bluuebunny/crossref_metadata_2025_split huggingface dataset:
Vaccines to prevent COVID-19: a protocol for a living systematic review with network meta-analysis including individual patient data (The LIVING VACCINE Project)
Authors: KORANG STEVEN KWASI , Juul Sophie , Nielsen Emil Eik , Feinberg Joshua , Siddiqui Faiza , Ong Giok , Klingenberg Sarah , Veroniki Areti Angeliki , Bu Fanlong , Thabane Lehana , Thomsen Allan Randrup , Jakobsen Janus C , Gluud Christian 
Published: November 2020

Abstract
Background: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes corona virus disease 2019 (COVID-19) which has rapidly spread worldwide. Several human randomized clinical trials assessing potential vaccines are currently underway. There is an urgent need for a living systematic review that continuously assesses the beneficial and harmful effects of all available vaccines for COVID-19.Methods/design: We will conduct a living systematic review based on searches of major medical databases (e.g. MEDLINE, EMBASE, CENTRAL) and clinical trial registries from their inception onwards to identify relevant randomized clinical trials. We will update the literature search once a week to continuously assess if new evidence is available. Two review authors will independently extract data and conduct risk of bias assessments. We will include randomized clinical trials comparing any vaccine aiming to prevent COVID-19 (including but not limited to messenger RNA; DNA; non-replicating viral vector; replicating viral vector; inactivated virus; protein subunit; dendritic cell; other vaccines) with any comparator (placebo; ‘active placebo’; no intervention; standard care; an ‘active’ intervention; another vaccine for COVID-19) for participants in all age groups.Primary outcomes will be all-cause mortality; a diagnosis of COVID-19; and serious adverse events. Secondary outcomes will be quality of life, and non-serious adverse events. The living systematic review will include aggregate data meta-analyses, Trial Sequential Analyses, network meta-analyses, and individual patient data meta-analyses. Within-study bias will be assessed using Cochrane risk of bias tool. The Grading of Recommendations, Assessment, Development and Evaluations (GRADE) and Confidence in Network Meta-Analysis (CINeMA) approaches will be used to assess certainty of evidence. Observational studies describing harms identified during the search for trials will also be included and described and analyzed separately.Discussion: COVID-19 has become a pandemic with substantial mortality. A living systematic review assessing the beneficial and harmful effects of different vaccines is urgently needed. This living systematic review will regularly inform best practice in vaccine prevention and clinical research of this highly prevalent disease.Systematic review registration: PROSPERO CRD42020196492
Screening for the Prevention and Early Detection of Cervical Cancer: Protocol for Systematic Reviews to Inform Canadian Recommendations
Authors: Gates Allison , Pillay Jennifer , Reynolds Donna , Stirling Robert , Traversy Gregory , Korownyk Christina , Moore Ainsley , Thériault Guylène , Thombs Brett D , Little Julian , Popadiuk Catherine , Niekerk Dirk van , Keto-Lambert Diana , Vandermeer Ben , Hartling Lisa 
Published: November 2020

Abstract
Purpose. To inform recommendations by the Canadian Task Force on Preventive Health Care on screening in primary care for the prevention and early detection of cervical cancer by systematically reviewing evidence of: (a) effectiveness; (b) test accuracy; (c) individuals’ values and preferences, and (d) strategies aimed at improving screening rates.Methods. De novo reviews will be conducted to evaluate effectiveness and to assess values and preferences. For test accuracy and strategies to improve screening rates, we will integrate studies from existing systematic reviews with search updates to the present. Two Cochrane reviews will provide evidence of adverse pregnancy outcomes from the conservative management of cervical intraepithelial neoplasia. We will search Medline, Embase, and Cochrane Central (except for individuals’ values and preferences, where Medline, Scopus, and EconLit will be searched) via peer-reviewed search strategies, and the reference lists of included studies and reviews. We will search ClinicalTrials.gov and the World Health Organization International Clinical Trials Registry Platform for ongoing trials. Two reviewers will screen potentially eligible studies and agree on those to include. Data will be extracted by one reviewer with verification by another. Two reviewers will independently assess risk of bias and reach consensus. Where possible and suitable, we will pool studies via meta-analysis. We will compare accuracy data per outcome and per comparison using the Rutter and Gatsonis hierarchical summary receiver operating characteristic model and report relative sensitivities and specificities. Findings on values and preferences will be synthesized using a narrative synthesis approach and thematic analysis, depending on study designs. Two reviewers will appraise the certainty of evidence for all outcomes using GRADE (Grading of Recommendations Assessment, Development and Evaluation) and come to consensus.Discussion. The publication of guidance on screening in primary care for the prevention and early detection of cervical cancer by the Task Force in 2013 focused on cytology. Since 2013, new studies using human papillomavirus tests for cervical screening have been published that will improve our understanding of screening in primary care settings. This review will inform updated recommendations based on currently available studies and address key evidence gaps noted in our previous review.Systematic review registration: not registered.
Financial Accountability Mechanisms in Local Governments in Uganda.A Case of Kabale District Local Government
Authors: Arinaitwe Perpetua - , Eton Marus - , Agaba Moses - , Turyahebwa Abanis - , Ogwel Benard Patrick , Mwosi Fabian - 
Published: November 2020

