bluuebunny/crossref_metadata_2025_split huggingface dataset:
Local attributable burden disease to PM2.5 ambient air pollution in Medellín, Colombia, 2010–2016
Authors: Grisales-Romero Hugo , Piñeros-Jiménez Juan Gabriel , Nieto Emmanuel , Porras-Cataño Sandra , Montealegre Nora , González Difariney , Ospina Dorian 
Published: May 2021

Background: Exposure to 2.5-micron diameter air pollutants (PM2.5) has been associated with an increased risk of illness and death worldwide; however, in Latin American health impacts assessment of this risk factor is scarce. Medellín is one of the most polluted cities in the region, with a population growth rate that is twice as high as that of other Colombian cities, which implies a growing population at risk. Methods: A descriptive study of the disease burden was carried out using the city as the unit of observation. Health events were selected based on epidemiologic evidence and the availability of the population attributable fraction associated with PM2.5. The mortality records were taken from the module of deceased of the Single Registry of Affiliates of the Health System; the morbidity records were taken from the Individual Health Services Registries. For the estimation of the burden of disease, the current Global Burden of Disease guidelines were followed. Results: Attributable disability-adjusted life years to exposure to ambient PM2.5 pollution (DALYsPM2.5) constituted 13.8% of total burden of the city. Males showed the greatest loss of DALYsPM2.5 due to acute events, while in women the greatest loss was due to chronic events. Ischemic heart disease, chronic diseases of the lower respiratory tract, and influenza and pneumonia were the events that contributed the most to DALYsPM2.5. 71.4% of the DALYsPM2.5 corresponded to mortality, mainly in the population over 65 years of age. Regarding attributable morbidity, acute events were more prevalent in both sexes, especially due to respiratory diseases Conclusion: Premature death among the elderly population has the greatest weight on burden of disease attributable to ambient PM2.5 pollution, mainly due to respiratory and cardiovascular diseases, without significant differences according to gender.
The efficacy of adjunctive alpha-blockers on ureteroscopy procedure for ureteral stones: a systematic review and meta-analysis
Authors: Serani Sesari Saras , Atmoko Widi , Birowo Ponco , Rasyid Nur 
Published: May 2021

Background:Urolithiasis cases are a common condition, and the number is still growing today. The prevalence of urinary tract stones globally currently ranges from 2-20% with a recurrence rate of around 50%. The present study aims to investigate the efficacy of adjunctive alpha-blockers in improving the success rate of ureteroscopy (URS) procedure for urolithiasis.Methods:We reviewed articles obtained from MEDLINE, CENTRAL, CINAHL, and Elsevier from 14 August to 9 September 2020, comparing alpha-blockers as adjunctive therapy, versus either a placebo or no drug at all, in post-URS urolithiasis patients. There were no restrictions on the type of URS and alpha-blockers given to patients. The quality of studies included was assessed using Cochrane’s Risk of Bias Assessment for Randomized-Controlled Trials.Results:Forest plot analysis emphasizes the statistically significant difference among the group, where the adjunctive alpha-blocker group had pooled relative risk (RR) of being stone-free, readmitted due to initial URS failure, having an overall complication, having haematuria, getting their ureteral mucous injured, and suffering a colic episode was 1.71 (95% CI, 1.11–1.24), 0.50 (95% CI, 0.25–1.01), 0.41 (95% CI, 0.27–0.61), 0.42 (95% CI, 0.22–0.79), 0.31 (95% CI, 0.13–0.73), and 0.21 (95% CI, 0.06–0.69), respectively.Conclusions:Alpha blockers minimize the frequency and duration of ureteral contractions, allowing smooth stone expulsion. With this knowledge, it is expected to help clinicians decide the importance of adjunctive alpha-blocker administration.
A review of the Cochrane COVID-19 Study Register reveals inconsistency in the choice and measurement of SARS-CoV-2 infection outcomes in prevention trials
Authors: Dodd Susanna , Gorst Sarah , Avery Kerry , Harman Nicola , Macefield Rhiannon , Williamson Paula , Blazeby Jane ,   COS-COVID-P Steering Committee
Published: May 2021

