bluuebunny/crossref_metadata_2025_split huggingface dataset:
Safety of influenza vaccination during pregnancy: a systematic review
Authors: Wolfe Dianna M , Fell Deshayne , Garritty Chantelle , Hamel Candyce , Butler Claire , Hersi Mona , Ahmadzai Nadera , Rice Danielle B , Esmaeilisaraji Leila , Michaud Alan , Soobiah Charlene , Ghassemi Marco , Khan Paul A , Sinilaite Angela , Skidmore Becky , Tricco Andrea C , Moher David , Hutton Brian 
Published: September 2023

ObjectiveWe conducted a systematic review to evaluate associations between influenza vaccination during pregnancy and adverse birth outcomes and maternal non-obstetric serious adverse events (SAEs), taking into consideration confounding and temporal biases.MethodsElectronic databases (Ovid MEDLINE ALL, Embase Classic+Embase and the Cochrane Central Register of Controlled Trials) were searched to June 2021 for observational studies assessing associations between influenza vaccination during pregnancy and maternal non-obstetric SAEs and adverse birth outcomes, including preterm birth, spontaneous abortion, stillbirth, small-for-gestational-age birth and congenital anomalies. Studies of live attenuated vaccines, single-arm cohort studies and abstract-only publications were excluded. Records were screened using a liberal accelerated approach initially, followed by a dual independent approach for full-text screening, data extraction and risk of bias assessment. Pairwise meta-analyses were conducted, where two or more studies met methodological criteria for inclusion. The Grading of Recommendations, Assessment, Development and Evaluation approach was used to assess evidence certainty.ResultsOf 9443 records screened, 63 studies were included. Twenty-nine studies (24 cohort and 5 case–control) evaluated seasonal influenza vaccination (trivalent and/or quadrivalent) versus no vaccination and were the focus of our prioritised syntheses; 34 studies of pandemic vaccines (2009 A/H1N1 and others), combinations of pandemic and seasonal vaccines, and seasonal versus seasonal vaccines were also reviewed. Control for confounding and temporal biases was inconsistent across studies, limiting pooling of data. Meta-analyses for preterm birth, spontaneous abortion and small-for-gestational-age birth demonstrated no significant associations with seasonal influenza vaccination. Immortal time bias was observed in a sensitivity analysis of meta-analysing risk-based preterm birth data. In descriptive summaries for stillbirth, congenital anomalies and maternal non-obstetric SAEs, no significant association with increased risk was found in any studies. All evidence was of very low certainty.ConclusionsEvidence of very low certainty suggests that seasonal influenza vaccination during pregnancy is not associated with adverse birth outcomes or maternal non-obstetric SAEs. Appropriate control of confounding and temporal biases in future studies would improve the evidence base.
Undernutrition in children aged 0–59 months by region and over time: secondary analysis of the Burkina Faso 2012–2018 National Nutrition Surveys
Authors: Boua Palwende Romuald , Rouamba Toussaint , Bambara Estelle , Kaboré Saidou , Compaore Ella W R , Ouedraogo Boureima , Tinto Halidou , Newell Marie-Louise , Ward Kate , Sorgho Hermann 
Published: September 2023

The global burden of undernutrition remains high, responsible for significant under-five mortality in resource-limited settings. Numerous sustainable development goals (SDGs) are linked to nutrition, and nationally representative nutrition surveillance is a key activity to track progress towards SDGs and guide efficient programmes.ObjectivesThe aim of this study is to look at spatial and temporal trends in undernutrition in children under 5 years age in Burkina Faso.SettingWe used data from annual National Nutrition Surveys using Standardised Monitoring and Assessment of Relief and Transitions methodology (anthropometry, morbidity) over 7 years (2012–2018) in Burkina Faso.ParticipantsChildren of under 5 years from households selected through systemic sampling at countrywide level.Main outcome measuresPrevalence of stunting (height-for-age z-score, <−2), underweight (weight-for-age z-score, <−2) and wasting (weight-for-height z-score, <−2) at regional and national. We used general linear mixed models, adjusted by age, survey year, sex, presence of fever and/or diarrhoea, and poverty index to quantify the risk of undernutrition over time and by region of residence.ResultsBetween 2012 and 2018, decreases were observed overall in the prevalence of growth retardation (stunting) decreased from 33.0% (95% CI 32.3 to 33.8) in 2012 to 26.7% (95% CI 26.2 to 27.3) in 2018. Underweight reduced from 24.4% (95% CI 23.7 to 25.1) to 18.7% (95% CI 18.2 to 19.2) for the same period and wasting decreased from 10.8% (95% CI 10.3 to 11.3) in 2012 to 8.4% (95% CI 8.1 to 8.8) in 2018. However, there was substantial variation across the country, with increased risk of undernutrition in the regions of Sahel, East and Cascades primarily. High-risk regions were characterised by a lower poverty index and limited access to healthcare services.ConclusionsOur findings could inform national policymakers in refining and optimising resource allocation based on the identification of high-risk areas.
Cost–utility analysis of commonly used anti-glaucoma interventions for mild-to-moderate primary open-angle glaucoma patients in rural and urban China
Authors: Li Ruyue , Zhang Kaiwen , Lu Zhecheng , Mou Dapeng , Wang Jin , Li Huiqi , Fan Sujie , Wang Ningli , Liu Hanruo 
Published: September 2023