Abstract
The paper presents financial accountability mechanisms in local governments, with reference to Kabale district local government. A cross-sectional research design, which used both quantitative and qualitative approaches to collect and analyze data, was adopted. Both simple random and purposive sampling techniques were used to select 117 respondents from 174 subjects. Questionnaires and personal interviews were used to collect data from respondents. Frequencies and percentages were used to analyze quantitative data while direct quotes from interviews conducted among key informants formed the basis for qualitative analysis. Quantitative analysis was aided by software for document analysis (SPSS V 20.0). In descending order of perception, service delivery was found to be the most commonly used financial accountability mechanism, followed by financial reporting, expenditure control and budget. The paper therefore, concluded that service delivery is the most used mechanism of financial accountability, though the district’s local budget seemed unclear on reflecting the priorities of the local people. This paper recommended that the local government should ensure that the district’s budget demonstrates community preference; salaries and wages should be paid in accordance with the district’s approved budget; expenditures on development should always be as per the approved budget, and the mode of financial reporting, particularly on liabilities should be standardized. Due to the scope of this paper, which could not quantitatively relate financial accountability and service delivery, there is need for a comprehensive study on the effect of financial accountability and service delivery in Kabale district local government
The economic burden of measles in children under five in Bangladesh
Authors: de Broucker Gatien , Ahmed Sayem , Hasan Md. Zahid , Mehdi Gazi Golam , Campo Jorge Martin del , Ali Md. Wazed , Uddin Md. Jasim , Constenla Dagna , Patenaude Bryan 
Published: November 2020

Abstract
Background: This study estimated the economic cost of treating measles in children under-5 in Bangladesh from the caregiver, government, and societal perspectives.Method: We conducted an incidence-based study using an ingredient-based approach. We surveyed the administrative staff and the healthcare professionals at the facilities, recording their estimates supported by administrative data from the healthcare perspective. We conducted 100 face-to-face caregiver interviews at discharge and phone interviews 7 to 14 days post-discharge to capture all expenses, including time costs related to measles. All costs are in 2018 USD ($).Results: From a societal perspective, a hospitalized and ambulatory measles cost $159 and $18, respectively. On average, the government spent $23 per hospitalized measles. At the same time, caregivers incurred $131 and $182 in economic costs, including $48 and $83 in out-of-pocket expenses in public and private not-for-profit facilities, respectively. Seventy-eight percent of the poorest caregivers faced catastrophic health expenditures compared to 21% of the richest. In 2018, 2263 cases of measles were confirmed, totaling $348,073 in economic costs to Bangladeshi society, with $121,842 in out-of-pocket payments for households.Conclusion: The resurgence of measles outbreaks is a substantial cost for society, requiring significant short-term public expenditures, putting households into a precarious financial situation. Improving vaccination coverage in areas where it is deficient (Sylhet division in our study) would likely alleviate most of this burden.
Prevalence and predictors of child labour among junior public secondary school students in Enugu, Nigeria: a cross-sectional study
Authors: Enebe Nympha Onyinye , Enebe Joseph Tochukwu , Agunwa Chuka Chike , Ossai Edmund Ndudi , Ezeoke Uchechukwu Enuma , Idoko Arthur Chinedu , Mbachu Chinyere Ojiugo 
Published: November 2020

Abstract
Background: Millions of children have been identified globally to be involved in child labour with low-income countries being mostly hit. This study was aimed at assessing child labour and its predictors among public secondary school students in Enugu metropolis. Methods: The study was a descriptive cross-sectional study of 332 junior secondary school students attending public secondary schools in Enugu metropolis, Nigeria. A structured interviewer-administered questionnaire was used for data collection and analyses were done using SPSS version 23 and STATA Software. The level of statistical significance was set at 5% p-value.Results: The prevalence of overall child labour among the respondents was high (71.7%) likewise its different categories: domestic (52.1%) and economic (34.0%) child labour. About 35.2% of the respondents worked under hazardous conditions while 8% were forced to work. Approximately 65% (236) of the respondents who have heard about child labour perceived it as wrong. They mainly worked to render financial assistance to their parents. Class of study (AOR=2.208 (95% CI: 1.199-4.066) and weekly income earned (AOR=0.316 (95% CI: 0.176-0.567) predicted child labour among the respondents. Conclusion: The prevalence of child labour among public secondary schools in Enugu was high and the predictors were the class of the respondents and the weekly income they made. This may imply that child labour in Enugu was driven by poverty as respondents who earned higher were more involved in child labour thereby calling for concerted economic and social reforms to reduce this menace.
Investigating the molecular control of deer antler extract on articular cartilage&nbsp;
Authors: Yao Baojin , Zhou Zhenwei , Zhang Mei , Leng Xiangyang , Zhao Daqing 
Published: November 2020

