bluuebunny/crossref_metadata_2025_split huggingface dataset:
The implications of outcome truncation in reproductive medicine RCTs: a simulation platform for trialists and simulation study
Authors: Wilkinson Jack , Huang Jonathan Y. , Marsden Antonia , Harhay Michael O. , Vail Andy , Roberts Stephen A. 
Published: August 2021

Abstract
Background
Randomised controlled trials in reproductive medicine are often subject to outcome truncation, where the study outcomes are only defined in a subset of the randomised cohort. Examples include birthweight (measurable only in the subgroup of participants who give birth) and miscarriage (which can only occur in participants who become pregnant). These outcomes are typically analysed by making a comparison between treatment arms within the subgroup (for example, comparing birthweights in the subgroup who gave birth or miscarriages in the subgroup who became pregnant). However, this approach does not represent a randomised comparison when treatment influences the probability of being observed (i.e. survival). The practical implications of this for the design and interpretation of reproductive trials are unclear however.

Methods
We developed a simulation platform to investigate the implications of outcome truncation for reproductive medicine trials. We used this to perform a simulation study, in which we considered the bias, type 1 error, coverage, and precision of standard statistical analyses for truncated continuous and binary outcomes. Simulation settings were informed by published assisted reproduction trials.

Results
Increasing treatment effect on the intermediate variable, strength of confounding between the intermediate and outcome variables, and the presence of an interaction between treatment and confounder were found to adversely affect performance. However, within parameter ranges we would consider to be more realistic, the adverse effects were generally not drastic. For binary outcomes, the study highlighted that outcome truncation could cause separation in smaller studies, where none or all of the participants in a study arm experience the outcome event. This was found to have severe consequences for inferences.

Conclusion
We have provided a simulation platform that can be used by researchers in the design and interpretation of reproductive medicine trials subject to outcome truncation and have used this to conduct a simulation study. The study highlights several key factors which trialists in the field should consider carefully to protect against erroneous inferences. Standard analyses of truncated binary outcomes in small studies may be highly biassed, and it remains to identify suitable approaches for analysing data in this context.
Livestock-associated methicillin-resistant Staphylococcus aureus (LA-MRSA) prevalence in humans in close contact with animals and measures to reduce on-farm colonisation
Authors: Crespo-Piazuelo Daniel , Lawlor Peadar G. 
Published: August 2021

AbstractSince the 1940s, Staphylococcus aureus has adapted to the use of different antimicrobials to treat infections. Although S. aureus can act as a commensal bacterium, some strains are facultative pathogens and acquiring them can be fatal. In particular, treating infections caused by S. aureus with acquired antimicrobial resistance is problematic, as their treatment is more difficult. Some of these S. aureus variants are methicillin-resistant S. aureus (MRSA) with prevalence across the globe in health-care facilities, community settings and on livestock farms. Apart from humans, MRSA can colonise other animal species, and because of this, resistance to new antimicrobials can appear and jump between species. Livestock and companion animals are particularly important in this regard considering the relatively high usage of antimicrobials in these species. There is a risk to humans who come into direct contact with animals acquiring MRSA but there is also the risk of animals acquiring MRSA from colonised humans. In this review, we summarise studies conducted worldwide to characterise the prevalence of MRSA in veterinarians, farmers and other personnel who come into close contact with animals. Finally, alternative treatment, preventive measures and on-farm strategies to reduce MRSA introduction to a farm and carriage within a herd are discussed.
Implementing a Physical Activity Consultation Clinic during a Global Pandemic
Authors: Butts Jessica F. , Schmitz Kathryn H. , Onks Cayce , Silvis Matthew 
Published: August 2021

Abstract
Ten percent of all premature deaths and 117 billion dollars in annual health care costs are attributable to physical inactivity in America. The positive impact exercise can have on overall health is irrefutable. While it is the responsibility of health care providers to assess and counsel for exercise, there are logistical, structural, and educational barriers preventing this counseling. A physical activity consultation clinic led by primary care sports medicine physicians would allow for focused exercise counseling by appropriately trained providers to motivated patients. While previously there have been many institutional and logistical barriers to establishing such a clinic, the COVID-19 pandemic has created a window of opportunity for doing so within a large academic medical center. This article reviews the importance of exercise on overall health, outlines the barriers for establishing a clinical experience dedicated to counseling for physical activity, and details how overcoming those barriers was facilitated by the COVID-19 pandemic.
Exercise Is Medicine for Immune Function: Implication for COVID-19
Authors: Nieman David C. 
Published: August 2021