Background: Multiple studies are evaluating how to prevent SARS-CoV-2 infection. Interventions are wide ranging and include vaccines, prophylactic drugs, public health safety measures, and behavioural interventions. Heterogeneity in the outcomes measured and reported is leading to research waste and inefficiency, slowing worldwide identification and implementation of effective methods to prevent infection. A core outcome set (COS) for studies of interventions to prevent SARS-CoV-2 infection has recently been developed, identifying infection as a critical outcome to measure. This paper examines how SARS-CoV-2 infection outcomes are measured in registered COVID-19 prevention trials and considers how this can be improved. Methods: We searched the Cochrane COVID-19 Study Register to identify and review SARS-CoV-2 infection outcomes in prevention trials, including the rationale for choice of outcome measurement. We included phase 3 and 4 trials of COVID-19 prevention interventions. Early phase trials and studies relating to the transmission, treatment or management of COVID-19 were excluded. Results: We identified 430 entries in the register, of which 199 unique prevention trials were included across eight settings and 12 intervention types. Fifteen (8%) trials did not include any SARS-CoV-2 infection outcomes. The remaining 184 (92%) studies included a total of 268 SARS-CoV-2 infection outcomes, of which 32 (17%) did not specify how infection would be measured. Testing (i.e. formal diagnostic test) as a standalone method for determining infection was used in 57 (31%) trials, whereas defining infection by symptoms alone was used in 16 (9%) trials. All other trials (n=79, 43%) included multiple infection outcomes, defined in different ways. Discussion: There is considerable variation in how SARS-CoV-2 infection is measured within and across different interventions and settings. Furthermore, few studies report the rationale for outcome selection and measurement. Better transparency and standardisation of SARS-CoV-2 infection measurement is needed for the findings from prevention trials to inform decision-making.
Knowledge of disease, diagnosis, adherence and impact of research in an Irish cohort of patients with inflammatory arthritis
Authors: Marzaioli Viviana , Canavan Mary , Donnolly Alex , Wade Siobhan , Fraser Alexander , O'Sullivan Tim , Harney Sinead , Ireland Arthritis , Veale Douglas J. , Fearon Ursula 
Published: May 2021

Background: Patient engagement with clinicians results in shared decision making and increased adherence to medication. However, in order for strong patient: clinician partnerships to be achieved, communication barriers need to be identified. Therefore, the aim of this study was to examine the level of understanding of inflammatory arthritis patients and the need for strong patient-partnership in research. Methods: An online anonymous survey was distributed to patients living with inflammatory arthritis which addressed questions about diagnosis, routine tests, medications and how they work, medication adherence, disease flare, heredity, pregnancy, and patient involvement in research. Results: There were 1,873 respondents, 1416 of which had inflammatory arthritis (IA)- rheumatoid arthritis (RA) (65.8%) and psoriatic arthritis (PsA) (34.2%). They were predominantly female (RA 86%, PsA 85 %), aged 55±13 and 50±12 years. Less than 35% of patients had an understanding of diagnostic tests, what was measured and the implication for disease, with 75.5% also concerned about heredity. There was a high level of understanding of how specific medications treat inflammatory arthritis (72.9%). Adherence was also very high (>87%), with the main reasons for stopping medication without the advice of their clinician, ‘feeling better’ and ‘side effects’ however a significant proportion of patients (69.9%) reported a disease-flare following cessation of medication. Patients (31%) were also concerned that inflammatory arthritis reduced their chances of getting pregnant, with only 8% believing arthritis medications were safe to take during pregnancy. Finally, only 9% of patients had ever been asked to participate in a research study. Conclusions: This study demonstrates a need for the development of stronger patient-partnerships with clinicians and researchers in relation to patient education and engagement with research, to create a platform where patients can have meaningful input and involvement in future research studies.
Study protocol: The clinical features, epidemiology, and causes of paediatric encephalitis in southern Vietnam
Authors: Huong Nguyen Hoang Thien , Toan Nguyen Duc , Quy Du Tuan , Khanh Truong Huu , Thinh Le Quoc , Nhan Le Nguyen Thanh , Minh Ngo Ngoc Quang , Turner Hugo , Thwaites Louise , Irani Sarosh , Hung Nguyen Thanh , Tan Le Van 
Published: May 2021

