bluuebunny/crossref_metadata_2025_split huggingface dataset:
COVID – 19 related knowledge and preventive practices early in the outbreak among health care workers in selected public health facilities of Illu aba Bor and Buno Bedelle zones, Southwest Ethiopia
Authors: Tsegaye Dereje , Shuremu Muluneh , Oljira Dereje , Dubale Sileshi , Befekadu Getachew , Bidira Kebebe 
Published: May 2021

Abstract
Background
Novel-coronavirus 2019 (COVID-19) disease is currently a worldwide health risk and public health emergency concern. The virus is transmitted from an infected person to another person through close contact and droplets. Frontline health care workers are the most at risk of infection, and so a WHO interim guidance document was issued by the World Health Organization (WHO) which underscores the importance of proper sanitation and waste management practices for COVID- 19 in health-care settings. This study aimed at assessing knowledge and preventive practices towards Covid-19 among health care providers in selected health facilities of Illu Aba Bor and Buno Bedele zones, Southwest Ethiopia.

Methods
An institution-based cross-sectional study was conducted from April to May 2020 among 330 health workers in selected health facilities of Illu Aba Bor and Buno-Bedelle Zones, Southwest Ethiopia. Data were collected using a self-administered structured questionnaire. The collected data were entered into Epidata version 3.1 and exported to SPSS version 23 for analysis. Bivariate and multivariable logistic regression analysis was used to identify independent predictors of preventive practices towards Covid-19. Statistical significance was declared at a p-value of < 0.05.

Result
The majority of respondents (93.3%) demonstrated good knowledge of COVID-19, and the mean (SD) knowledge score was 9.04 ± 1.06. Nearly two-thirds (64.2%) of the study participants had good infection prevention practices. Being male (AOR = 3.65, 95% CI: (1.96, 6.80)), education level (AOR = 1.82, 95% CI (1.02, 3.22)), profession (AOR = 3.17, 95% CI (1.08, 9.33)), service year (5–10 years) (AOR = 2.00 (1.02, 3.92)) and more than 10 years (AOR = 3.14 (1.51, 6.52)), availability of personal protective equipment (AOR = 1.96 (1.06, 3.61)) and Knowledge level (AOR = 2.61 (1.48, 4.62)) were independent predictors of COVID-19 preventive practices.

Conclusion
The overall level of knowledge of HCWs was good. However, the practice was relatively low. Gender, educational status, profession, year of service, knowledge towards COVID-19, and availability of personal protective equipment were independent predictors of good infection prevention practices. Optimizing the infection prevention and control loop of the health facilities is recommended.
Prophylactic pegfilgrastim to prevent febrile neutropenia among patients receiving biweekly (Q2W) chemotherapy regimens: a systematic review of efficacy, effectiveness and safety
Authors: Mahtani Reshma , Crawford Jeffrey , Flannery Sinéad M. , Lawrence Tatiana , Schenfeld Jennifer , Gawade Prasad L. 
Published: May 2021

Abstract
Background
Pegfilgrastim, a long-acting granulocyte colony-stimulating factor (G-CSF), is commonly used to prevent febrile neutropenia (FN), a potentially life-threatening complication, following myelosuppressive chemotherapy. The FDA label for pegfilgrastim specifies that it should not be administered 14 days before or within 24 h of administration of myelosuppressive chemotherapy, precluding the use of pegfilgrastim in biweekly (Q2W) regimens. The National Comprehensive Cancer Network and the European Organisation for Research and Treatment of Cancer guidelines support the use of prophylactic pegfilgrastim in patients receiving Q2W regimens. The objective of this study was to systematically review evidence from randomized clinical trials (RCTs) and observational studies that describe the effectiveness and safety of prophylactic pegfilgrastim in preventing FN among patients receiving Q2W regimens.

Methods
An Ovid MEDLINE, Embase, and Cochrane Library literature search was conducted to evaluate the evidence regarding efficacy, effectiveness, and safety of prophylactic pegfilgrastim versus no prophylactic pegfilgrastim or prophylaxis with other G-CSF in patients who were receiving Q2W chemotherapy regimens with high (> 20%) or intermediate (10–20%) risk of FN for a non-myeloid malignancy. Studies that addressed absolute or relative risk of FN, grade 1–4 neutropenia, all-cause or any hospitalization, dose delays or dose reductions, adverse events, or mortality were included. Studies where the comparator was a Q3W chemotherapy regimen with primary prophylactic pegfilgrastim were also included.