ObjectiveAn increasing number of studies have explored the clinical effects of antiglaucoma surgical procedures; however, economic evidence was scarce. We aimed to compare the cost-effectiveness between maximal medical treatment (MMT) and commonly used surgical procedures (trabeculectomy, Ahmed glaucoma valve implantation, gonioscopy-assisted transluminal trabeculotomy and ab interno canaloplasty).Design and settingA Markov model study.ParticipantsA hypothetical cohort of 100 000 patients with mild-to-moderate primary open-angle glaucoma (POAG).OutcomesData were obtained from public sources. The main outcomes were incremental cost–utility ratios (ICURs) using quality-adjusted life-years (QALYs). Sensitivity analyses were conducted to verify the robustness and sensitivity of base-case results.Main resultsBoth cumulative costs and QALYs gained from surgical procedures (US$6045–US$13 598, 3.33–6.05 QALYs) were higher than those from MMT (US$3117–US$6458, 3.14–5.66 QALYs). Compared with MMT, all surgical procedures satisfied the cost-effectiveness threshold (lower than US$30 501 and US$41 568 per QALY gained in rural and urban settings, respectively). During the 5-year period, trabeculectomy produced the lowest ICUR (US$21 462 and US$15 242 per QALY gained in rural and urban settings, respectively). During the 10-year-follow-up, trabeculectomy still produced the lowest ICUR (US$13 379 per QALY gained) in urban setting; however, gonioscopy-assisted transluminal trabeculotomy (US$19 619 per QALY gained) and ab interno canaloplasty (US$18 003 per QALY gained) produced lower ICURs than trabeculectomy (US$19 675 per QALY gained) in rural areas. Base-case results were most sensitive to the utilities and costs of initial treatment and maintenance.ConclusionsThe long-term cost-effectiveness of commonly used surgical procedures could be better than the short-term cost-effectiveness for mild-to-moderate POAG patients in China. Health economic studies, supported by more rigorous structured real-world data, are needed to assess their everyday cost-effectiveness.
Epidemiology of extrapulmonary tuberculosis in Brunei Darussalam: a retrospective cohort study
Authors: Chaw Liling , Mat Salleh Lena , Abdul Hamid Rafizah , Thu Kyaw 
Published: September 2023

ObjectivesWe reported the incidence and associated factors of extrapulmonary tuberculosis (EPTB).DesignA retrospective cohort study.SettingBrunei Darussalam, an intermediate tuberculosis (TB)-burden country with stagnating annual TB rates.ParticipantsAll active TB cases identified in the country between January 2001 and December 2018 (18 years).Primary and secondary outcome measuresAnnual proportions of EPTB (overall and specific) were calculated. Multiple logistic regression was done to investigate factors associated with developing EPTB, when compared with pulmonary TB (PTB). Χ2trend test was used to determine any trends during the 18-year study period.ResultsWe identified 3916 TB cases, among which 743 (19.0%) were EPTB cases. Lymphatic (44.8%) and pleural (19.4%) EPTB were most common. The main modes of diagnosis were tissue biopsy (73.6%) and radiological assessment (18.3%). Treatment success and mortality rate were 79.7% and 7.0%, respectively. Associations with specific EPTB types varies with age-group and gender. Younger age-group (adjusted OR (aOR)≥1.94) and women (aOR: 2.45 (95% CI: 1.94 to 3.11)) had higher adjusted odds of developing lymphatic EPTB, but had lower adjusted odds of developing pleural EPTB (younger age-group (aOR≤0.54) and women (aOR: 0.41 (95% CI: 0.17 to 0.90)). When compared to foreign residents, locals had higher adjusted odds of skeletal (aOR: 4.44 (95% CI: 2.04 to 11.69)), gastrointestinal (aOR: 3.91 (95% CI: 1.84 to 9.66)) and other types of EPTB (aOR: 3.42 (95% CI: 1.53 to 9.14)). No significant trend differences were observed for overall and specific EPTB types.ConclusionDespite being generally non-infectious and less recognised than PTB, understanding EPTB epidemiology is important as it also contributes to the overall TB burden in a country. Examining EPTB cases by their specific anatomical site would provide more information on risk factors. Raising public awareness on the EPTB symptoms and that TB affects lungs and other parts of the body could promote early health seeking behaviour and early EPTB diagnosis.
Dual hormone fully closed loop in type 1 diabetes: a randomised trial in the Netherlands – study protocol
Authors: Jancev Milena , Snoek Frank J , Frederix Geert W J , Knottnerus Heleen , Blauw Helga , Witkop Maureen , Moons Karel G M , van Bon Arianne C , DeVries J Hans , Serné Erik H , van Sloten Thomas T , de Valk Harold W 
Published: September 2023