Abstract
This review supports that physical activity improves immunosurveillance and has the potential to counter COVID-19 infection and symptomatology at three prevention levels. At the primary prevention level, several lines of evidence support that physical activity is an immune system adjuvant in combating infectious diseases. Recent epidemiological studies indicate that regular physical activity is associated with a reduced risk for COVID-19, similar to what has been reported for other respiratory infections. Although specific COVID-19-related studies are needed, data from investigations with other types of infectious agents, such as influenza, support the potential role of physical activity in augmenting COVID-19 vaccine efficacy (secondary prevention level). There is a growing awareness that COVID-19 can cause sustained morbidity in some patients, and physical training and rehabilitation (tertiary prevention level) can be directed toward improvement in physical fitness, quality of life, and immune health.
Dosimetric analyses of intra-arterial versus standard intravenous administration of 177Lu-DOTATATE in patients of well differentiated neuroendocrine tumor with liver-dominant metastatic disease
Authors: Thakral Parul , Sen Ishita , Das Subha Shankar , Manda Divya , CB Virupakshappa , Malik Dharmender 
Published: August 2021

Objective:
The aim of the present study was to perform calculation of the absorbed doses to organs at risk and to neuroendocrine tumors and to determine whether hepatic intra-arterial (IA) injection of 177Lu-DOTATATE Peptide Receptor Radionuclide Therapy (PRRT) would achieve higher intratumoral concentrations than standard intravenous administration of 177Lu-DOTATATE.

Methods:
29 patients with Grade I-II, inoperable, metastatic gastro-entero-pancreatic neuroendocrine tumor (GEPNET) were prospectively identified and enrolled for the study. 15 patients of GEPNETs with liver-dominant metastatic disease and less than 3 sites of extrahepatic metastatic disease were administered a single dose of 177Lu-DOTATATE therapy through the selective catheterization of the hepatic artery (IA group). The other 14 patients received a single dose of 177 Lu- DOTATATE through standard intravenous route (IV group). For dosimetry, whole-body γ (anterior and posterior planar acquisitions) and SPECT/CT scans of the abdomen at 2, 24 and 96 h post 177Lu-DOTATATE administration were acquired. Dosimetric calculations were done using the HERMES software.

Results:
The mean dose per unit activity (DpA) in the liver and tumor lesions in the IA group differed significantly (p &lt; 0.05) but differed insignificantly in spleen and kidneys (p &gt; 05) with the IV group. The mean tumor/non-tumor concentration at 96 h was 76.83 ± 7.9 (range 10.2–251.3) in the IA group whereas it was 25.6 ± 5.9 (Range: 12–55) in the IV group. There was an average threefold increase in tumoral concentration over the standard intravenous group.

Conclusion:
IA administration of 177Lu-DOTATATE results in higher concentration and absorbed dose in hepatic metastases in patients of GEPNETs as compared to a single dose of PRRT administered through standard IV route, and thus seems to be a powerful tool to improve the efficacy of PRRT.

Advances in knowledge:
Measurement of the dose received by the tumor lesions and the critical organs is of paramount importance for the prognostication of a radionuclide therapy. Scant data exist on the dosimetric impact of IA administration of the therapy with 177Lu-DOTATATE on the tumors and other organs, and this study would add an impact towards the better treatment outcome in patients of neuroendocrine tumor with liver-dominant metastatic disease.
Protocol for a systematic review and meta-analysis: to investigate the association of adherence to plant-based diets with cardiovascular disease risk
Authors: Lopes Tatum , Zemlin Annalise E. , Faber Mieke , Durao Solange , Erasmus Rajiv T. , Kengne Andre P. 
Published: August 2021

Background: Plant-based diets (PBDs) are characterised as healthy dietary patterns that emphasise the intake of plant foods and limit the intake of animal foods. The Mediterranean and Dietary Approaches to Stop Hypertension (DASH) diets are common examples of healthy dietary patterns that are mainly plant based. There are different dietary pattern analysis approaches and scoring systems available to construct indices that measure adherence to a dietary pattern. Nutritional epidemiology studies necessitate the use of appropriate dietary indices when investigating diet-disease associations. Methods: This systematic review protocol was developed according to the Preferred Reporting Items for Systematic reviews and Meta-Analysis protocols (PRISMA-P) guidelines. PubMed–Medline, Scopus and relevant biomedical databases within EBSCOhost will be searched up to August 2021 using relevant key words. Two reviewers will independently screen the identified records and review the eligible full texts for inclusion. Discrepancies will be resolved by consensus or through discussion with a third reviewer. Appropriate meta-analysis will be performed where possible and consistency of the findings checked through subgroup analysis. Heterogeneity across studies will be assessed and quantified, and publication bias investigated. Relevant sensitivity analyses will be performed to substantiate the robustness of the study findings. Conclusion: Currently, there is some inconsistency in defining and measuring adherence to a PBD across study populations. In addition to this, a lack of global data on the association between adherence to a PBD and CVD risk. This systematic review could aid in promoting the worldwide uptake of these findings for policy and practice purposes. This research will use previously published studies; and therefore, will not require ethical approval.
Understanding the use of pulse oximetry in COVID-19 disease
Authors: Silverston Paul 
Published: August 2021