Results
The initial literature search identified 2258 publications. Thirteen publications met the eligibility criteria, including eight retrospective, one prospective, one phase 1 dose escalation study, and three RCTs. In nine of the 13 studies reporting incidence of FN, and in seven of the nine studies reporting incidence of neutropenia, administration of prophylactic pegfilgrastim in patients receiving Q2W regimens resulted in decreased or comparable rates of FN or neutropenia compared with patients receiving filgrastim, no G-CSF, lipefilgrastim or pegfilgrastim in Q3W regimens. In six of the nine studies reporting safety data, lower or comparable safety profiles were observed between pegfilgrastim and comparators.

Conclusions
In a variety of non-myeloid malignancies, administration of prophylactic pegfilgrastim was efficacious in reducing the risk of FN in patients receiving high- or intermediate-risk Q2W regimens, with an acceptable safety profile.

Trial registration
PROSPERO registration no: CRD42019155572.
Attitudes of Lebanese adults regarding COVID-19 vaccination
Authors: Kasrine Al Halabi Carina , Obeid Sahar , Sacre Hala , Akel Marwan , Hallit Rabih , Salameh Pascale , Hallit Souheil 
Published: May 2021

Abstract
Background
COVID-19 was first detected in Lebanon on February 21, 2020; it reached its peak in January 2021, with a total number of 418,448 confirmed cases and 5380 deaths (until March 15, 2021). Gaining insight into factors regarding willingness or refusal for vaccination might guide our goals in raising the awareness and target efforts to increase acceptance of the COVID-19 vaccine and maximize the uptake. Therefore, this study aims to assess the intent to receive the COVID-19 vaccine among Lebanese adults and the factors associated with vaccine refusal.

Methods
We conducted a cross-sectional study during November–December 2020 among Lebanese adults from all Lebanese regions using a survey tool with closed-ended questions that included sociodemographic data and questions about vaccine hesitancy, knowledge, attitude, practice, and fear of COVID-19. We used the snowball technique to collect the data because of the COVID-19 imposed lockdown.

Results
Of the 579 participants, 21.4% were willing to receive the vaccine, 40.9% refused, and the remainder were unsure of their response. More vaccine hesitancy (adjusted odds ratio (aOR) = 1.06; 95% CI 1.03–1.09) was significantly associated with more odds of disagreeing/ strongly disagreeing on receiving the COVID-19 vaccine compared to being neutral. More vaccine hesitancy (aOR = 0.95; 95% CI 0.91–0.99), female gender compared to males (aOR = 0.53; 95% CI 0.32–0.87), and being married compared to single (aOR = 0.53; 95% CI 0.29–0.98) were significantly associated with lower odds of agreeing/strongly agreeing on receiving the COVID-19 vaccine compared to being neutral.

Conclusion
Overall, our findings revealed a high percentage of people (40%) who strongly disagreed with receiving the vaccine, mainly females, married participants, and those who have a general vaccine hesitancy. Moreover, no significant association was found with knowledge, attitude, or prevention practice regarding COVID-19. Targeted efforts are necessary to increase acceptance of a COVID-19 vaccine among the Lebanese population to control the COVID-19 pandemic. Further studies with a larger sample size are warranted to validate our results and provide better insights into the underlying reasons for refusing vaccination.
Motivating antibiotic stewardship in Bangladesh: identifying audiences and target behaviours using the behaviour change wheel
Authors: Unicomb Leanne E. , Nizame Fosiul Alam , Uddin Mohammad Rofi , Nahar Papreen , Lucas Patricia J. , Khisa Nirnita , Akter S. M. Salim , Islam Mohammad Aminul , Rahman Mahbubur , Rousham Emily K. 
Published: May 2021

Abstract
Background
South Asia is a hotspot for antimicrobial resistance due largely to over-the-counter antibiotic sales for humans and animals and from a lack of policy compliance among healthcare providers. Additionally, there is high population density and high infectious disease burden. This paper describes the development of social and behavioural change communication (SBCC) to increase the appropriate use of antibiotics.