IntroductionThe management of type 1 diabetes (T1DM) has undergone significant advancements with the availability of novel technologies, notably continuous and flash glucose monitoring (CGM and FGM, respectively) and hybrid closed loop (HCL) therapy. The dual hormone fully closed loop (DHFCL) approach with insulin and glucagon infusion has shown promising effects in small studies on glycaemic regulation and quality of life in T1DM.Methods and analysisThe Dual Hormone Fully Closed Loop for Type 1 Diabetes (DARE) study is a non-commercial 12-month open-label, two-arm randomised parallel-group trial. The primary aim of this study is to determine the long-term effects on glycaemic control, patient-reported outcome measurements and cost-effectiveness of the DHFCL compared with usual care, that is, HCL or treatment with multiple daily insulin injections+FGM/CGM. We will include 240 adult patients with T1DM in 14 hospitals in the Netherlands. Individuals will be randomised 1:1 to the DHFCL or continuation of their current care.Ethics and disseminationEthical approval has been obtained from the Medical Research Ethics Committee NedMec, Utrecht, the Netherlands. Findings will be disseminated through peer-reviewed publications and presentations at local, national and international conferences.Trial registration numberNCT05669547.
Ultrasonography in thoracic and abdominal stab wound injury: results from the FETTHA study
Authors: Bouzid Donia , Tran-Dinh Alexy , Lortat-Jacob Brice , Atchade Enora , Jean-Baptiste Sylvain , Tashk Parvine , Snauwaert Aurelie , Zappella Nathalie , Augustin Pascal , Pellenc Quentin , Castier Yves , Ribeiro Lara , Gaudemer Augustin , Khalil Antoine , Montravers Philippe , Tanaka Sebastien 
Published: September 2023

BackgroundWhile the role of Extended Focused Assessment with Sonography in Trauma (eFAST) is well defined in the management of severe blunt trauma, its performance in injuries caused by stab wounds has been poorly assessed.MethodsProspective single centre study which included all patients with stab wounds to the thorax or abdomen between December 2016 and December 2018. All patients underwent initial investigation with both eFAST and CT scan, except in cases of haemodynamic or respiratory instability, and in cases with a positive diagnosis by eFAST in which case surgery without CT scan was performed.ResultsOf the 200 consecutive patients included, 14 unstable patients underwent surgery immediately after eFAST. In these 14 patients, 9 had cardiac tamponade identified by eFAST and all were confirmed by surgery. In the remaining 186 patients, the median time between eFAST and CT scan was 30 min (IQR 20–49 min). Test characteristics (including 95% CI) for eFAST compared with reference standard of CT scan for detecting pneumothorax were as follows: sensitivity 77% (54%–92%), specificity 93% (90%–97%), positive predictive value (PPV) 60% (49%–83%), negative predictive value (NPV) 97% (93%–99%). Test characteristics (including 95% CI) for eFAST compared with CT scan for detecting haemothorax were as follows: sensitivity 97% (74%–99%), specificity 96% (92%–98%), PPV 83% (63%–93%) and NPV 99% (96%–100%). Finally, test characteristics (including 95% CI) for eFAST compared with CT scan for detecting haemoperitoneum were as follows: sensitivity 75% (35%–97%), specificity 97% (93%–99%), PPV 55% (23%–83%) and NPV 99% (96%–99%).ConclusionsIn patients admitted with stab wounds to the torso, eFAST was not sensitive enough to diagnose pneumothorax and haemoperitoneum, but performed better in the detection of cardiac tamponade and haemothorax than the other injuries. More robust multicentre studies are needed to better define the role of eFAST in this specific population.
Prehospital early warning scores for adults with suspected sepsis: retrospective diagnostic cohort study
Authors: Goodacre Steve , Sutton Laura , Thomas Ben , Hawksworth Olivia , Iftikhar Khurram , Croft Susan , Fuller Gordon , Waterhouse Simon , Hind Daniel , Bradburn Mike , Smyth Michael Anthony , Perkins Gavin D , Millins Mark , Rosser Andy , Dickson Jon M , Wilson Matthew Joseph 
Published: September 2023