Abstract
Background: Deer antler is considered as a precious traditional Chinese medicinal material, and has been widely used to reinforce kidney’s yang, nourish essence and strengthen bone function. The most prominent bioactive components in deer antler are water-soluble proteins that play potential roles in bone formation and repair. The aim of this study was to explore the molecular control and therapeutic targets of deer antler extract (DAE) on articular cartilage.Methods: DAE was prepared as previously described. All rats were randomly divided into Blank group and DAE group (10 rats per group) after 7-day adaptive feeding. The rats in DAE group were orally administrated with DAE at a dose of 0.2 g/kg per day for 3 weeks and the rats in Blank group were fed with drinking water. Total RNA was isolated from the articular cartilage of knee joints. RNA sequencing (RNA-seq) experiment combined with quantitative real-time polymerase chain reaction (qRT-PCR) verification assay were carried out to explore the molecular control and therapeutic targets of DAE on articular cartilage.Results: We demonstrated that DAE significantly increased the expression levels of functional genes involved in cartilage formation, growth and repair, and decreased the expression levels of susceptibility genes involved in the pathophysiology of osteoarthritis. Conclusions: DAE might serve as a candidate supplement for maintaining cartilage homeostasis, and preventing cartilage degeneration and inflammation. These effects were possibly achieved by accelerating the expression of functional genes involved in chondrocyte commitment, survival, proliferation and differentiation, and suppressing the expression of susceptibility genes involved in the pathophysiology of osteoarthritis. Thus, our findings will contribute towards deepening the knowledge about the molecular control and therapeutic targets of DAE on the treatment of cartilage related diseases.
Effects of the COVID-19 Pandemic on Medical Students: A Multicenter Quantitative Study
Authors: Harries Aaron , Lee Carmen , Jones Lee , Rodriguez Robert M. , Davis John , Boysen-Osborn Megan , Kashima Kathleen , Krane N. Kevin , Rae Guenevere , Kman Nicholas , Langsfeld Jodi , Juarez Marianne 
Published: November 2020

Abstract
Background: The COVID-19 pandemic disrupted the United States (US) medical education system with the necessary, yet unprecedented Association of American Medical Colleges (AAMC) national recommendation to pause all student clinical rotations with in-person patient care. This study is a quantitative analysis investigating the educational and psychological effects of the pandemic on US medical students and their reactions to the AAMC recommendation in order to inform medical education policy.Methods: The authors sent a cross-sectional survey via email to medical students in their clinical training years at six medical schools during the initial peak phase of the COVID-19 pandemic. Survey questions aimed to evaluate students' perceptions of COVID-19's impact on medical education; ethical obligations during a pandemic; infection risk; anxiety and burnout; willingness and needed preparations to return to clinical rotations. Results: 741 (29.5%) students responded. Nearly all students (93.7%) were not involved in clinical rotations with in-person patient contact at the time the study was conducted. Reactions to being removed were mixed, with 75.8% feeling this was appropriate, 34.7% guilty, 33.5% disappointed, and 27.0% relieved.Most students (74.7%) agreed the pandemic had significantly disrupted their medical education, and believed they should continue with normal clinical rotations during this pandemic (61.3%). When asked if they would accept the risk of infection with COVID-19 if they returned to the clinical setting, 83.4% agreed. Students reported the pandemic had moderate effects on their stress and anxiety levels with 84.1% of respondents feeling at least somewhat anxious. Adequate personal protective equipment (PPE) (53.5%) was the most important factor to feel safe returning to clinical rotations, followed by adequate testing for infection (19.3%) and antibody testing (16.2%). Conclusions: The COVID-19 pandemic disrupted the education of US medical students in their clinical training years. The majority of students wanted to return to clinical rotations and were willing to accept the risk of COVID-19 infection. Students were most concerned with having enough PPE if allowed to return to clinical activities.
Pain is a common problem in patients with ILD
Authors: Shen Qinxue , Guo Ting , Song Min , Guo Wei , Zhang Yi , Duan Wang , Peng Yating , Ni Shanshan , Ouyang Xiaoli , Peng Hong 
Published: November 2020

