bluuebunny/crossref_metadata_2025_split huggingface dataset:
Testosterone is positively associated with coronary artery calcium in a low cardiovascular disease risk population
Authors: Trumble Benjamin C , Negrey Jacob , Koebele Stephanie V , Thompson Randall C , Samuel Wann L , Allam Adel H , Beheim Bret , Linda Sutherland M , Sutherland James D , Eid Rodriguez Daniel , Michalik David E , Rowan Chris J , Lombardi Guido P , Garcia Angela R , Cummings Daniel K , Seabright Edmond , Alami Sarah , Kraft Thomas S , Hooper Paul , Buetow Kenneth , Irimia Andrei , Gatz Margaret , Stieglitz Jonathan , Gurven Michael D , Kaplan Hillard , Thomas Gregory S ,   Tsimane Health and Life History Project Teams
Published: November 2023

Abstract

Background
In industrialized populations, low male testosterone is associated with higher rates of cardiovascular mortality. However, coronary risk factors like obesity impact both testosterone and cardiovascular outcomes. Here, we assess the role of endogenous testosterone on coronary artery calcium in an active subsistence population with relatively low testosterone levels, low cardiovascular risk and low coronary artery calcium scores.

Methodology
In this cross-sectional community-based study, 719 Tsimane forager-horticulturalists in the Bolivian Amazon aged 40+ years underwent computed tomography (49.8% male, mean age 57.6 years).

Results
Coronary artery calcium levels were low; 84.5% had no coronary artery calcium. Zero-inflated negative binomial models found testosterone was positively associated with coronary artery calcium for the full sample (Incidence Rate Ratio [IRR] = 1.477, 95% Confidence Interval [CI] 1.001–2.170, P = 0.031), and in a male-only subset (IRR = 1.532, 95% CI 0.993–2.360, P = 0.053). Testosterone was also positively associated with clinically relevant coronary atherosclerosis (calcium &gt;100 Agatston units) in the full sample (Odds Ratio [OR] = 1.984, 95% CI 1.202–3.275, P = 0.007) and when limited to male-only sample (OR = 2.032, 95% CI 1.118–4.816, P = 0.024). Individuals with coronary artery calcium &gt;100 had 20% higher levels of testosterone than those with calcium &lt;100 (t = –3.201, P = 0.007).

Conclusions and Implications
Among Tsimane, testosterone is positively associated with coronary artery calcium despite generally low normal testosterone levels, minimal atherosclerosis and rare cardiovascular disease (CVD) events. Associations between low testosterone and CVD events in industrialized populations are likely confounded by obesity and other lifestyle factors.
Changes in weight status during the COVID-19 pandemic: impact of educational level and mental health
Authors: Rosenkilde Siri , Sørensen Thorkild I A , Algren Maria H , Thygesen Lau C 
Published: November 2023

Abstract

Background
The COVID-19 pandemic has resulted in a disruption of daily routines and changes in health behaviors leading to widespread concerns about unfavorable changes in weight status and a potential increase in the prevalence of obesity. This study examined the long-term impact of the COVID-19 pandemic on changes in weight status and its possible dependency on educational level and mental health.

Methods
The study utilizes the Danish Health and Well-being Survey with repeated self-reported information on weight status collected before the COVID-19 pandemic (autumn of 2019) and twice during the pandemic (autumns of 2020 and 2021). Information on educational level was derived from registers, whereas mental health was measured using validated scales. Generalized estimating equations were performed to investigate changes in mean weight and body mass index (BMI) category (BMI &lt; 30 to BMI ≥ 30) between 2019 and 2021 and to investigate potential differences in changes in weight status by pre-pandemic educational level and mental health.

Results
Mean weight significantly increased by 0.34 kg [95% confidence interval (CI): 0.16–0.51] in 2020 and by 0.46 kg (95% CI: 0.26–0.66) in 2021 compared with pre-pandemic weight status. The increase was greater among individuals with lower educational levels and poorer mental health. There were no significant changes in BMI category during the pandemic.