BackgroundAmbulance services need to identify and prioritise patients with sepsis for early hospital assessment. We aimed to determine the accuracy of early warning scores alongside paramedic diagnostic impression to identify sepsis that required urgent treatment.MethodsWe undertook a retrospective diagnostic cohort study involving adult emergency medical cases transported to Sheffield Teaching Hospitals ED by Yorkshire Ambulance Service in 2019. We used routine ambulance service data to calculate 21 early warning scores and categorise paramedic diagnostic impressions as sepsis, infection, non-specific presentation or other presentation. We linked cases to hospital records and identified those meeting the sepsis-3 definition who received urgent hospital treatment for sepsis (reference standard). Analysis determined the accuracy of strategies that combined early warning scores at varying thresholds for positivity with paramedic diagnostic impression.ResultsWe linked 12 870/24 955 (51.6%) cases and identified 348/12 870 (2.7%) with a positive reference standard. None of the strategies provided sensitivity greater than 0.80 with positive predictive value greater than 0.15. The area under the receiver operating characteristic curve for the National Early Warning Score, version 2 (NEWS2) applied to patients with a diagnostic impression of sepsis or infection was 0.756 (95% CI 0.729, 0.783). No other early warning score provided clearly superior accuracy to NEWS2. Paramedic impression of sepsis or infection had sensitivity of 0.572 (0.519, 0.623) and positive predictive value of 0.156 (0.137, 0.176). NEWS2 thresholds of >4, >6 and >8 applied to patients with a diagnostic impression of sepsis or infection, respectively, provided sensitivities and positive predictive values of 0.522 (0.469, 0.574) and 0.216 (0.189, 0.245), 0.447 (0.395, 0.499) and 0.274 (0.239, 0.313), and 0.314 (0.268, 0.365) and 0.333 (0.284, 0.386).ConclusionNo strategy is ideal but using NEWS2 alongside paramedic diagnostic impression of infection or sepsis could identify one-third to half of sepsis cases without prioritising unmanageable numbers. No other score provided clearly superior accuracy to NEWS2.Trial registration numberresearchregistry5268,https://www.researchregistry.com/browse-the-registry%23home/registrationdetails/5de7bbd97ca5b50015041c33/
Remission, response, retention and persistence to treatment with disease-modifying agents in patients with rheumatoid arthritis: a study of harmonised Swedish, Danish and Norwegian cohorts
Authors: Westerlind Helga , Glintborg Bente , Hammer Hilde Berner , Saevarsdottir Saedis , Krogh Niels Steen , Hetland Merete Lund , Hauge Ellen-Margrethe , Martinez Tejada Isabel , Sexton Joseph , Askling Johan 
Published: September 2023

ObjectivePrecision medicine in rheumatoid arthritis (RA) requires a good understanding of treatment outcomes and often collaborative efforts that call for data harmonisation. We aimed to describe how harmonisation across study cohorts can be achieved and investigate how the observed proportions reaching remission vary across remission criteria, study types, disease-modifying antirheumatic drugs (DMARDs) and countries, and how they relate to other treatment outcomes.MethodsWe used data from eight existing large-scale, clinical RA registers and a pragmatic trial from Sweden, Denmark and Norway. In these, we defined three types of treatment cohorts; methotrexate monotherapy (as first DMARD), tumour necrosis factor inhibitors (TNFi) (as first biological DMARD) and rituximab. We developed a harmonised study protocol defining time points during 36 months of follow-up, collected clinical visit data on treatment response, retention, persistence and six alternative definitions of remission, and investigated how these outcomes differed within and between cohorts, by treatment.ResultsCohort sizes ranged from ~50 to 22 000 patients with RA. The proportions reaching each outcome varied across outcome metric, but with small to modest variations within and between cohorts, countries and treatment. Retention and persistence rates were high (>50% at 1 year), yet <33% of patients starting methotrexate or TNFi, and only 10% starting rituximab, remained on drug without other DMARDs added and achieved American Congress of Rheumatology/European Alliance of Associations for Rheumatology or Simplified Disease Activity Index remission at 1 year.ConclusionHarmonisation of data from different RA data sources can be achieved without compromising internal validity or generalisability. The low proportions reaching remission, point to an unmet need for treatment optimisation in RA.
So Grateful for My X: Sex Chromosomes Drive Differences in Glioblastoma Immunity
Authors: Alspach Elise 
Published: September 2023