Encephalitis is a major cause of morbidity and mortality worldwide. The clinical syndrome of encephalitis consists of altered mental status, seizures, neurologic signs, and is often accompanied by fever, headache, nausea, and vomiting. The encephalitis in children has been known that more common than in adult, with the incidence rate of infants was 3.9 times higher than that of people 20-44 years of age. The reported incidence of hospitalization attributed to paediatric encephalitis ranged from 3 to 13 admissions per 100,000 children per year with the overall mortality ranging from 0 to 7%. There are however more than 100 pathogens that can cause encephalitis and accurate diagnosis is challenging. Over 50% of patients with encephalitis are left undiagnosed despite extensive laboratory investigations. Furthermore, recent studies in high-income settings have suggested autoimmune encephalitis has now surpassed infectious aetiologies, mainly due to increased awareness and diagnostic capacity, which further challenges routine diagnosis and clinical management, especially in developing countries. There are limited contemporary data on the causes of encephalitis in children in Vietnam. Improving our knowledge of the causative agents of encephalitis in this resource-constrained setting remains critical to informing case management, resource distribution and vaccination strategy. Therefore, we conduct a prospective observational study to characterise the clinical, microbiological, and epidemiological features of encephalitis in a major children’s hospital in southern Vietnam. Admission clinical samples will be collected alongside meta clinical data and from each study participants. A combination of classical assays (serology and PCR) and metagenomic next-generation sequencing will used to identify the causative agents. Undiagnosed patients with clinical presentations compatible with autoimmune encephalitis will then be tested for common forms of the disease. Finally, using direct- and indirect costs, we will estimate the economic burden of hospitalization and seven days post hospital discharge of paediatric encephalitis in our setting.
Accuracy of the Mologic COVID-19 rapid antigen test: a prospective multi-centre analytical and clinical evaluation
Authors: Cubas-Atienzar Ana I , Bell Fiona , Byrne Rachel L. , Buist Kate , Clark David J. , Cocozza Michael , Collins Andrea M. , Cuevas Luis E. , Duvoix Annelyse , Easom Nicholas , Edwards Thomas , Ferreira Daniella M. , Fletcher Tom , Groppelli Elisabetta , Hyder-Wright Angela , Kadamus Ewelina , Kirwan Daniela E. , Kontogianni Konstantina , Krishna Sanjeev , Kluczna Diana , Mark Julian , Mensah-Kane Josephine , Miller Elisha , Mitsi Elena , Norton Donna , O'Connor Emma , Owen Sophie I. , Planche Tim , Shelley Samuel , Staines Henry M. , Tate David , Thompson Caitlin R. , Walker Gemma , Williams Christopher T. , Wooding Dominic , Fitchett Joseph R. A. , Adams Emily R. 
Published: May 2021

Background: The coronavirus disease 2019 (COVID-19) pandemic has highlighted the reliance on antigen detection rapid diagnostic tests (Ag-RDTs). Their evaluation at point of use is a priority. Methods: Here, we report a multi-centre evaluation of the analytical sensitivity, specificity, and clinical accuracy of the Mologic COVID-19 Ag-RDT by comparing to reverse transcriptase polymerase chain reaction (RT-qPCR) results from individuals with and without COVID-19 symptoms. Participants had attended hospitals in Merseyside, hospital and ambulance services in Yorkshire, and drive-through testing facilities in Northumberland, UK. Results: The limit of detection of the Mologic COVID-19 Ag-RDT was 5.0 x 102 pfu/ml in swab matrix with no cross-reactivity and interference for any other pathogens tested. A total of 347 participants were enrolled from 26th of November 2020 to 15th of February 2021 with 39.2% (CI 34.0-44.6) testing RT-qPCR positive for SARS-CoV-2. The overall sensitivity and specificity of the Mologic Ag-RDT compared to the reference SARS-CoV-2 RT-qPCR were 85.0% (95% CI 78.3-90.2) and 97.8% (95.0-99.3), respectively. Sensitivity was stratified by RT-qPCR cycle threshold (Ct) and 98.4% (91.3-100) of samples with a Ct less than 20 and 93.2% (86.5-97.2) of samples with a Ct less than 25 were detected using the Ag-RDT. Clinical accuracy was stratified by sampling strategy, swab type and clinical presentation. Mologic COVID-19 Ag-RDT demonstrated highest sensitivity with nose/throat swabs compared with throat or nose swabs alone; however, the differences were not statistically significant. Conclusions: Overall, the Mologic test had high diagnostic accuracy across multiple different settings, different demographics, and on self-collected swab specimens. These findings suggest the Mologic rapid antigen test may be deployed effectively across a range of use settings.
The association between physical activity and menopause-related quality of life
Authors: D'souza Cyanna Joseph , Haripriya Santhakumar , Krishna Harish Sreekantan 
Published: May 2021