Conclusion
The results showed a significant increase in mean weight among the Danish population, particularly among individuals with lower educational levels and poorer mental health, but without detectable differences in obesity, supporting a long-term but minor impact of the COVID-19 pandemic on weight status.
Adolescent behavioural risk screening in primary care: physician’s point of view
Authors: Eisner-Fellay Taslina , Suris Joan-Carles , Barrense-Dias Yara 
Published: November 2023

Abstract

Background
Despite regular consultation between adolescents/young adults (AYA) and their physicians, they are not regularly screened for psychosocial risk behaviours. This study examines physicians’ self-reported psychosocial risk behaviour screening in AYA. It aims to highlight which elements hinder or improve screening abilities.

Methodology
The design was a cross-sectional quantitative survey. Data were obtained through a self-reported questionnaire sent out to primary care physicians (PCP) in Switzerland in 2018. The target population consisted of 1,824 PCP (29% response rate). Participants were asked whether they screened youths from 3 age groups [10–14 y/o, 15–20 y/o, and 21–25y/o] for the HEEADSSS items during child well visits and routine checkups. Barriers to screening included primary consultation motive prioritization, insufficient time, patient compliance, reimbursement, lack of skills related to adolescent health, lack of referral options. Data were analysed first through a bivariate analysis using Chi-square tests then through a multinomial logistic regression.

Results
The majority of physicians partook in preventive screening for 3–5 psychosocial risk elements. They reported the primary consultation motive as well as a lack of available time as having a high impact on their screening habits. Physician’s experience and having discussed confidentiality were related to an increase in the number of topics addressed. Confidentiality remained a significant variable throughout all analyses.

Conclusion
Barriers such as lack of consultation time and prioritization issues were found by physicians to be critical but did not hinder screening habits. The main element impacting screening habits was assuring confidentiality and the second is self-efficacy.
Genetic models of fibrillinopathies
Authors: Summers Kim M 
Published: November 2023

Abstract
The fibrillinopathies represent a group of diseases in which the 10–12 nm extracellular microfibrils are disrupted by genetic variants in one of the genes encoding fibrillin molecules, large glycoproteins of the extracellular matrix. The best-known fibrillinopathy is Marfan syndrome, an autosomal dominant condition affecting the cardiovascular, ocular, skeletal, and other systems, with a prevalence of around 1 in 3,000 across all ethnic groups. It is caused by variants of the FBN1 gene, encoding fibrillin-1, which interacts with elastin to provide strength and elasticity to connective tissues. A number of mouse models have been created in an attempt to replicate the human phenotype, although all have limitations. There are also natural bovine models and engineered models in pig and rabbit. Variants in FBN2 encoding fibrillin-2 cause congenital contractural arachnodactyly and mouse models for this condition have also been produced. In most animals, including birds, reptiles, and amphibians, there is a third fibrillin, fibrillin-3 (FBN3 gene) for which the creation of models has been difficult as the gene is degenerate and nonfunctional in mice and rats. Other eukaryotes such as the nematode C. elegans and zebrafish D. rerio have a gene with some homology to fibrillins and models have been used to discover more about the function of this family of proteins. This review looks at the phenotype, inheritance, and relevance of the various animal models for the different fibrillinopathies.
“A Soft Death”: Perceptions and Attitudes Toward Palliative Care in Senegal
Authors: Silverstein Hannah I , Sahawneh Fursan , Carpenter Brian D 
Published: November 2023

Abstract

Background and Objectives
Palliative care (PC) is a specialty medical service that aims to address the bio-psycho-social–spiritual needs of patients with serious illnesses and their care partners. Despite the value of PC, its expansion in Sub-Saharan Africa has been uneven and particularly underdeveloped in Senegal due to variability in access to training resources and funding. This study sought to understand the current landscape of PC services in Senegal and the barriers and opportunities in its growth.

Research Design and Methods
Semistructured interviews were conducted with six PC clinicians, four caregivers of people with serious illnesses, one driver for a PC service, and one public health professor, all native to Senegal. Questions addressed their experience delivering or receiving PC, perceptions of barriers to implementation and access, and recommendations for additional resources and initiatives. Interviews were translated and transcribed from French into English. Transcripts were qualitatively coded for concepts during open and focused coding to identify themes.