Summary:Males are at a greater risk of developing glioblastoma and face poorer prognoses compared with their female counterparts for reasons that are not well understood. Lee and colleagues uncover a role for sex-based differences in CD8+ T-cell function, which adds another layer to our growing understanding that antitumor immunity is not generated equivalently between males and females.See related article by Lee et al., p. 2090 (5).
Express Delivery of Next-Generation CAR T Cells with Preserved Naive and Stemness Phenotypes for the Treatment of Aggressive Lymphomas
Authors: Wang Michael 
Published: September 2023

Summary:In this issue of Cancer Discovery, Dickinson and colleagues present clinical data from a first-in-human study of YTB323, a novel autologous CD19-directed chimeric antigen receptor T-cell therapy generated on the T-Charge platform with preserved naive state and stemness phenotypes. Treatment with YTB323 achieved high overall response rates, durable complete remissions, and good overall safety. Their cell doses are up to 25-fold lower than with tisagenlecleucel.See related article by Dickinson et al., p. 1982 (10).
Challenges and Opportunities in Building a Global Representative Single-Cell and Spatial Atlas in Cancer
Authors: Plummer Jasmine T. , George Sophia H.L. 
Published: September 2023

Summary:
Cancer health disparities are complex and a mixture of factors that need to be accounted for in both our planning, implementation, and execution across all researchers, especially in single-cell and spatial technologies, which have a higher burden for adoption in low- and middle-income countries. This commentary tackles the hurdles these technologies face in creating a diverse, representative atlas of cancer and is a call to arms for a strategic plan toward inclusivity across all global populations.
Impacts of Digitization of Business Permits and Licenses in District 3 Quezon City
Authors: Alindajao Ian Dave U. , Abbot Neygen D. , Mariňas Jayson B. , Malang Bernandino P. , Vigonte Florinda G. 
Published: September 2023

This study aimed to determine the Impacts of Digitization of Business Permits and Licenses in District 3 Quezon City in terms of service satisfaction on time efficiency, reliability, cost-effectiveness, and convenience in business permit and license application of the business owners as the respondents of the study. The researchers used a descriptive method of research instruments to gather vital data from 380 business owners and guided the researchers in determining the result of the study. The researchers found that the respondents were very satisfied with digitizing business permits and licenses.
It was recommended by the researchers that in order to enhance e-governance, the Business Permit and Licensing Department must include alert/reminder messages thru Short Message Service (SMS) in informing the status and deficiency of business permit and license application documents submitted by the business owners. Furthermore, there must be a system integration of all departments involved in processing business permits and licenses to ensure complete compliance in order not to hamper the business owners’ applications.
Awareness and Acceptability of Camarines Norte State College Vision and Mission, The Graduate School Goal and Objectives of Curricular Programs
Authors: Mabeza Ma. Reina A. , Macasinag Nora J. , Fajardo Corazon S. 
Published: September 2023

This study assessed the respondents’ extent of awareness and acceptability of the Camarines Norte State College (CNSC) vision and mission, the Graduate School goal and the objectives of curricular programs. A descriptive research survey was used in the study and employed a structured survey questionnaire in gathering the relevant data from the respondents. The findings revealed that the respondents which also identified as the stakeholders of the CNSC such as the students, parents, faculty members, employees, and alumni are highly aware on the CNSC’s vision and mission, the Graduate School goal and the objectives of its different curricular programs. Likewise, the findings revealed that the respondents highly accepted the CNSC mandates, the Graduates School goals and its different curricular objectives. Using One-way Analysis of Variance (ANOVA), results inferred that no significant differences on the extent of awareness of the respondents in terms of CNSC vision, mission, GS Goal and in the objectives of its different curricular programs. The study recommended that there may be an extensive dissemination of the CNSC vision, mission, the Graduate School goal and the objectives of its curricular programs during the beginning of the school term and these must be disseminated sustainably through different fora and to other platform of information like College Webpage, in local TV and radio programs, posted in bulletin boards, flyers and the like.