Background/aims Menopause can cause drastic changes that trigger severe symptoms in women and, in turn, influence their quality of life. Many women no longer prefer hormone replacement therapy because of its potential adverse effects. Hence, it is crucial to establish alternate interventions to alleviate menopausal symptoms. The aim of this study was to estimate the relationship between quality of life and level of physical activity in menopausal women. Methods A total of 260 postmenopausal women were recruited in this cross-sectional study. The Menopause Rating Scale and International Physical Activity Questionnaire – Short Form were used to assess quality of life and physical activity respectively. Results Women with higher levels of physical activity had fewer total menopausal, somato-vegetative and psychological symptoms (P<0.001); no differences were found in vasomotor and urogenital symptoms. Conclusions Women with low physical activity levels presented with greater menopausal symptoms. Regular physical activity can be recommended to alleviate symptoms following menopause, thereby improving quality of life.
High-pulse-energy high-brightness Q-switched Tm3+:Ho3+-codoped triple-clad polarization- maintaining fiber laser
Authors: Forster Patrick , Romano Clément , Eichhorn Marc , Kieleck Christelle 
Published: May 2021

A Q-switched polarization-maintaining (PM) Thulium (Tm3+):Holmium (Ho3+)-codoped triple-clad fiber (THTF) laser is under investigation with special focus on important optical parameters enabling efficient frequency conversion into mid-infrared (mid-IR). An active fiber of 5 m length is used in a single-oscillator free-space cavity arrangement and operated in continuous-wave and pulsed operation. In Q-switched regime at a repetition rate of 63 kHz, high pulse energies up to 760 μJ were obtained while reaching pulse widths as low as 45.6 ns, resulting in pulse peak powers of 15.7 kW with an average output power of 48 W. In addition, an

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and a FWHM of 290 pm for the emission spectrum was measured.
Miltefosine for the treatment of cutaneous leishmaniasis—A pilot study from Ethiopia
Authors: van Henten Saskia , Tesfaye Annisa Befekadu , Abdela Seid Getahun , Tilahun Feleke , Fikre Helina , Buyze Jozefien , Kassa Mekibib , Cnops Lieselotte , Pareyn Myrthe , Mohammed Rezika , Vogt Florian , Diro Ermias , van Griensven Johan 
Published: May 2021

Background
Cutaneous leishmaniasis (CL) in Ethiopia, caused by Leishmania aethiopica, is often severe and hard to treat compared to CL caused by other species elsewhere. Miltefosine is the only oral anti-leishmanial drug, with a favorable side-effect profile compared to routinely available sodium stibogluconate (SSG), but evidence about its use for L. aethiopica is lacking.

Methodology and principal findings
In an observational cohort study, treatment outcomes, safety and adherence among CL patients who required systemic treatment and received miltefosine for 28 days in Boru Meda Hospital and University of Gondar Hospital were studied. Patient cure was defined as 100% flattening for non-ulcerated lesions and 100% flattening and 100% re-epithelization for ulcerated lesions. Outcomes were documented for day 28, 90 and 180, both per site, and pooled, adjusting for site as a fixed effect with effect coding. Among 94 included patients (32 in Gondar, 62 in Boru Meda), median lesion duration was 12 months, median size six cm, and mucosal involvement (46.8%) and diffuse (30.9%) lesions were common. Adherence to miltefosine was good, and side-effects were tolerable. Initial outcomes at day 28 were promising, with 68.8% and 94.0% of patients having good improvement or cure in Gondar and Boru Meda respectively. In Boru Meda, outcomes were good with 72.7% and 72.9% cure at day 90 and day 180 respectively. In Gondar, results were less promising, with only 12.5% and 26.7% cure at day 90 and day 180, although confidence intervals were wide. In pooled estimates, 48.7% of patients reached cure at day 180, and 32.3% relapsed. Outcomes were better in Boru Meda Hospital, for smaller lesions and for mucosal lesions.

Conclusions/Significance
Based on miltefosine’s good initial response, tolerable side-effects, tablet-form, we propose to include miltefosine for future clinical trials using extended treatment schedules, combination therapy, or targeting specific subgroups.

