bluuebunny/crossref_metadata_2025_split huggingface dataset:
Immunogenicity and safety of the MF59-adjuvanted seasonal influenza vaccine in non-elderly adults: A systematic review and meta-analysis
Authors: Domnich Alexander , Trombetta Carlo-Simone , Fallani Elettra , Salvatore Marco 
Published: December 2024

Objective
In Europe, the age indication for the MF59-adjuvanted quadrivalent influenza vaccine (aQIV) has recently been extended from ≥65 to ≥50 years. Considering that the earliest approval of its trivalent formulation (aTIV) in Italy was for people aged ≥12 years, we aimed to systematically appraise data on the immunogenicity, efficacy, and safety of aTIV/aQIV in non-elderly adults.

Methods
A systematic literature review was conducted according to the available guidelines and studies were searched in MEDLINE, Biological Abstracts, Web of Science, Cochrane Library and clinical trial registries. Studies on absolute and relative immunogenicity, efficacy, effectiveness, and safety of aTIV/aQIV in non-elderly adults (<65 years) were potentially eligible. These endpoints were analyzed by virus (sub)types and characteristics of vaccinees. Fixed- and random-effects meta-analyses were performed for data synthesis. Protocol registration: CRD42024512472.

Results
Twenty-four publications were analyzed. aTIV/aQIV was more immunogenic than non-adjuvanted vaccines towards vaccine-like strains: the absolute differences in seroconversion rates were 8.8% (95% CI: 3.7%, 14.0%), 13.1% (95% CI: 6.7%, 19.6%) and 11.7% (95% CI: 7.2%, 16.2%) for A(H1N1), A(H3N2), and B strains, respectively. This immunogenicity advantage was more pronounced in immunosuppressed adults. Additionally, aTIV/aQIV was more immunogenic than non-adjuvanted counterparts towards heterologous A(H3N2) strains with a 10.7% (95% CI: 3.2%, 18.2%) difference in seroconversion rates. Data on antibody persistence and efficacy were limited and inconclusive. Overall, aTIV/aQIV was judged safe and well tolerated, although reactogenic events were more frequent in aTIV/aQIV recipients versus comparators. Serious adverse events were uncommon and no difference (risk ratio 1.02; 95% CI: 0.64, 1.63) between aTIV/aQIV and non-adjuvanted formulations was found.

Conclusions
In non-elderly adults, aTIV/aQIV is safe and generally more immunogenic than non-adjuvanted standard-dose vaccines.
Prevalence and risk factors of cutaneous leishmaniasis in a newly identified endemic site in South-Ethiopia
Authors: Merdekios Behailu , Kote Mesfin , Pareyn Myrthe , Van Geertruyden Jean-Pierre , van Griensven Johan 
Published: December 2024

Background
Although there are several areas in southern Ethiopia environmentally favourable for cutaneous leishmaniasis (CL), studies on the existence and risk factors of CL are lacking beyond a few well-known hotspots. This study aimed to assess the prevalence and risk factors of CL in Bilala Shaye, a village in the southern Ethiopian highlands at an altitude of 2,250 meters.

Methods
A cross-sectional house-to-house survey was done between July-August 2021. Those with skin lesions were clinically assessed and data on individual risk behaviour and environmental and household features were collected using questionnaires. Univariate and multivariable logistic regression models were used to identify independent risk factors of CL at a 5% significance level with two-sided P-values <0.05 considered statistically significant.

Result
A total of 1012 individuals were interviewed; the median age was 23 years (interquartile range 12–50), with 7% below the age of five; 51% were female. All households had domestic animals, and for 143 (57%) households goats/sheep lived inside or around the house. Animal dung was found in the compounds of 194 (77%) households. The overall prevalence of active CL was 2.5% (95% confidence interval (CI) 1.6–3.6), reaching 6.7% (95% CI 3.6–11.2) in children between 5–12 years old. The prevalence of CL scars was 38.5% (95% CI 35.5–41.6). In multivariate analysis, the presence of animal dung in the compound (adjusted odds ratio (OR) 2.1; 95% CI: 1.3–3.5, P = 0.003) and time spent outside in the late evening in areas where hyraxes live (adjusted OR 2.4; 95% CI: 1.7–3.3, P <0.001) were identified as independent risk factors.