The pandemic has led to an increase in the use of pulse oximetry to assess and manage patients with COVID-19 disease. Paul Silverston explains the principles of pulse oximetry and the factors that can affect the reliability and accuracy of readings Pulse oximetry is performed to detect and quantify the degree of hypoxia in patients with respiratory symptoms and illnesses, including patients with COVID-19 disease. Pulse oximeters are non-invasive, simple to use and inexpensive, but it is important to know how to interpret the readings in the context of the patient's symptoms and the other clinical findings. In COVID-19 disease, very small differences in the oxygen saturation reading result in significant differences in the way that the patient is managed, so it is important to be aware of the factors that can affect these readings. It is also important to appreciate that a low reading in a patient with suspected or confirmed COVID-19 disease may be the result of another disease process.
Essential skills for using research evidence in public health policy: a systematic review
Authors: Ziam Saliha , Gignac Pierre , Courant Élodie , Mc Sween-Cadieux Esther 
Published: August 2021

Background: Decisions related to the development and implementation of public health programmes or policies can benefit from more effective use of the best available knowledge. However, decision makers do not always feel sufficiently equipped or may lack the capacity to use evidence. This can lead them to overlook or set aside research results that could be relevant to their practice area.
Aims and objectives: The objective of this systematic review was to synthesise the essential skills that facilitate the use of research evidence by public health decision makers.
Methods: Thirty-nine articles that met our inclusion criteria were included. An inductive approach was used to extract data on evidence-informed decision-making-related skills and data were synthesised as a narrative review.
Findings: The analysis revealed three categories of skills that are essential for evidence-informed decision-making process: interpersonal, cognitive, and leadership and influencing skills. Such cross-sectoral skills are essential for identifying, obtaining, synthesising, and integrating sound research results into the decision-making process.
Discussion and conclusions: The results of this systematic review will help direct capacity-building efforts towards enhancing research evidence use by public health decision makers, such as developing different types of training that would be relevant to their needs. Also, when considering the evidence-informed decision-making skills development, there are several useful and complementary approaches to link research most effectively to action. On one hand, it is important not only to support decision makers at the individual level through skills development, but also to provide them with a day-to-day environment that is conducive to evidence use.
The changing epidemiology of hemorrhagic fever with renal syndrome in Southeastern China during 1963–2020: A retrospective analysis of surveillance data
Authors: Zhang Rong , Mao Zhiyuan , Yang Jun , Liu Shelan , Liu Ying , Qin Shuwen , Tian Huaiyu , Guo Song , Ren Jiangping , Shi Xuguang , Li Xuan , Sun Jimin , Ling Feng , Wang Zhen 
Published: August 2021

Background
Hemorrhagic fever with renal syndrome (HFRS) is a rodent-borne disease caused by hantavirus which was endemic Zhejiang Province, China. In this study, we aim to explore the changing epidemiology of HFRS in Zhejiang, identify high-risk areas and populations, and evaluate relevant policies and interventions to better improve HFRS control and prevention.

Methods
Surveillance data on HFRS during 1963–2020 in Zhejiang Province were extracted from Zhejiang Provincial Center for Disease Control and Prevention archives and the Chinese Notifiable Disease Reporting System. The changing epidemiological characteristics of HFRS including seasonal distribution, geographical distribution, and demographic features, were analyzed using joinpoint regression, autoregressive integrated moving average model, descriptive statistical methods, and Spatio-temporal cluster analysis.