Trial registration
ClinicalTrials.gov NCT04004754.
Production, reproduction and some adaptation characteristics of Boran cattle breed under changing climate: A systematic review and meta-analysis
Authors: Bayssa Merga , Yigrem Sintayehu , Betsha Simret , Tolera Adugna 
Published: May 2021

Introduction
Climate change affects livestock production and productivity, which could threaten livestock-based food security in pastoral and agro-pastoral production systems of the tropics and sub-tropics. Boran cattle breed is one of the hardiest Zebu cattle reared by Borana Oromo pastoralists for milk and meat production. However, there is limited comprensive information on production, reproduction and adaption traits of the Boran cattle in Ethiopia. Thus, this paper aims to compile the main production, reproduction and some adaptation traits of Boran cattle based on systematic review and meta-analysis of peer reviewed published and unpublished literature.

Methodology
A combination of systematic review and meta-analysis based on PRISMA guideline was employed. Accordingly, out of 646 recorded articles identified through database searching, 64 were found to be eligible for production, reproduction and adaptation characteristics of the Boran cattle, 28 articles were included in qualitative systematic review while 36 articles were used for quantitative meta-analysis.

Result
The Boran cattle breed has the ability to survive, produce and reproduce under high ambient temperature, utilize low quality forage resources, and resist water shortage or long watering intervals and tick infestations. The review revealed that the breed employs various adaptation responses (morphological, physiological, biochemical, metabolic, cellular and molecular responses) to cope with harsh environmental conditions including climate change, rangeland degradation, seasonal feed and water shortages and high incidences of tick infestations. The meta-analysis using a random-effects model allowed provision of pooled estimates of heritability and genetic correlations for reproduction and production traits, which could be used to solve genetic prediction equations under a population level in purebred Boran cattle. In addition, heritability and genetic-correlation estimates found in the present study suggest that there is high genetic variability for most traits in Boran cattle, and that genetic progress is possible for all studied traits in this breed.

Conclusion
The Boran cattle breed has the ability to survive, produce and reproduce under high ambient temperature, utilize low quality forage resources, and resist water shortage or long watering intervals and tick infestations. However, currently there are several challenges such as recurrent droughts, pasture deterioration and lack of systematic selection and breeding programs that play to undermine the realization of the potential of the breed. Thus, we recommend systematic selection for enhancing the reproductive and production performances without compromising the adaptation traits of the breed coupled with improved management of rangelands.
Impact of influenza vaccination in the Netherlands, 2007–2016: Vaccinees consult their general practitioner for clinically diagnosed influenza, acute respiratory infections, and pneumonia more often than non-vaccinees
Authors: Caini Saverio , Paget John , Spreeuwenberg Peter , Korevaar Joke C. , Meijer Adam , Hooiveld Mariëtte 
Published: May 2021

Introduction
We aimed to develop an innovative population-based method to estimate the health effect of influenza vaccination based on electronic medical records collected within a general practitioner (GP)-based influenza surveillance system in the Netherlands.

Methods
In each season between 2006/07 and 2015/16, we fitted multilevel Poisson regression models to compare GP consultation rates for clinically diagnosed influenza, acute respiratory infections (ARI), pneumonia, and lower back pain (as a control) between vaccinated vs. unvaccinated individuals. Season-specific relative risks and 95% confidence intervals (CI) were pooled into summary risk ratio (SRR) through random-effects meta-analysis models. Analyses were stratified by patient age (<45, 45–59, 60–74, ≥75 years) and medical indication for the vaccine (any vs. none, subjects aged ≤60 years only).

Results
Overall, 12.6% and 21.4% of study subjects were vaccinated because of their age only or because of an underlying medical condition. Vaccine uptake declined over time, especially among subjects aged ≤74 years with medical indications for vaccination. Vaccinated individuals had significantly higher GP consultation rates for clinically diagnosed influenza (SRR 1.24, 95% CI 1.12–1.38, p-value <0.001), ARI (SRR 1.33, 95% CI 1.27–1.39, p-value <0.001), pneumonia (SRR 1.27, 95% CI 1.19–1.36, p-value <0.001), and lower back pain (SRR 1.21, 95% CI 1.14–1.28, p-value <0.001) compared to unvaccinated individuals.

Discussion
Contrary to expectations, influenza vaccinees have GP consultation rates for clinically diagnosed influenza, ARI and pneumonia that are 24–33% higher compared to unvaccinated individuals. The lower back pain finding suggests that the increase in consultation rates is partially caused by confounding. Importantly, considering the data are not laboratory-confirmed, our results cannot be linked directly to influenza, but only to respiratory illnesses in general.