Methods
We used formative research to explore contextual drivers of antibiotic sales, purchase, consumption/use and promotion among four groups: 1) households, 2) drug shop staff, 3) registered physicians and 4) pharmaceutical companies/medical sales representatives. We used formative research findings and an intervention design workshop with stakeholders to select target behaviours, prioritise audiences and develop SBCC messages, in consultation with a creative agency, and through pilots and feedback. The behaviour change wheel was used to summarise findings.

Results
Workshop participants identified behaviours considered amenable to change for all four groups. Household members and drug shop staff were prioritised as target audiences, both of which could be reached at drug shops. Among household members, there were two behaviours to change: suboptimal health seeking and ceasing antibiotic courses early. Thus, SBCC target behaviours included: seek registered physician consultations; ask whether the medicine provided is an antibiotic; ask for instructions on use and timing. Among drug shop staff, important antibiotic dispensing practices needed to change. SBCC target behaviours included: asking customers for prescriptions, referring them to registered physicians and increasing customer awareness by instructing that they were receiving antibiotics to take as a full course.

Conclusions
We prioritised drug shops for intervention delivery to all drug shop staff and their customers to improve antibiotic stewardship. Knowledge deficits among these groups were notable and considered amenable to change using a SBCC intervention addressing improved health seeking behaviours, improved health literacy on antibiotic use, and provision of information on policy governing shops. Further intervention refinement should consider using participatory methods and address the impact on profit and livelihoods for drug shop staff for optimal compliance.
Development and validation of an instrument to measure physician awareness of bioethics and medical law in Oman
Authors: Al-Busaidi Ahmed S. , Ganesh Anuradha , Al-Adawi Samir , Al-Farsi Yahya M. , Al-Rawahi Maryam K. , Al-Mawali Nusaiba A. , Al-Kharousi Nadiya S. , Al-Alawi Mohammed , Al-Mujaini Abdullah S. 
Published: May 2021

Abstract
Background
A different ethos with respect to the perception of medical ethics prevails in societies in transition such as those in the Arabian Peninsula, which makes it difficult to apply international principles of bioethics in medical practice. This study aimed to develop and psychometrically test an instrument that measures physicians’ awareness of bioethics and medical law and their attitudes towards the practice of medical ethics. Additionally, it examined physician correlates influencing the awareness of bioethics.

Methods
Following a rigorous review of relevant literature by a panel of experts, a 13-item instrument, the Omani physicians’ bioethics and medical law awareness (OBMLA) questionnaire was developed with the aim of assessing physicians’ awareness of bioethics and medical law. The study tool’s construct validity and internal consistency reliability were examined by exploratory factor analysis (EFA) and Cronbach’s alpha. In a cross-sectional study, the questionnaire was distributed among a random sample of 200 physicians at a tertiary hospital in Muscat, Oman. Participant characteristics that may influence awareness of bioethics and medical law were explored.

Results
The EFA of the OBMLA questionnaire resulted in three well-loading factors: (1) Physicians’ bioethics practice subscale (2) incentive related bioethics subscale and (3) medical law awareness subscale. Internal consistency reliability ranged between Cronbach’s α: 0.73–0.8. Of the total 200 participants, 52% reported that teaching medical ethics during medical school was inadequate. The overall mean (standard deviation, SD) of the bioethics awareness score and Omani medical law awareness were 27.6 (3.5) and 10.1 (2.1) respectively. The majority of physicians (73%) reported that they frequently encountered ethical dilemmas in their practice and 24.5% endorsed the view that unethical decisions tended to occur in their practice.

Conclusion
The study provides an insight into the practice of bioethics, and the awareness of bioethics and medical law among physicians in a teaching hospital in Oman. The OBMLA questionnaire appears to be a valid and reliable tool to assess a physician’s awareness of bioethics and medical law. In this preliminary study, it appears that participants have suboptimal scores on the indices which measure practice and awareness of bioethics and medical law.
Maintaining proper health records improves machine learning predictions for novel 2019-nCoV
Authors: Khan Koffka , Ramsahai Emilie 
Published: May 2021

Abstract
Background
An ongoing outbreak of a novel coronavirus (2019-nCoV) pneumonia continues to affect the whole world including major countries such as China, USA, Italy, France and the United Kingdom. We present outcome (‘recovered’, ‘isolated’ or ‘death’) risk estimates of 2019-nCoV over ‘early’ datasets. A major consideration is the likelihood of death for patients with 2019-nCoV.