Results
Five themes were identified: (1) the current landscape of PC, (2) barriers to implementing PC, (3) strategies and philosophies in care, (4) unique features of Senegalese culture, and (5) the future of PC.

Discussion and Implications
Our findings demonstrate that PC in Senegal remains an underresourced and underutilized specialty medical service, but work is being done by personally committed clinicians. Results can inform PC expansion by highlighting important cultural factors influencing care in Senegal, as well as the need to expand training opportunities for clinicians, increase education of other medical providers and the public about the nature of PC, integrate PC into the healthcare system, and expand research to evaluate the impact of these resources. PC has the potential to be an important force for improving the quality of life for Senegalese patients and their care partners.
HIV Prevention Among Men Who Have Sex With Men: Tenofovir Alafenamide Combination Preexposure Prophylaxis Versus Placebo
Authors: Zivich Paul N , Cole Stephen R , Edwards Jessie K , Glidden David V , Das Moupali , Shook-Sa Bonnie E , Shao Yongwu , Mehrotra Megha L , Adimora Adaora A , Eron Joseph J 
Published: November 2023

AbstractBackgroundWhile noninferiority of tenofovir alafenamide and emtricitabine (TAF/FTC) as preexposure prophylaxis (PrEP) for the prevention of human immunodeficiency virus (HIV) has been shown, interest remains in its efficacy relative to placebo. We estimate the efficacy of TAF/FTC PrEP versus placebo for the prevention of HIV infection.MethodsWe used data from the DISCOVER and iPrEx trials to compare TAF/FTC to placebo. DISCOVER was a noninferiority trial conducted from 2016 to 2017. iPrEx was a placebo-controlled trial conducted from 2007 to 2009. Inverse probability weights were used to standardize the iPrEx participants to the distribution of demographics and risk factors in the DISCOVER trial. To check the comparison, we evaluated whether risk of HIV infection in the shared tenofovir disoproxil fumarate and emtricitabine (TDF/FTC) arms was similar.ResultsNotable differences in demographics and risk factors occurred between trials. After standardization, the difference in risk of HIV infection between the TDF/FTC arms was near zero. The risk of HIV with TAF/FTC was 5.8 percentage points lower (95% confidence interval [CI], −2.0% to −9.6%) or 12.5-fold lower (95% CI, .02 to .31) than placebo standardized to the DISCOVER population.ConclusionsThere was a reduction in HIV infection with TAF/FTC versus placebo across 96 weeks of follow-up.Clinical Trials RegistrationNCT02842086 and NCT00458393.
Prospective Assessment of Humoral and Cellular Immune Responses to a Third COVID-19 mRNA Vaccine Dose Among Immunocompromised Individuals
Authors: Haidar Ghady , Hodges Jacob C , Bilderback Andrew , Lukanski Amy , Linstrum Kelsey , Postol Barbara , Troyan Rachel , Wisniewski Mary K , Coughenour Lindsay , Heaps Amy , Jacobs Jana L , Hughes Kramer Kailey , Klamar-Blain Cynthia , Kohl Joshua , Liang Wendy , Morris Benjamin , Macatangay Bernard J C , Parikh Urvi M , Sobolewksi Michele D , Musgrove Christopher , Crandall Melissa D , Mahon John , Mulvey Katie , Collins Kevin , King Adam C , Wells Alan , Zapf Rachel , Agha Mounzer , Minnier Tami , Angus Derek C , Mellors John W 
Published: November 2023

Abstract

Background
Improved coronavirus disease 2019 (COVID-19) prevention is needed for immunocompromised individuals.

Methods
A prospective study was performed of health care workers (HCW) and immunocompromised participants with baseline serology following 2 mRNA vaccine doses and who were retested after dose 3 (D3); multivariable regression was used to identify predictors of serological responses. IFN-γ/TNF-α T-cell responses were assessed in a subset.