Conclusion
This is the first report on the existence of CL in this village, with the high prevalence of CL scars indicating long-term endemicity. Further studies are needed to understand the role of animals and their dung in (peri)-domestic CL transmission.
Prognostic value of procalcitonin in acute exacerbation of chronic obstructive pulmonary disease: A systematic review and meta-analysis
Authors: Qiyuan Pang , Changyang Lin , Gaigai Li , Ju Qiu , Xun Zhou 
Published: December 2024

Aims
To evaluate the prognostic role of procalcitonin(PCT) on all-cause mortality in acute exacerbation of chronic obstructive pulmonary disease (AECOPD).

Methods
Database including PubMed, EMBASE, and the Cochrane Central Register of Controlled Trials were searched to find relevant trials. We included studies with patients hospitalized for AECOPD, which assessed procalcitonin levels and reported on the association between procalcitonin and mortality..

Results
Fourteen trials involving 2983 patients were included. We found PCT levels in patients hospitalized for AECOPD are not associated with increased risk of mortality (RR 1.03, 95%CI 0.99–1.08). However, subgroup analysis showed PCT levels are indeed associated with an increased risk of mortality in mild to moderate AECOPD(RR 1.74, 95%CI 1.11–2.73). Deceased patients had significantly higher PCT levels, compared to survivors (MD 0.61, 95%CI 0.30–0.92). In PCT positive group, there was a significant increase in all-cause mortality(OR 3.21, 95%CI 1.84–5.61).

Conclusions
Results from this meta-analysis suggest that procalcitonin levels at the time of hospital admission for mild to moderate AECOPD are positively correlated with mortality.
Association between demographic, clinical characteristics and severe complications by SARS-CoV-2 infection in a community-based healthcare network in Chile
Authors: Leniz Javiera , Hernández-Jaña Sam , Soto Mauricio , Arenas Eduardo , Margozzini Paula , Suarez Francisco , Capurro Daniel , Rojas María Paulina , Bambs Claudia 
Published: December 2024

Background
Most of the evidence on risk factors for COVID-19 complications comes from North America or Europe with very little research from Latin-America. We aimed to evaluate the association between sociodemographic, clinical factors and the risk of COVID-19 complications among adults in Chile, the fifth Latin-American country with more COVID-19 reported cases since de beginning of the Pandemic.

Methods
A retrospective population-based cohort study using data from electronic health records from a large Primary Care Network, linked to national hospital, immunization, Covid-19 PCR surveillance, mortality and birth records. We included people 18+ years old enrolled in the Primary Care Network between 1st January 2020 and 31st December 2021. Using Multivariate Cox proportional hazard models, we evaluate the association between sociodemographic, clinical characteristics with three COVID-19 complications: (1) a hospital admission, (2) an ICU admission, and (3) death due to a COVID-19 infection that occurred between the 1st January 2020 and the 31st December 2021.

Results
44,674 people were included. The mean age was 44.30 (sd 17.31), 55.6% were female, 15.9% had a type of healthcare insurance for people from the lowest category of income, 11.6% and 9.4% had a record of hypertension or diabetes mellitus diagnosis. Among the 44,674 people, 455 (1.02%) had a hospital admission due to a COVID-19 infection and 216(0.48%) of them also had an ICU admission. Among the 44,674 people,148(0.33%) died due to COVID-19 infection. Older age and male sex were consistently associated with a higher risk of the three COVID-19 complications. Hypertension and diabetes were associated with a higher risk of a hospital admission and death, but not with an ICU admissions due to COVID-19 infection. Having two or more COVID-19 vaccine doses compared with no doses was associated with a lower risk of any hospital admission (HR 0.81; 95% CI 0.77–0.84), an ICU admission (HR 0.60; 95% CI 0.57–0.63) and death (HR 0.50; 95% CI 0.46–0.54). Pregnant or puerperal women were more likely to be admitted to hospital (HR 2.89; 95% CI 1.41–5.89) or ICU (HR 3.04; 95% CI 1.01–9.14).