Method
Accounting for the impact of the variations in the reporting rate of 2019-nCoV, we used machine learning techniques (AdaBoost, bagging, extra-trees, decision trees and k-nearest neighbour classifiers) on two 2019-nCoV datasets obtained from Kaggle on March 30, 2020. We used ‘country’, ‘age’ and ‘gender’ as features to predict outcome for both datasets. We included the patient’s ‘disease’ history (only present in the second dataset) to predict the outcome for the second dataset.

Results
The use of a patient’s ‘disease’ history improves the prediction of ‘death’ by more than sevenfold. The models ignoring a patent’s ‘disease’ history performed poorly in test predictions.

Conclusion
Our findings indicate the potential of using a patient’s ‘disease’ history as part of the feature set in machine learning techniques to improve 2019-nCoV predictions. This development can have a positive effect on predictive patient treatment and can result in easing currently overburdened healthcare systems worldwide, especially with the increasing prevalence of second and third wave re-infections in some countries.
Care plus study: a multi-site implementation of early palliative care in routine practice to improve health outcomes and reduce hospital admissions for people with advanced cancer: a study protocol
Authors: Philip Jennifer , Le Gautier Roslyn , Collins Anna , Nowak Anna K. , Le Brian , Crawford Gregory B. , Rankin Nicole , Krishnasamy Meinir , Mitchell Geoff , McLachlan Sue-Anne , IJzerman Maarten , Hudson Robyn , Rischin Danny , Sousa Tanara Vieira , Sundararajan Vijaya 
Published: May 2021

Abstract
Background
Current international consensus is that ‘early’ referral to palliative care services improves cancer patient and family carer outcomes. In practice, however, these referrals are not routine. An approach which directly addresses identified barriers to early integration of palliative care is required. This protocol details a trial of a standardized model of early palliative care (Care Plus) introduced at key defined, disease-specific times or transition points in the illness for people with cancer. Introduced as a ‘whole of system’ practice change for identified advanced cancers, the key outcomes of interest are population health service use change.
The aims of the study are to examine the effect of Care Plus implementation on (1) acute hospitalisation days in the last 3 months of life; (2) timeliness of access to palliative care; (3) quality and (4) costs of end of life care; and (5) the acceptability of services for people with advanced cancer.

Methods
Multi-site stepped wedge implementation trial testing usual care (control) versus Care Plus (practice change). The design stipulates ‘control’ periods when usual care is observed, and the process of implementing Care Plus which includes phases of planning, engagement, practice change and evaluation. During the practice change phase, all patients with targeted advanced cancers reaching the transition point will, by default, receive Care Plus.
Health service utilization and unit costs before and after implementation will be collated from hospital records, and state and national health service administrative datasets. Qualitative data from patients, consumers and clinicians before and after practice change will be gathered through interviews and focus groups.

Discussion
The study outcomes will detail the impact and acceptability of the standardized integration of palliative care as a practice change, including recommendations for ongoing sustainability and broader implementation.

Trial registration
Australian New Zealand Clinical Trials Registry ACTRN 12619001703190. Registered 04 December 2019.
Gestational diabetes mellitus is associated with the neonatal gut microbiota and metabolome
Authors: Chen Ting , Qin Yufeng , Chen Minjian , Zhang Yuqing , Wang Xu , Dong Tianyu , Chen Guanglin , Sun Xian , Lu Ting , White Richard Allen , Ye Peng , Tun Hein M. , Xia Yankai 
Published: May 2021

Abstract
Background
Gestational diabetes mellitus (GDM) is a metabolic disease that occurs in pregnant women and increases the risk for the development of diabetes. The relationship between GDM and meconium microbiota and metabolome remains incompletely understood.