Results
In total, 536 participants were included: 492 immunocompromised (206 solid organ transplant [SOT], 128 autoimmune, 80 hematologic malignancy [HM], 48 solid tumor, 25 HIV), and 44 HCW. D3 significantly increased spike IgG levels among all, but SOT and HM participants had the lowest median antibody levels post-D3 (increase from 0.09 to 0.83 and 0.27 to 1.92, respectively), versus HCW and persons with HIV, autoimmune conditions, and solid tumors (increases from 4.44 to 19.79, 2.9 to 15.75, 3.82 to 16.32, and 4.1 to 25.54, respectively). Seropositivity post-D3 was lowest for SOT (49.0%) and HM (57.8%), versus others (&gt;90%). Neutralization post-D3 was lowest among SOT and HM. Predictors of lower antibody levels included low baseline levels and shorter intervals between vaccines. T-cell responses against spike increased significantly among HCW and nonsignificantly among immunocompromised individuals.

Conclusions
D3 significantly improves serological but not T-cell responses among immunocompromised individuals. SOT and HM patients have suboptimal responses to D3.
Financial cooperation in the Asia-Pacific as regime complex: explaining patterns of coverage, membership, and rules
Authors: Grimes William W , Lee Yaechan , Kring William N 
Published: November 2023

Abstract
Since the 1997 Asian Financial Crisis, East Asia has gone from having virtually no regional financial cooperation to having multiple cooperative arrangements. This article focuses on the issue area of emergency liquidity provision, where global (International Monetary Fund), regional (Chiang Mai Initiative Multilateralization), and bilateral arrangements co-exist and overlap in complicated ways, forming a regime complex. While the overall system offers more options and greater funding than were available in 1997, it also raises questions about how those levels will operate in a crisis. This article shows how national preferences of likely creditor and likely borrower countries have interacted to create the current regime complex, as well as the political compromises and remaining uncertainties about how they will work together. It argues that the evolution and current shape of the regime complex have been driven by the efforts of key states to take advantage of or thwart power asymmetries.
UK clinicians’ attitudes towards the application of molecular diagnostics to guide antibiotic use in ICU patients with pneumonias: a quantitative study
Authors: Stewart Sarah-Jane F , Pandolfo Alyssa M , Moon Zoe , Jani Yogini , Brett Stephen J , Brealey David , Singh Suveer , Enne Virve I , Livermore David M , Gant Vanya , Horne Robert 
Published: November 2023

Abstract

Background
Molecular diagnostic tests may improve antibiotic prescribing by enabling earlier tailoring of antimicrobial therapy. However, clinicians’ trust and acceptance of these tests will determine their application in practice.

Objectives
To examine ICU prescribers’ views on the application of molecular diagnostics in patients with suspected hospital-acquired and ventilator-associated pneumonia (HAP/VAP).

Methods
Sixty-three ICU clinicians from five UK hospitals completed a cross-sectional questionnaire between May 2020 and July 2020 assessing attitudes towards using molecular diagnostics to inform initial agent choice and to help stop broad-spectrum antibiotics early.

Results
Attitudes towards using molecular diagnostics to inform initial treatment choices and to stop broad-spectrum antibiotics early were nuanced. Most (83%) were positive about molecular diagnostics, agreeing that using results to inform broad-spectrum antibiotic prescribing is good practice. However, many (58%) believed sick patients are often too unstable to risk stopping broad-spectrum antibiotics based on a negative result.

Conclusions
Positive attitudes towards the application of molecular diagnostics to improve antibiotic stewardship were juxtapositioned against the perceived need to initiate and maintain broad-spectrum antibiotics to protect unstable patients.
Cartel leniency programme in India—why no race here?
Authors: T.S. Somashekar , Tripathi Praveen 
Published: November 2023

