research should explore how the shift in publication timelines has shaped medical education scholarship.
Status of physical activity and its associated factors among the secondary school teachers in Pokhara, Nepal
Authors: Ranabhat Kamal , Shahi Shubhadra , Shrestha Kiran , Kunwar Ramesh , Rana Himalaya , Choulagai Bishnu Prasad 
Published: January 2024

ABSTRACTCardiovascular diseases are the leading cause of all the cause of death globally and physical activity is the proven cost effective modifiable behavior risk factors for the prevention of cardiovascular diseases. The objective of the study was to assess the status of the physical activity and its determining factors among the school teachers of Pokhara Nepal. We used quantitative approach for data collection among 406 samples that were drawn using probability proportion to enrollment size. The international questionnaire on physical activity (IPAQ)-long form was used for data collection. SPSS V.27 was used for univariate and bivariate analysis.The study have found the 13.2 percent of prevalence of physical inactivity. Sex, ethnicity, educational qualification, availability of walking environment around home, mean screen time per day were found having statistical association with the outcome variable. The prevalence of low physical activity was found 13.2 percent. Majority of the study participants achieved WHO global recommendation on physical activity. Domestic and garden work contributed most in domain specific physical activity among the participants.
Prevalence of Hypertension, awareness, treatment, and blood pressure control in Sierra Leone: A systematic review and meta-analysis
Authors: Koroma Theresa Ruba , Russell James Baligeh Walter , Samura Sallieu Kabay , Coker Joshua M , Conteh Sorie , Yendewa George A. , Lisk Durodami Radcliffe 
Published: January 2024

AbstractBackgroundIn recent years, the prevalence of Hypertension (HTN) has increased in sub-Saharan countries. However, reports on the prevalence of HTN in Sierra Leone are limited. Therefore, we conducted a systematic review and meta-analysis to assess the overall estimates of the prevalence of HTN in Sierra Leone.MethodA systematic search of electronic databases (PubMed, Embase, African Journal Online and Google Scholar) was conducted by three independent investigators using keywords such as “hypertension”, “prevalence”, “blood pressure”, and “Sierra Leone”. A random-effects model was used to estimate the prevalence across studies. Heterogeneity among studies was assessed using the Cochran Q test and I2statistic, and publication bias was assessed using funnel plots and the Egger test.ResultsWe pooled the data from 15 studies (n=14,707) that met the inclusion criteria. The overall prevalence of HTN in Sierra Leone was 27.64% [95% CI = 27.45, 27.82], with significant heterogeneity observed among studies (I2=99.82%, p-value < 0.001). The pooled prevalence of Hypertension among males was higher than that among females (25.11% [95% CI = 24.90-25.32], I2=99.79%, p-value < 0.001) and 24.11% [95% CI = 23.92,24.31, I2=99.67%, p-value < 0.001]). The prevalence of HTN among urban residents (29.76%) was almost twice that among their rural counterparts (15.77%). Of those with HTN, 37.21% were aware of their illness, 12.87% received treatment, and only 29.73% had blood pressure control.ConclusionMore than 1 in 4 adults aged ≥ 15 years are living with HTN in Sierra Leone, with a low awareness rate and even lower treatment and control rates. Our findings highlighted the need for robust and comprehensive hypertension prevention, treatment and control policies.
Predictors of unsuccessful tuberculosis treatment outcomes in Brazil: an analysis of 259,484 patient records
Authors: Ryuk Do Kyung , Pelissari Daniele M , Alves Kleydson , Oliveira Patricia Bartholomay , Castro Marcia C , Cohen Ted , Sanchez Mauro , Menzies Nicolas A 
Published: January 2024

AbstractIntroductionTuberculosis (TB) causes over 1 million deaths annually. Providing effective treatment is a key strategy for reducing TB deaths. In this study, we identified factors associated with unsuccessful treatment outcomes among individuals treated for TB in Brazil.MethodsWe obtained data on individuals treated for TB between 2015 and 2018 from Brazil’s National Disease Notification System (SINAN). We excluded patients with a history of prior TB disease or with diagnosed TB drug resistance. We extracted information on patient-level factors potentially associated with successful treatment, including demographic and social factors, comorbid health conditions, health-related behaviors, health system level at which care was provided, use of directly observed therapy (DOT), and clinical examination results. We categorized treatment outcomes as successful (cure, completed) or unsuccessful (death, regimen failure, loss to follow-up). We fit multivariate logistic regression models to identify factors associated with unsuccessful treatment outcome.ResultsAmong 259,484 individuals treated for drug susceptible TB, 19.7% experienced an unsuccessful treatment outcome (death during treatment 7.8%, regimen failure 0.1%, loss to follow-up 11.9%). The odds of unsuccessful outcome were higher with older age (adjusted odds ratio (aOR) 2.90 [95% confidence interval: 2.62–3.21] for 85-100-year-olds vs. 25-34-year-olds), male sex (aOR 1.28 [1.25– 1.32], vs. female sex), Black race (aOR 1.23 [1.19–1.28], vs. White race), no education (aOR 2.03 [1.91– 2.17], vs. complete high school education), HIV infection (aOR 2.72 [2.63–2.81], vs. no HIV infection), illicit drug use (aOR 1.95 [1.88–2.01], vs. no illicit drug use), alcohol consumption (aOR 1.46 [1.41– 1.50], vs. no alcohol consumption), smoking (aOR 1.20 [1.16–1.23], vs. non-smoking), homelessness (aOR 3.12 [2.95–3.31], vs. no homelessness), and immigrant status (aOR 1.27 [1.11–1.45], vs. non-immigrants). Treatment was more likely to be unsuccessful for individuals treated in tertiary care (aOR 2.20 [2.14–2.27], vs. primary care), and for patients not receiving DOT (aOR 2.35 [2.29–2.41], vs. receiving DOT).ConclusionThe risk of unsuccessful TB treatment varied systematically according to individual and service-related factors. Concentrating clinical attention on individuals with a high risk of poor treatment outcomes could improve the overall effectiveness of TB treatment in Brazil.