bluuebunny/crossref_metadata_2025_split huggingface dataset:
What Factors Are Associated With Willingness to Use HIV Pre-exposure Prophylaxis (PrEP) Among U.S. Men Who Have Sex With Men Not on PrEP? A Systematic Review and Meta-analysis
Authors: Kamitani Emiko , Wichser Megan E. , Mizuno Yuko , DeLuca Julia B. , Higa Darrel H. 
Published: December 2022

Abstract
Pre-exposure prophylaxis (PrEP), an antiretroviral medication to prevent HIV, is becoming more widely available in the United States since the Federal Drug Administration approved it in 2012. However, PrEP use among men who have sex with men (MSM) is still limited and many MSM who are willing to take PrEP are not on PrEP. We performed a systematic review to identify factors associated with willingness to use PrEP among MSM who are not on PrEP. The majority of the 23 relevant studies had low risk of bias and used a cross-sectional design. Willingness was associated with being Hispanic/Latino (odds ratio [OR] = 1.68, 95% confidence interval [CI] [1.01-2.78]), Black (OR = 1.41, 95% CI [1.02-1.95]), younger (OR = 1.08, 95% CI [1.02-1.15]), having no college degree (OR = 1.37, 95% CI [1.12-1.59]), or low income (OR = 1.21, 95% CI [1.12-1.32]). A higher proportion of MSM who had recent condomless anal sex (OR = 1.85, 95% CI [1.49-2.29]) were diagnosed with sexually transmitted infection (OR = 1.60, 95% CI [1.27-2.01]), or MSM who had multiple sex partners (OR = 1.58, 95% CI [1.07-2.32]) were more willing to use PrEP compared with their respective counterparts. Findings suggest that MSM with racial/ethnic minority status, low-socioeconomic status, younger age, and engagement in HIV risk behaviors are willing to take PrEP but may lack access. Study limitations include the inability to conduct meta-analyses on certain predictor variables due to a small number of studies. This review identified MSM subpopulations who may benefit from interventions increasing PrEP access.
Eicosapentaenoic acid vs. docosahexaenoic acid for the prevention of cardiovascular disease
Authors: Sweeney Ty E. , Gaine Sean P. , Michos Erin D. 
Published: December 2022

Purpose of review
Populations with greater fatty fish intake have lower risk of coronary heart disease. However, trials testing omega-3 fatty acids (FA) on cardiovascular outcomes have yielded inconsistent results. In this review, we summarize the major cardiovascular trials examining omega-3 FA supplementation, and compare differences with eicosapentaenoic acid (EPA) alone vs. docosahexaenoic acid (DHA) combined with EPA.

Recent findings
The JELIS and REDUCE-IT trials both demonstrated significant reduction in cardiovascular events with high dose EPA in the form of icosapent ethyl (IPE), with a similar trend seen in the RESPECT-EPA trial. In contrast, the ASCEND, VITAL, STRENGTH, and OMEMI trials examining EPA+DPA combinations failed to demonstrate benefit. Beyond the difference in omega-3 FA formulations (IPE vs. omega-3 carboxylic acid), other differences between REDUCE-IT and STRENGTH include the achieved EPA levels, differing properties that EPA and DHA have on membrane stabilization, and the comparator oils tested in the trials.

Summary
The totality of evidence suggests EPA alone, administered in a highly-purified, high-dose form, improves cardiovascular outcomes among patients with elevated triglycerides at high cardiovascular risk, but EPA and DHA together does not. Current guidelines endorse the use of IPE in statin-treated patients at high cardiovascular risk who have triglycerides >135 mg/dl.
Inflammation and kidney stones: cause and effect?
Authors: Capolongo Giovanna , Ferraro Pietro Manuel , Unwin Robert 
Published: December 2022

Purpose of review
This short review is intended to highlight the potential role of inflammation as a key pathological driver, rather than a mere consequence, of nephrolithiasis. Although there is clearly a strong likelihood that the relationship is bidirectional, and that kidney stone-triggered inflammation can establish a vicious cycle of tissue injury and stone formation.

Recent findings
These consist of data from both recent preclinical and clinical studies demonstrating the importance of inflammation in models of stone disease and in kidney tissue from patients with nephrolithiasis, and as a potential driver of disease recurrence and a suitable treatment target. In particular, the role of immune cells and their relationship to the NLRP3 inflammasome is becoming clearer, as well as the potential contribution to tissue injury and stone formation of the pro-inflammatory cytokines interleukin-1β and interleukin-18.