Conclusions
Sociodemographic and clinical factors associated with COVID-19 complications such as age, sex and pre-existing conditions were comparable to those reported in similar studies from higher-income countries, and can be used to predict severity in COVID-19 patients.
Ascertaining provider-level implicit bias in electronic health records with rules-based natural language processing: A pilot study in the case of prostate cancer
Authors: Ramaswamy Ashwin , Hung Michael , Pelt Joe , Iranmahboub Parsa , Calderon Lina P. , Scherr Ian S. , Wang Gerald , Green David , Patel Neal , McClure Timothy D. , Barbieri Christopher , Hu Jim C. , Lindvall Charlotta , Scherr Douglas S. 
Published: December 2024

Purpose
Implicit, unconscious biases in medicine are personal attitudes about race, ethnicity, gender, and other characteristics that may lead to discriminatory patterns of care. However, there is no consensus on whether implicit bias represents a true predictor of differential care given an absence of real-world studies. We conducted the first real-world pilot study of provider implicit bias by evaluating treatment parity in prostate cancer using unstructured data–the most common way providers document granular details of the patient encounter.

Methods and findings
Patients ≥18 years with a diagnosis of very-low to favorable intermediate-risk prostate cancer followed by 3 urologic oncologists from 2010 through 2021. The race Implicit Association Test was administered to all providers. Natural language processing screened human annotation using validated regex ontologies evaluated each provider’s care on four prostate cancer quality indicators: (1) active surveillance utilization; (2) molecular biomarker discussion; (3) urinary function evaluation; and (4) sexual function evaluation. The chi-squared test and phi coefficient were utilized to respectively measure the statistical significance and the strength of association between race and four quality indicators. 1,094 patients were included. While Providers A and B demonstrated no preference on the race Implicit Association Test, Provider C showed preference for White patients. Provider C recommended active surveillance (p<0.01, φ = 0.175) and considered biomarkers (p = 0.047, φ = 0.127) more often in White men than expected, suggestive of treatment imparity. Provider A considered biomarkers (p<0.01, φ = 0.179) more often in White men than expected. Provider B demonstrated treatment parity in all evaluated quality indicators (p>0.05).

Conclusions
In this pilot study, providers’ practice patterns were associated with both patient race and implicit racial preferences in prostate cancer. Alerting providers of existing implicit bias may restore parity, however future assessments are needed to validate this concept.
Content validation of an activity-based therapy tracking tool in a community setting for people living with spinal cord injury or disease using cognitive debriefing interviews
Authors: Kaiser Anita , Idd Hanan , Chan Katherine , Djuric Alexander , Marshall Sandi , Cairns-Mills Heather , Leo Jennifer , Musselman Kristin E. 
Published: December 2024

Background
Activity-based therapy (ABT) has shown promise as a viable therapeutic intervention to promote neurorecovery in people with spinal cord injury/disease (SCI/D). Tools that track the details of ABT sessions may facilitate the collection of data needed to inform best practice guidelines for ABT.

Objective
The purpose of this study was to evaluate the content validity of a prototype ABT tracking tool.

Methods
Nine clinicians and five individuals with SCI/D from three community-based ABT clinics in Canada used the prototype tracking tool over three ABT sessions and then participated in individual cognitive debriefing interviews. The interview guide was developed based on recommendations by Brod and colleagues for establishing content validity (i.e., appropriate, comprehensive, comprehensibility). Interviews were transcribed verbatim and analysed using deductive followed by inductive content analysis.

Results
Overall, the ABT tracking tool was found to have good content validity. Identified categories included: (1) Content validity of the ABT tracking tool. Participants found the tool to be comprehensive and appropriate for all levels and severities of injury. Recommendations to improve the tool included adding a comment section and additional parameters to each activity. (2) Facilitators of tool use, dissemination and implementation. Using the tool during rest breaks or after the session were suggested to maximize therapy time. Providing the tool as an app and offering education and training on use of the tool were highly recommended. Advertising through community clinics and social media may facilitate dissemination of the tool. (3) Barriers of tool use, dissemination and implementation. The paper format of the tool, added workload, learning curve and challenge to adopt a new documentation system were considered barriers to tool use.