Results
From 1963 to 2020, 114 071 HFRS cases and 1269 deaths were reported in Zhejiang Province. The incidence increased sharply from 1973 and peaked in 1986, then decreased steadily and maintained a stable incidence from 2004. HFRS cases were reported in all 11 prefecture-level cities of Zhejiang Province from 1963 to 2020. The joint region (Shengzhou, Xinchang, Tiantai, and surrounding areas), and Kaihua County are the most seriously affected regions throughout time. After 1990, the first HFRS incidence peak was in May-June, with another one from November to January. Most HFRS cases occurred in 21- (26.48%) and 30- years group (24.25%) from 1991 to 2004, but 41- (25.75%) and 51-years (23.30%) had the highest proportion from 2005 to 2020. Farmers accounted for most cases (78.10%), and cases are predominantly males with a male-to-female ratio of 2.6:1. It was found that the median time from onset to diagnosis was 6.5 days (IQR 3.75–10.42), and the time from diagnosis to disease report was significantly shortened after 2011.

Conclusions
We observed dynamic changes in the seasonal distribution, geographical distribution, and demographic features of HFRS, which should be well considered in the development of control and prevention strategies in future. Additional researches are warranted to elucidate the environmental, meteorological, and social factors associated with HFRS incidence in different decades.
Approaching precision public health by automated syndromic surveillance in communities
Authors: Chan Ta-Chien , Tang Jia-Hong , Hsieh Cheng-Yu , Chen Kevin J. , Yu Tsan-Hua , Tsai Yu-Ting 
Published: August 2021

Background
Sentinel physician surveillance in communities has played an important role in detecting early signs of epidemics. The traditional approach is to let the primary care physician voluntarily and actively report diseases to the health department on a weekly basis. However, this is labor-intensive work, and the spatio-temporal resolution of the surveillance data is not precise at all. In this study, we built up a clinic-based enhanced sentinel surveillance system named “Sentinel plus” which was designed for sentinel clinics and community hospitals to monitor 23 kinds of syndromic groups in Taipei City, Taiwan. The definitions of those syndromic groups were based on ICD-10 diagnoses from physicians.

Methods
Daily ICD-10 counts of two syndromic groups including ILI and EV-like syndromes in Taipei City were extracted from Sentinel plus. A negative binomial regression model was used to couple with lag structure functions to examine the short-term association between ICD counts and meteorological variables. After fitting the negative binomial regression model, residuals were further rescaled to Pearson residuals. We then monitored these daily standardized Pearson residuals for any aberrations from July 2018 to October 2019.

Results
The results showed that daily average temperature was significantly negatively associated with numbers of ILI syndromes. The ozone and PM2.5 concentrations were significantly positively associated with ILI syndromes. In addition, daily minimum temperature, and the ozone and PM2.5 concentrations were significantly negatively associated with the EV-like syndromes. The aberrational signals detected from clinics for ILI and EV-like syndromes were earlier than the epidemic period based on outpatient surveillance defined by the Taiwan CDC.

Conclusions
This system not only provides warning signals to the local health department for managing the risks but also reminds medical practitioners to be vigilant toward susceptible patients. The near real-time surveillance can help decision makers evaluate their policy on a timely basis.
Prevalence of dermatological toxicities in patients with melanoma undergoing immunotherapy: Systematic review and meta-analysis
Authors: Mineiro dos Santos Garrett Náthali Felícia , Carvalho da Costa Ana Cristina , Barros Ferreira Elaine , Damiani Giovanni , Diniz dos Reis Paula Elaine , Inocêncio Vasques Christiane 
Published: August 2021

Background
Checkpoint inhibitors have revolutionized advanced melanoma care; however, their cutaneous side effects have not been definitively elucidated.

Objective
To identify the prevalence of cutaneous toxicity in patients with melanoma treated with immune checkpoint inhibitors as monotherapy and/or in combination with chemotherapy and/or radiotherapy.

Materials and methods
We performed a systematic review and meta-analysis, which encompassed both clinical trials and observational studies describing the dermatological toxicities in patients treated with immune checkpoint inhibitors. The protocol was registered in the International Prospective Register of Systematic Review under the number CRD42018091915. The searches were performed using the CINAHL, Cochrane CENTRAL, LILACS, LIVIVO, PubMed, Scopus, and Web of Science databases. The methodological quality of the studies was evaluated with the JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data

Results
A total of 9,802 articles were identified in the databases. The final sample comprised 39 studies. The evaluated drugs were ipilimumab, tremelimumab, pembrolizumab, and nivolumab. The results suggest that the most prevalent side effect was grade 1 and 2 pruritus (24%), followed by grade 1 and 2 rash (21%) and grade 1 and 2 vitiligo (10%).

Conclusion
The most prevalent side effects in patients treated with checkpoint inhibitors are pruritus, rash, and vitiligo, and they are rated mostly as grades 1 and 2 adverse events. Remarkably, vitiligo is most commonly found in patients treated with PD-1 inhibitors.