Abstract
This article evaluates the implementation of the cartel leniency programme by the Competition Commission of India (CCI) using comprehensive data covering all related decisions of the CCI from 2009 to 2021. All other things remaining the same prima facie discoveries of cartels should have resulted in a ‘shock’ to ex ante expected returns of cartels, thereby encouraging more leniency applications. But, we find no such results or rather no ‘race’ to the agency. A successful leniency programme requires a transparent and deterrent penalty, plus consistency in applying leniency provisions. However, inconsistencies in the choice of penalty base and uncertainties in determining final penalties while using mitigating and aggravating factors have led to a poor correlation of penalties with cartel gain or harm. Strategic or otherwise, this has encouraged appeals to the appellate authority, thereby reducing the effective penalty to levels below deterrence. Many acts of bid rigging have been penalized using less stringent criteria and, in a few circumstances, also provided the benefit of leniency. Further, while individuals concerned in leniency cases have always been penalized, the CCI has not been so consistent in non-leniency cartel cases. These asymmetries and ‘other’ costs create disincentives for exercising the leniency option. We offer suggestions for enhancing the possibility of a race to the agency.
Fungal composition, quantification of mycotoxins, and enzyme activity in processed Solanum tuberosum Linn (potato) products stored at different relative humidity
Authors: Danladi Margaret M A , Ogbonna Chike I C , Ogbonna Abigail I , Giles Cindy , Fletcher Mary T , Akinsanmi Olufemi A 
Published: November 2023

Abstract

Aim
Postharvest loss of potatoes at the peak of harvest is of global concern. This study aimed to determine the quality of stored processed potato products based on fungal composition, mycotoxin contamination, and fungal enzyme activity.

Materials and methods
Potato products from three cultivars (Caruso, Marabel, and Nicola) were grouped as peeled or unpeeled, oven- or sun-dried, and all samples were in flour form. Samples were incubated separately for 6 weeks at 25%, 74%, and 87% relative humidities (RH) at 25°C. The pH, moisture content (MC), visible deterioration, mycotoxin, fungal identity by DNA sequencing, and enzyme activity were determined.

Results
Results of grouped products (based on variety, drying, and peeling method) revealed that MC increased in the oven-dried samples and the pH value reduced after incubation. About 26% of the products at 87% RH showed visible deterioration, low amounts of fumonisin were detected in fermented potato product and nine fungal genera were identified across the three RH levels. Enzyme activities by Aspergillus niger, Fusarium circinatum, and Rhizopus stolonifer isolates were confirmed.

Conclusion
RH influenced deterioration and fungal activities in some stored processed potato products. Low levels of fumonisin were detected.
Dietary supplementation with lysine (protein) in late pregnancy does not enhance mammary development in multiparous sows
Authors: Farmer Chantal , Gillies Caroline , Johannsen Jakob C , Hovey Russell C , Huber Lee-Anne 
Published: November 2023

Abstract
This project was conducted to determine if providing standardized ileal digestible (SID) Lys at 40% above estimated requirements (NRC, 2012), with the concomitant increased protein intake, from days 90 to 110 of gestation stimulates mammary development in multiparous sows. From day 90 of gestation, Yorkshire × Landrace multiparous sows (parities 2 and 3) were fed 2.6 kg/d of either a conventional diet (CTL, control, n = 17) providing 14.8 g/d of SID Lys or a diet providing 20.8 g/d of SID Lys via additional soybean meal (HILYS, n = 16). The diets were isoenergetic. Concentrations of IGF-1, glucose, free fatty acids (FFA), urea, and amino acids (AA) were measured in jugular blood samples obtained on days 90 and 110 of gestation. Sows were necropsied on day 110 ± 1 of gestation to obtain mammary glands for compositional and histological analyses. Backfat or BW changes of sows during late gestation were unaffected by treatment (P &gt; 0.10), as was the case for fetal BW (P &gt; 0.10). None of the variables measured in mammary tissue were altered by supplementary Lys (P &gt; 0.10). Circulating IGF-1, glucose, and FFA did not differ (P &gt; 0.10) between HILYS and CTL sows on day 110 of gestation, whereas concentrations of urea were greater (P &lt; 0.01) in HILYS versus CTL gilts. Concentrations of Ile and Thr in plasma were also greater (P &lt; 0.05), and those of Glu were lower (P &lt; 0.01) in HILYS than CTL sows. These results demonstrate that feeding Lys (via protein) above current NRC recommendations during late gestation does not improve mammary development of multiparous sows. Hence, the use of a two-phase feeding strategy to provide more Lys (protein) to multiparous sows during this period is not necessary.