Conclusions
The prototype ABT tracking tool was validated for content using cognitive debriefing interviews. Recommendations will be used to improve the tool and assist in dissemination and implementation efforts.
Awareness of anaphylaxis among public in Al-Ahsa City of Saudi Arabia: A cross-sectional study
Authors: Alanazy Ahmed , Boodai Raja Saad , Alhulaybi Badiah Ibrahim , Alraihan Amenah Ibrahim , Almulhim Raghad Ahmed , Almulhim Bainah Fahad , Rajappan Suchithra K. , Alruwaili Abdullah , Alanazi Ahmad 
Published: December 2024

Background
Anaphylaxis is a severe, life-threatening allergic reaction requiring prompt treatment with epinephrine. However, gaps in public understanding exist globally. To guide future education efforts, this study assessed anaphylaxis awareness among adults in Al-Ahsa, Saudi Arabia.

Methods
A cross-sectional survey assessed knowledge among 380 adults using a validated questionnaire. Convenience sampling was used with data collected via online platforms. Descriptive statistics were calculated, and associations were tested. We analyzed the data using SPSS software.

Results
Knowledge was suboptimal, with a mean score of 34.5/60. Most identified the anaphylaxis definition (76.1%) and rapid symptom onset (78.9% within minutes). But just 37.9% recognized epinephrine as a first-line treatment and only 17.4% had auto-injector training. Nearly half (48.4%) needed to learn the proper EpiPen injection site. Under half understood the need for long-term allergen avoidance. Older age, more education, and Job status were associated with higher scores.

Conclusion
This study reveals critical gaps in anaphylaxis knowledge among adults in Al-Ahsa, Saudi Arabia. Poor understanding of emergency treatment and long-term management highlights the urgent need for improved public awareness. Targeted educational initiatives must emphasize prompt epinephrine administration, proper auto-injector use, and allergen avoidance. Collaborative efforts engaging healthcare professionals, schools, and policymakers are essential to enhance anaphylaxis preparedness through focused training and tailored awareness campaigns. This will empower the Saudi public to recognize symptoms quickly and respond effectively, saving lives from this dangerous allergic reaction.
Preparation and validation of the content of an instrument to assess the quality of services of reception with risk classification in obstetrics
Authors: de Oliveira Dannielly Azevedo , Ferreira Douglissandra de Morais , Lisboa Lilian Lira , Nobre Thaiza Teixeira Xavier 
Published: December 2024

Introduction
The expectations and needs of users and those assisting determine the quality of services. It becomes a priority to understand how all elements involved in the care process perceive the quality of the services offered, aiming to intervene promptly and organize them to satisfy the needs of both and improve the assistance provided.

Objective
To develop and carry out content validation of an instrument for evaluating the quality of the Reception service with Risk Classification in obstetrics with evaluation dimensions for users, health professionals, and managers.

Methodology
This is a methodological study for constructing and validating content. Consider the Pasquali Model, following the theoretical pole’s component steps and the empirical’s beginning. An instrument was created and divided into 3 modules: with a dimension for the user (module 1), health workers (module 2), and manager (module 3), created based on the theoretical framework according to Donabedian and the objectives proposed by the World Health Organization and Brazilian Ministry of Health. Validated for content by a committee of judges (experts) specializing in the area of the instrument. The analysis was carried out based on the committee’s agreement rate, Content Validity Index (CVI), and Kappa index for the evaluation and achievement of the ideal parameters of agreement and content validity of the tool among the judges.

Results
The results suggest that the tool has good content validity. CVI, Kappa, and CI were evaluated above 0.8. Item values considered lower than 0.8 were excluded.

Conclusion
The results suggest that the tool has good content validity, and the pilot test stage can be continued to complete the validation process.
Colchicine combination therapy increases treatment tolerance in patients with arthritis: A systematic review and meta-analysis
Authors: Zhao Changwei , Hao Xiaogang , Cai Wenjun , Zeng Ling-Feng , Zhao Wenhai , Li Xiangxin 
Published: December 2024

Background
Arthritis seriously affects people’s quality of life, and there is an urgent clinical need to improve the efficacy of medications as well as to reduce the adverse effects induced by treatment. Combined colchicine therapy is gradually being embraced in clinical care, but the evidence remains insufficient.

Methods
English databases were searched from the establishment to September 4, 2024. Eleven eligible Randomized controlled trials (RCTs) were included. The quality of the literature was assessed by the risk of bias tool in the Cochrane Handbook. Relative risk (RR) and Cohen’s d (SMD) were used for categorical and continuous variables, respectively, at 95% confidence interval (CI), and Stata 17.0 software was used for statistical analysis. Sensitivity analyses were used to verify the stability of the analyzed results, and heterogeneity analyses were used to explore the sources of heterogeneity in the studies. Funnel plots and Egger’s test were used to assess publication bias.