Summary
This concept is not new and raises the possibility that targeting inflammation directly may prove to be a novel and suitable means of treatment for at least some types of kidney stone, and in certain clinical settings, both acutely and as prevention, especially in those patients experiencing recurrent stone episodes and/or who have a well defined metabolic cause such as uric acid or calcium oxalate stones.
Is There a Reduction in Chemsex Practice in Men Who Have Sex With Men During COVID-19 Lockdown? Results of the CheRRLock Study
Authors: L’Yavanc Thomas , Gosset Daniel , Plathey Marine , Jedrzejewski Thibaut , Gazalet Philippe , Lasry Stéphane , Pierre Nadège , Kachal Abdessamad , Fremondiere Marc , Ohayon Michel , Palich Romain ,   on behalf of the “190” working group
Published: December 2022

Background and aims:
Chemsex is a growing concern among men who have sex with men (MSM). COVID-19 lockdowns have had consequences on social and sexual interactions. We aimed to assess changes in chemsex practices during COVID-19 lockdown in France among MSM and factors associated with maintaining or increasing chemsex practice.

Methods:
Repeated face-to-face questionnaires were conducted at “Le 190” Sexual Health Center, Paris, France, exploring lifestyle, sexual, and chemsex practices, COVID-19 concerns and mental health before and during second lockdown in France (30/10/2020–15/12/2020). Inclusion criteria were chemsex practices at least 3 times throughout lifetime and at least once in the 3 months before second lockdown. The primary end point was the proportion of participants who declared having stopped, decreased, maintained, or increased their chemsex practice during lockdown. Univariable and multivariable logistic regressions were used to analyze factors associated with evolutions of chemsex practice.

Results:
Ninety-three MSM were included: 66% HIV-positive and 30% taking PrEP. Drugs most used were cathinones (91%) and GHB/GBL (52%). Participants reported stopping, decreasing, maintaining, and increasing chemsex drugs use in 14%, 22%, 22%, and 42% of cases, respectively. Despite this overall increase in chemsex practice, MSM decreased their number of sexual partners. Factors significantly associated with maintaining or increasing chemsex drugs use were feeling lonely (OR = 3.24), craving (OR = 4.51), and working during lockdown (OR = 3.27), contrasting with fear of COVID-19 (OR = 0.31).

Conclusion:
Restriction measures lead to changes in sexual behavior and seem to increase chemsex practice. Maintaining care for most isolated patients should be a priority in COVID-19 context.
Impact of a multi-disease integrated screening and diagnostic model for COVID-19, TB, and HIV in Lesotho
Authors: Katende Bulemba , Bresser Moniek , Kamele Mashaete , Chere Lebohang , Tlahali Mosa , Erhardt Rahel Milena , Muhairwe Josephine , Ayakaka Irene , Glass Tracy R , Ruhwald Morten , van Ginneken Bram , Murphy Keelin , de Vos Margaretha , Amstutz Alain , Mareka Mathabo , Mooko Sekhele Matabo , Labhardt Niklaus D. , Reither Klaus , González Fernández Lucia 
Published: December 2022

AbstractIntroductionThe surge of the COVID-19 pandemic challenged health services globally, and in Lesotho, the HIV and tuberculosis (TB) services were similarly affected. Integrated, multi-disease diagnostic services were proposed solutions to mitigate these disruptions. We describe and evaluate the effect of an integrated, hospital-based COVID-19, TB and HIV screening and diagnostic model in two rural districts in Lesotho, during the period between December 2020 and August 2022.MethodsAdults and children above 5 years attending two hospitals were screened for COVID-19 and TB symptoms. After a positive screening, participants were offered to enroll in a service model that included clinical evaluation, chest radiography, SARS-CoV-2, Xpert MTB/RIF Ultra and HIV testing. Participants diagnosed with COVID-19, TB, or HIV were contacted after 28 days evaluate their health status, and linkage to HIV or TB services.ResultsOf the 179160 participants screened, 6623(37%) screened positive, and 4371(66%) were enrolled in this service model, yielding a total of 458 diagnoses. One positive rapid antigen test for SARS-CoV-2 was found per 11 participants screened, one Xpert-positive TB case was diagnosed per 85 people screened, and 1 new HIV diagnosis was done per 182 people screened. Of the 321(82.9%) participants contacted after 28 days of diagnosis, 304(94.7%) reported to be healthy. Of the individuals that were newly diagnosed with HIV or TB, 18/24(75.0%) and 46/51(90.1%) started treatment. This service showed no difference in the detection of new HIV and TB cases when compared to other hospitals, where no such integrated service model was provided.ConclusionThis screening and diagnostic model successfully maintained same-day, integrated COVID-19, TB, and HIV testing services through different COVID-19 incidence periods in a resource-limited context. There were positive effects in avoiding diagnostic delays and ensuring linkage to services, however, efficiencies were contingent on the successful adaptation to the changing environment.
Community-based emergency transport system in Shinyanga, Tanzania: a local innovation to avert maternal and newborns deaths for a low-resource setting
Authors: Munishi Castory , Mateshi Gilbert , Mlunde Linda B. , Njiro Belinda J , Ngowi Jackline E , Kengia James T. , Kapologwe Ntuli A. , Deng Linda , Timbrell Alice , Kitinya Wilson , Pembe Andrea B. , Sunguya Bruno F. 
Published: December 2022