Methods
Four hundred eighteen mothers (147 women with GDM and 271 normal pregnant women) and their neonates from the GDM Mother and Child Study were included in this study. Meconium microbiota were profiled by 16S rRNA gene sequencing. Meconium and maternal serum metabolome were examined by UPLC-QE.

Results
Microbial communities in meconium were significantly altered in neonates from the GDM mothers. A reduction in alpha diversity was observed in neonates of GDM mothers. At the phylum level, the abundance of Firmicutes and Proteobacteria changed significantly in neonates of GDM mothers. Metabolomic analysis of meconium showed that metabolic pathways including taurine and hypotaurine metabolism, pyrimidine metabolism, beta-alanine metabolism, and bile acid biosynthesis were altered in GDM subjects. Several changed metabolites varying by the similar trend across the maternal serum and neonatal meconium were observed.

Conclusion
Altogether, these findings suggest that GDM could alter the serum metabolome and is associated with the neonatal meconium microbiota and metabolome, highlighting the importance of maternal factors on early-life metabolism.
The m6A epitranscriptome on neural development and degeneration
Authors: Yen Ya-Ping , Chen Jun-An 
Published: May 2021

AbstractN6-methyladenosine (m6A) is the most prevalent, conserved, and abundant RNA modification of the mRNAs of most eukaryotes, including mammals. Similar to epigenetic DNA modifications, m6A has been proposed to function as a critical regulator for gene expression. This modification is installed by m6A methylation “writers” (Mettl3/Mettl14 methyltransferase complex), and it can be reversed by demethylase “erasers” (Fto and Alkbh5). Furthermore, m6A can be recognized by “readers” (Ythdf and Ythdc families), which may be interpreted to affect mRNA splicing, stability, translation or localization. Levels of m6A methylation appear to be highest in the brain, where it plays important functions during embryonic stem cell differentiation, brain development, and neurodevelopmental disorders. Depletion of the m6A methylation writer Mettl14 from mouse embryonic nervous systems prolongs cell cycle progression of radial glia and extends cortical neurogenesis into postnatal stages. Recent studies further imply that dysregulated m6A methylation may be significantly correlated with neurodegenerative diseases. In this review, we give an overview of m6A modifications during neural development and associated disorders, and provide perspectives for studying m6A methylation.
Downregulation of CD151 restricts VCAM-1 mediated leukocyte infiltration to reduce neurobiological injuries after experimental stroke
Authors: Gao Ceshu , Jia Wangyue , Xu Wendeng , Wu Qiong , Wu Jian 
Published: May 2021

Abstract
Background
Translational failures in anti-adhesion molecule therapies after stroke reveal the necessity of developing new strategies that not only interrupt leukocyte recruitment but also consider the inhibition of endothelial cell inflammation, verification of therapeutic time window, and normal function maintenance of circulating leukocytes. Our study focused on the potential therapeutic value of CD151 downregulation in improving current anti-adhesion molecule therapies.

Methods
Lentivirus intracerebroventricular administration was conducted to inhibit the CD151 expression and observe its functional influence on neurological injuries and outcomes. Then, immunohistochemistry and myeloperoxidase activity assessment were performed to explore the effects of CD151 expression on neutrophil and monocyte recruitment after rat cerebral ischemia. Primary rat brain microvascular endothelial cells were subjected to oxygen glucose deprivation and reoxygenation to elucidate the underlying working mechanisms between CD151 and VCAM-1.

Results
The CD151 downregulation remarkably reduced neurological injuries and improved neurological outcomes, which were accompanied with reduced neutrophil and monocyte infiltration after the CD151 downregulation. The VCAM-1 expression was remarkably decreased among the adhesion molecules on the endothelial cell responsible for neutrophil and monocyte infiltration. The activation of p38 MAPK and NF-κB pathways was restricted after the CD151 downregulation. p38 MAPK and NF-κB inhibitors decreased the VCAM-1 expression, and p38 acted as an upstream regulator of NF-κB. However, CD151 downregulation did not directly influence the neutrophil and monocyte activation.

Conclusions
Overall, CD151 regulated the expression of adhesion molecules. It also played a critical role in suppressing VCAM-1-mediated neutrophil and monocyte infiltration via the p38/NF-κB pathway. This study possibly provided a new basis for improving current anti-adhesion molecule therapies.