Abstract
Background: As it is less known about the prevalence and characteristics of pain in the patients with interstitial lung disease (ILD), this paper aims at determining the characteristics of the pain in the patients with ILD.Methods: Subjects with ILD and health controls with the matched ages and genders completed Short Form McGill Pain Questionnaire (SF-MPQ) and part of the Brief Pain Inventory (BPI) Short Form to elicit the characteristics of the pain. The patients with ILD were also assessed through Pulmonary Function Test, Six Minutes Walking Test (6MWT), modified Medical Research Council Dyspnea Scale (mMRC) for state of the illness and measured health-related quality of life (HRQoL) by Short Form-36 (SF-36) and psychological associations by Hospital Anxiety and Depression Scale (HADS).Results: A total of 63 subjects with ILD and 63 healthy controls (HC) were recruited in our study. The prevalence of the pain was 61.9% in ILD versus 25.3% in HC (p=0.005) and the median score of the pain rank index (PRI) in ILD was higher than that in HC (P=0.014). Chest (46.1%) accounted for the highest of overall pain locations in subjects with ILD. Associated clinical factors for pain intensity in the patients with ILD included exposure history of risk factors of ILD, with a longer distance of 6MWD (≥250m), and a higher mMRC score (2-4). The patients with ILD and pain are more likely to suffer impaired HRQoL (P=0.0014) and psychological problems (P=0.0017, P=0.044).Conclusion: The pain is common in those with ILD and the pain intensity is associated with exposure history, 6MWD, and mMRC score. The patients with ILD and pain were possibly to suffer depression, anxiety, and impaired HRQoL.
Correlation between sestrin2 expression and airway remodeling in COPD
Authors: Zhang Da-Wei , Wei Yuan-Yuan , Ji Shuang , Fei Guang-He 
Published: November 2020

Abstract
Background. Airway remodeling is a major pathological characteristic of chronic obstructive pulmonary disease (COPD), and has been shown to be associated with oxidative stress. Sestrin2 has recently drawn attention as an important antioxidant protein. However, the underlying correlation between sestrin2 and airway remodeling in COPD has yet to be clarified.Methods. A total of 124 subjects were enrolled in this study, including 62 control subjects and 62 COPD patients. The pathological changes in airway tissues were assessed by different staining methods. The expression of sestrin2 and matrix metalloproteinase 9 (MMP9) in airway tissues was monitored by immunohistochemistry. Enzyme-linked immunosorbent assays (ELISAs) were used to detect the serum concentrations of sestrin2 and MMP9. The airway parameters on computed tomography (CT) from all participants were measured for evaluating airway remodeling. The relationship between serum sestrin2 and MMP9 concentration and airway parameters in chest CT was also analyzed.Results. In patients with COPD, staining of airway structures showed distinct pathological changes of remodeling, including cilia cluttered, subepithelial fibrosis, and reticular basement membrane (Rbm) fragmentation. Compared with control subjects, the expression of sestrin2 and MMP9 was significantly increased in both human airway tissues and serum. Typical imaging characteristics of airway remodeling and increased airway parameters were also found by chest CT. Additionally, serum sestrin2 concentration was positively correlated with serum MMP9 concentration and airway parameters in chest CT.Conclusion. Increased expression of sestrin2 is related to airway remodeling in COPD. We demonstrated for the first time that sestrin2 may be a novel biomarker for airway remodeling in patients with COPD.
Psychometric Evaluation of the Arabic Version of the Higher Education Inventory Scale for Nursing Students
Authors: Masha’al Dina , Hayajneh Audai A. , Tawalbeh Loai Issa 
Published: November 2020

Abstract
Background: Studies in the literature have relied on a single instrument to assess stress levels and sources among nursing students in Jordan and in other Arab countries. Thus, there is a need for adopting Arabic versions of psychometrically validated instruments for evaluating a wider range of aspects related to stress and stressors. The Higher Education Stress Inventory (HESI) is an instrument used to assess various features of stress and stressors related to higher education in different educational settings and among different student populations. To date, no exploratory or confirmatory factor analyses (EFA) (CFA) have been conducted to study the factor structure of the Arabic version of the HESI. The current study aimed to evaluate the psychometric properties of the Arabic version of the HESI (Arabic-HESI) among nursing students in Jordan.Methods: The structure of the instrument was tested using EFA, CFA and using maximum likelihood estimation among a sample of 355 nursing students at five Jordanian universities.Results: The Arabic-HESI proved to have excellent content validity (CVI = 0.92The instrument showed good internal consistency reliability (Cronbach’s α was0.75), as well as for the two emerged factors “challenges” and “dissatisfaction” (Cronbach’s α were 0.75, 0.72 respectively). The results support the two-factor model for the Arabic-HESI because it has robust structure and acceptable goodness-of-fit indices.Conclusion: The Arabic-HESI is a reliable and valid instrument for assessing stress levels and stressors among nursing students in Jordan. Using the reduced version of the HESI to assess stress among nursing students is recommended. Identifying new features of stress and stressors among nursing students in Jordan will enable universities and nursing faculties to better support their students.