AbstractIntroductionIn achieving sustainable development goal 3.1, Tanzania needs substantial investment to address the persistent burden of maternal mortality. Efforts are needed to curtail the three delays which underlie most of the deaths. The government of Tanzania implemented a community-based emergency transport intervention to address the second delay through m-mama program to address these delays. This examined the cost-effectiveness of this intervention as compared to the use of a standard ambulance system alone.Materials and MethodsProgram data provided by the program implementers was used in this secondary data analysis. The data included costs of referral services using the Emergency Transportation System (EmTS) and comparing with the standard ambulance system. Analysis was conducted using Microsoft Excel to generate data that was fed in a TreeAge Pro Healthcare 2022 model. The cost and effectiveness data were discounted at 5% to make fair comparisons of the two systems.ResultsA total of 989 referrals were made where, 30.1% were completed using the standard referral system using ambulance, and the majority (69.9%) were completed using the EmTS. The Emergency transport system costed USD 170.4 per completed referral compared to USD 472 per referral using ambulance system alone in the six councils of Shinyanga region where the intervention was conducted.ConclusionThe introduction of m-mama emergency transportation system has proved to be cost effective compared to the use of standard ambulance system alone in Shinyanga region. Given the high burden of maternal mortality in Tanzania, this community-based program can save implementation costs and may be more sustainable should be scaled up to other regions in Tanzania. Using implementation science methods while scaling up, lessons learned in various regions may further improve the effectiveness of the EmTS.
Deep Learning of Electrocardiograms Enables Scalable Human Disease Profiling
Authors: Venn Rachael A. , Wang Xin , Friedman Sam Freesun , Diamant Nate , Khurshid Shaan , Achille Paolo Di , Weng Lu-Chen , Choi Seung Hoan , Reeder Christopher , Pirruccello James P. , Singh Pulkit , Lau Emily S. , Philippakis Anthony , Anderson Christopher D. , Ellinor Patrick T. , Ho Jennifer E. , Batra Puneet , Lubitz Steven A. 
Published: December 2022

ABSTRACTThe electrocardiogram (ECG) is an inexpensive and widely available diagnostic tool, and therefore has great potential to facilitate disease detection in large-scale populations. Both cardiac and noncardiac diseases may alter the appearance of the ECG, though the extent to which diseases across the human phenotypic landscape can be detected on the ECG remains unclear. We developed a deep learning variational autoencoder model that encodes and reconstructs ECG waveform data within a multidimensional latent space. We then systematically evaluated whether associations between ECG encodings and a broad range of disease phenotypes could be detected using the latent space model by deriving disease vectors and projecting individual ECG encodings onto the vectors. We developed models for both 12- and single-lead ECGs, akin to those used in wearable ECG technology. We leveraged phecodes to generate disease labels using International Classification of Disease (ICD) codes for about 1,600 phenotypes in three different datasets linked to electronic health record data. We tested associations between ECG encodings and disease phenotypes using a phenome-wide association study approach in each dataset, and meta-analyzed the results. We observed that the latent space ECG model identified associations for 645 (40%) diseases tested in the 12-lead model. Associations were enriched for diseases of the circulatory (n=140, 82% of category-specific diseases), respiratory (n=53, 62%), and endocrine/metabolic (n=73, 45%) systems, with additional associations evident across the human phenome; results were similar for the single-lead models. The top ECG latent space association was with hypertension in the 12-lead ECG model, and cardiomyopathy in the single-lead ECG model (p<2.2×10-308for each). The ECG latent space model demonstrated a greater number of associations than ECG models using standard ECG intervals alone, and generally resulted in improvements in discrimination of diseases compared to models comprising only age, sex, and race. We further demonstrate how a latent space model can be used to generate disease-specific ECG waveforms and facilitate disease profiling for individual patients.
Risk Factor Analysis for Extended-Spectrum Beta-Lactamase Producing Enterobacterales Colonization or Infection: Evaluation of a Novel Approach to Assess Local Prevalence as a Risk Factor
Authors: Cherian Jerald , Cosgrove Sara E. , Haghpanah Fardad , Klein Eili Y. ,   the Centers for Disease Control and Prevention’s Prevention Epicenters Program and the Modeling Infectious Diseases in Healthcare Network
Published: December 2022