Results
Eleven eligible RCTs were included in this study. Compared with conventional treatment, combined colchicine treatment improved patient’s global assessment results (SMD = 1.24, 95% CI [0.01, 2.47], P = 0.05, I2 = 0]), stiffness (SMD = -0.81, 95% CI [-1.43, -0.19], P = 0.01, I2 = 63.91%]) and did not increase adverse effects (RR = 0.79, 95% CI [0.31, 1.27], P = 0.36, I2 = 0.00%). However, combined colchicine treatment did not improve visual analog scores (VAS) (SMD = -0.96, 95% CI [-2.85, 0.93], P = 0.13, I2 = 97.99%]), Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain (SMD = 0.01, 95% CI [-0.24, 0.27], P = 0.91, I2 = 0]), WOMAC function (SMD = -0.01, 95% CI [-0.36, 0.16], P = 0.44, I2 = 0]), Total WOMAC scale (SMD = -0.05, 95% CI [-0.33, 0.22], P = 0.70, I2 = 0]), physician ’s global assessment (SMD = 0.36, 95% CI [-2.27, 3.00], P = 0.79, I2 = 97.04%]) and Modified Clinical Health Assessment Questionnaire (ModHAD) (SMD = -1.72, 95% CI [-4.90,1.45], P = 0.29, I2 = 99.11%]).

Conclusion
Compared with colchicine alone, combination therapy improves patients’ quality of life without increasing the incidence of adverse events.
Exploring the perspectives of healthcare workers and Program managers on the use of Truenat as a new tool for TB and DR-TB diagnosis in Nigeria: A qualitative study
Authors: Nwokoye Nkiru , Ihesie Austin , Olabamiji Jamiu , Ochei Kingsley , Eneogu Rupert , Umoren Michael , Odola Femi , Nongo Debby , Agbaje Aderonke , Odume Bethrand , Oyelaran Omosalewa , van Germert Wayne , Mupfumi Lucy , Emeka Elom , Anyaike Chukwuma , Scalise Sarah Cook , Ossai Edmund Ndudi 
Published: December 2024

Background
World Health Organization in the year 2020 recommended the use of Truenat as a replacement for smear microscopy in Tuberculosis (TB) diagnosis and detection of rifampicin resistance. This study was designed to assess enablers and barriers to effective implementation of Truenat assays for TB diagnosis in Nigeria and determine the acceptability of use of Truenat among healthcare workers and TB Program managers in Nigeria.

Methods
A descriptive exploratory study design was used. Qualitative data were collected via Zoom platform using a pre-tested focus group discussion (FGD) guide and key informant interview (KII) guide. Four FGDs were conducted among Truenat laboratory staff, State Quality Assurance Officers, Local Government Tuberculosis Supervisors and Clinicians working at Truenat sites. Three KIIs were conducted among laboratory leads of Truenat implementing partners and the National TB Control Program.

Results
All the participants attested to the reliability and acceptability of Truenat results, they also highlighted the portability and ease-of-use especially for community outreach testing. Stakeholder engagement, training of Truenat laboratory staff and the perceived low operational cost associated with Truenat were the enablers of Truenat implementation. Major barriers to the implementation included human resource for health constraints, lack of power supply, frequent Trueprep breakdown and Truenat machine connectivity. The same human resource constraint was viewed as the major barrier to scale up of Truenat while employment and retention of Truenat staff coupled with training were seen as the facilitators to scale-up. The participants implored the manufacturers of Truenat to increase the number of modules for Truenat, enable the use of stool for diagnosis of TB and attach a solar panel to the machine.

Conclusion
Truenat has gained high acceptance among health workers and TB Program managers in Nigeria. The perceived low operational cost and low infrastructural requirements have been a major boost. There is a need to ensure the retention of health workers especially the Truenat laboratory staff. Training should be sustained including the payment of incentives. Increasing the number of modules of the Truenat machine, enabling the use of stool for TB diagnosis and having a solar panel attached to Truenat machine are essential.