AbstractObjectiveTo explore an approach to identify the risk of local prevalence of extended-spectrum beta-lactamase producing Enterobacterales (ESBL-E) on ESBL-E colonization or infection, and reassess known risk factors.DesignCase-control study.SettingJohns Hopkins Health System emergency departments (EDs) in the Baltimore-Washington, D.C. region.PatientsPatients aged ≥18 years with a culture growing Enterobacterales between 4/2019-12/2021. Cases had a culture growing an ESBL-E.MethodsAddresses were linked to Census Block Groups and placed into communities using a clustering algorithm. Prevalence in each community was estimated by the proportion of ESBL-E among Enterobacterales isolates. Logistic regression was used to determine risk factors for ESBL-E colonization or infection.ResultsESBL-E were detected in 1167 of 11,229 patients (10.4%). Risk factors included a history of ESBL-E in the prior year (OR, 15.62; 95% CI, 11.25-21.68), and exposure to a skilled nursing or long term care facility (OR, 1.66; 95% CI, 1.39-1.99), 3rd generation cephalosporin (OR, 1.83; 95% CI, 1.50-2.23), carbapenem (OR, 2.01; 95% CI, 1.46-2.78) or trimethoprim-sulfamethoxazole (OR, 1.53; 95% CI, 1.05-2.22) within the prior 6 months. Patients were at lower risk if their community had a prevalence <25thpercentile in the prior 3 months (OR, 0.84; 95% CI, 0.71-0.98), 6 months (OR, 0.84; 95% CI, 0.71-0.99) or 12 months (OR, 0.81; 95% CI, 0.69-0.96). There was no association between being in a community >75thpercentile and the outcome.ConclusionsThis method of defining the recent local prevalence of ESBL-E may partially capture differences in the likelihood of a patient having an ESBL-E.
Dynamics of Covid-19 Vaccine-Hesitancy among Primary Health Care Workers in an Urban City in India
Authors: Ali Syeda Sana , Iyer Gowri , Mahajan Hemant , Kannuri Nanda Kishore 
Published: December 2022

AbstractBackgroundThe health care workers (HCWs) were one of the vulnerable populations prioritized during the Covid-19 vaccination (COVISHIELD and COVAXIN) campaign. They are also the first point of contact for vaccine-related information and therefore, play a crucial role in shaping peoples’ vaccine seeking behaviour.Objectives(i) To estimate the proportion of Covid-19 vaccine hesitancy among HCWs in urban primary health care centres (UPHC) across Hyderabad; and (ii) To explore factors influencing vaccine hesitancy and vaccine acceptance in this population.MethodsA cross-sectional study was conducted among 238 HCWs from 21 urban health centres in Hyderabad between June and July 2021. The prevalence of vaccine hesitancy was assessed using the questions adapted from ‘the UNICEF Guyana Covid-19 Vaccination Hesitancy Survey’. We used ‘the SAGE determinants of vaccine hesitancy’ to determine factors underlying vaccine hesitancy and acceptance.ResultsThe prevalence of vaccine hesitancy among HCWs was 17% (12.3% - 22.2%) during the 6 months following emergency vaccine approval. ‘Self-protection’, ‘Vaccine-confidence’, and ‘Responsibility towards the general population’ were some of the reasons in favour of Covid-19 vaccination. Whereas ‘Vaccine-safety’ has emerged as the primary determinant of vaccine-hesitancy in this population. HCWs were susceptible to misinformation in the social media and in their communities, which might have shaped their opinion about the vaccines for the Covid-19.ConclusionAlthough the COVID-19 vaccines (COVISHIELD and COVAXIN) were approved for administration by the Drugs Controller General of India, one in every six HCWs working in the UPHCs in Hyderabad, India had eitherrefused or delayedvaccinations mainly due to limited information on ‘vaccine-safety’. This highlights a critical need to address the vaccine-hesitancy among HCWs (especially during the initial phases of novel vaccine introduction), as similar behaviour of the HCWs towards novel vaccines could affect the uptake of these vaccines among the general population (which they serve).
Efficacy of a self-management program using an eHealth system to reduce symptom severity in patients with irritable bowel syndrome simultaneously with changes in gut microbiota: a randomized controlled trial
Authors: Tayama Jun , Hamaguchi Toyohiro , Koizumi Kohei , Yamamura Ryodai , Okubo Ryo , Kawahara Jun-ichiro , Inoue Kenji , Takeoka Atsushi , Schneider Antonius , Fukudo Shin 
Published: December 2022

ABSTRACTObjectiveThis study aimed to evaluate whether a self-management program using the eHealth system could reduce symptom severity in patients with irritable bowel syndrome (IBS). Impact of the intervention on quality of life and gut microbiota were also examined.DesignThis study was designed as an open label, simple randomized controlled trial comparing an intervention group that attended an eHealth self-management program and a treatment as usual group. Participants were Japanese women between the ages of 18 and 36. Forty symptomatic IBS individuals who met the inclusion criteria were recruited and randomly assigned to the two groups. The eHealth group received 8 weeks of unlimited access to the self-management program containing a wide variety of e-learning content. Participants’ severity of IBS symptoms, the main outcome, was assessed using the irritable bowel syndrome-severity index (IBS-SI) at baseline and 8 weeks. The secondary outcomes of participants’ quality of life and gut bacteria were also assessed at baseline and week 8.ResultsThere was a significant difference in the net change in IBS severity index (IBS-SI) score between the eHealth and treatment as usual group (−50.1; 95% CI, −87.6 to -12.6; p = 0.010). The eHealth group had significantly lower IBS-SI scores following 8 weeks of intervention compared with the baseline scores (t = − 3.2, p < 0.01). The implementation of the eHealth program was accompanied by improvement of quality of life and decrease of phylum-level Cyanobacteria occupancy, respectively.ConclusionThe implementation of eHealth for IBS was shown to reduce IBS symptoms.Key MessagesWhat is already known on this topic –eHealth programs based on diet and probiotic use have shown good results in reducing IBS symptomsWhat this study adds– a self-management program with an e-learning component based on a successful self-help guidebook for IBSHow this study might affect research, practice or policy– The proposed eHealth model reduces symptoms and improves the quality of life of IBS patients, providing an efficient and cost-effective intervention option to be adopted in policy and practice, and creates scope for future research in food intake, exercise, and sleep management through eHealth for IBS.
RNF43 mutations facilitate colorectal cancer metastasis via formation of a tumour-intrinsic niche
Authors: Bugter Jeroen M. , Bouazzaoui Layla El , Küçükköse Emre , Hong Yourae , Sprangers Joep , Jordens Ingrid , Fenderico Nicola , Gonzalez Diego Montiel , van Boxtel Ruben , Suijkerbuijk Saskia J.E. , Tejpar Sabine , Snippert Hugo J.G. , Kranenburg Onno , Maurice Madelon M. 
Published: December 2022

SummaryIn colorectal cancer (CRC),RNF43mutations are linked to BRAF V600E-initiated serrated adenomas that advance into mucinous adenocarcinomas with poor prognosis upon metastasis. HowRNF43mutations facilitate a metastasis-prone growth state remains unknown. Here, we addressed this issue by repairing mutantRNF43in patient-derived BRAF-mutant CRC organoids using gene editing. UponRNF43correction, CRC organoids exhibit strongly decreased mucus production and, moreover, display loss of niche factor independence and metastatic capacity upon orthotopic transplantation in mice. Mechanistically, we show that mutant RNF43 promotes cancer cell lineage specification towards a non-dividing niche population that secretes essential growth factors, providing a state of self-sufficiency to the cancer epithelium. We show that phenotypic diversification into tumour-intrinsic niche cells (TINCs) and proliferative cancer stem cells depends on tuneable WNT levels enabled by mutations inRNF43, but notAPC. In patient samples, enhanced TINC profiles correlate withRNF43-mutant CRC, mucinous histology and metastatic disease, thus representing a general cellular mechanism by which tumours acquire a self-sufficient, pro-metastatic growth state.