bluuebunny/crossref_metadata_2025_split huggingface dataset:
Step width variability as a discriminator of age-related gait changes
Authors: Skiadopoulos Andreas , Moore Emily E. , Sayles Harlan R. , Schmid Kendra K. , Stergiou Nicholas 
Published: March 2020

Abstract
Background
There is scientific evidence that older adults aged 65 and over walk with increased step width variability which has been associated with risk of falling. However, there are presently no threshold levels that define the optimal reference range of step width variability. Thus, the purpose of our study was to estimate the optimal reference range for identifying older adults with normative and excessive step width variability.

Methods
We searched systematically the BMC, Cochrane Library, EBSCO, Frontiers, IEEE, PubMed, Scopus, SpringerLink, Web of Science, Wiley, and PROQUEST databases until September 2018, and included the studies that measured step width variability in both younger and older adults during walking at self-selected speed. Data were pooled in meta-analysis, and standardized mean differences (SMD) with 95% confidence intervals (CI) were calculated. A single-decision threshold method based on the Youden index, and a two-decision threshold method based on the uncertain interval method were used to identify the optimal threshold levels (PROSPERO registration: CRD42018107079).

Results
Ten studies were retrieved (older adults = 304; younger adults = 219). Step width variability was higher in older than in younger adults (SMD = 1.15, 95% CI = 0.60; 1.70; t = 4.72, p = 0.001). The single-decision method set the threshold level for excessive step width variability at 2.14 cm. For the two-decision method, step width variability values above the upper threshold level of 2.50 cm were considered excessive, while step width variability values below the lower threshold level of 1.97 cm were considered within the optimal reference range.

Conclusion
Step width variability is higher in older adults than in younger adults, with step width variability values above the upper threshold level of 2.50 cm to be considered as excessive. This information could potentially impact rehabilitation technology design for devices targeting lateral stability during walking.
Breastfeeding as a balancing act – pregnant Swedish women’s voices on breastfeeding
Authors: Cato Karin , Sylvén Sara M. , Henriksson Helena Wahlström , Rubertsson Christine 
Published: March 2020

Abstract
Background
Breastfeeding provides health benefits to both women and children. The rationale behind an individual woman’s decision to breastfeed or not can depend on several factors, either independently or in combination. The aim of the current study was to explore attitudes towards breastfeeding among pregnant women in Sweden who intend to breastfeed.

Methods
Eleven mothers-to-be, one of whom had previous breastfeeding experience, participated in the study. The women were interviewed either by telephone or face-to-face during late pregnancy, with the aim of exploring their attitudes towards breastfeeding. A semi-structured interview-guide was used, and the transcripts of the interviews were analyzed using thematic analysis. The social ecological model of health is the theory-based framework underpinning this study. The model provides a comprehensive approach to understanding the factors that influence breastfeeding intention.

Results
When interviewed during pregnancy, women described breastfeeding as a balancing act between societal norms and personal desires. The women perceived a societal pressure to breastfeed, however it was accompanied by boundaries and mixed messages. This perceived pressure was balanced by their own knowledge of breastfeeding, in particular their knowledge of other women’s experience of breastfeeding. When envisioning their future breastfeeding, the women made uncertain and preliminary plans, and negotiated the benefits and drawbacks of breastfeeding. There was a wish for individual breastfeeding support and information.

Conclusions
Pregnant Swedish women perceive their future breastfeeding as a balancing act between societal norms and personal desires. These findings suggest that while discussing breastfeeding during pregnancy, it could be of interest to collect information from pregnant women on their knowledge of breastfeeding and from where they have gained this knowledge, since stories from family and friends may make them question their own capacity to breastfeed. A thorough review of the woman’s experiences and attitudes of breastfeeding is important in order to offer the best evidence-based breastfeeding support.

Trial registration
Ethical approval for the study was obtained from the Regional Ethical Review Board in Uppsala (Dnr: 2017/256).
Exclusive breastfeeding in first-time mothers in rural Kenya: a longitudinal observational study of feeding patterns in the first six months of life
Authors: Talbert Alison , Jones Caroline , Mataza Christine , Berkley James Alexander , Mwangome Martha 
Published: March 2020

Abstract
Background
Exclusive breastfeeding up to 6 months of age is recommended by the World Health Organization as the optimal mode of infant feeding, providing adequate nutrition for the baby and protection against infectious diseases. Breastfeeding can be adversely affected by individual, cultural and socio-economic factors. The study aimed to explore barriers of exclusive breastfeeding in the first 6 months of life among first-time mothers in rural Kenya.

Methods
An observational longitudinal design aimed to provide rich data on breastfeeding behaviour. Twenty pregnant first-time mothers were recruited through antenatal clinics and snowballing. Mothers were visited nine times at home from late pregnancy, at 1 week and 2 weeks post-delivery, then monthly until the baby was aged 6 months. Visits were conducted between November 2016 and April 2018. At the first visit, participants were asked about breastfeeding intentions and infant feeding education received. At each postnatal visit, direct observation of breastfeeding, a recorded semi-structured interview on feeding, mother’s and baby’s health was performed. Interviews were transcribed, checked, content was grouped into categories and analyzed using a qualitative descriptive approach.

Results
Most participants were adolescent (75%) and unmarried (65%). All 20 mothers intended to and did breastfeed, however additional fluids and semi-solids were commonly given. Only two mothers exclusively breastfed from birth up to 6 months of age. Prelacteal feeds, home remedies and traditional medicine were given by over a third of mothers in the first week of life. Concern over babies’ bowel habits and persistent crying perceived as abdominal colic led to several mothers receiving advice to give gripe water and traditional remedies. Early introduction of maize porridge from 3 months of age because of perceived hunger of the child was recommended by other family members. Breastfeeding observation showed persistent problems with positioning and attachment of infants.

Conclusions
Exclusive breastfeeding from birth to 6 months was uncommon. Prioritization of capacity to detect mothers with breastfeeding problems and provide breastfeeding education and support is necessary, particularly during the antenatal and early postnatal period. It is important to engage with other women resident in the household who may offer conflicting feeding advice.
Deep convolutional neural networks for image-based Convolvulus sepium detection in sugar beet fields
Authors: Gao Junfeng , French Andrew P. , Pound Michael P. , He Yong , Pridmore Tony P. , Pieters Jan G. 
Published: March 2020

Abstract
Background
Convolvulus sepium (hedge bindweed) detection in sugar beet fields remains a challenging problem due to variation in appearance of plants, illumination changes, foliage occlusions, and different growth stages under field conditions. Current approaches for weed and crop recognition, segmentation and detection rely predominantly on conventional machine-learning techniques that require a large set of hand-crafted features for modelling. These might fail to generalize over different fields and environments.

Results
Here, we present an approach that develops a deep convolutional neural network (CNN) based on the tiny YOLOv3 architecture for C. sepium and sugar beet detection. We generated 2271 synthetic images, before combining these images with 452 field images to train the developed model. YOLO anchor box sizes were calculated from the training dataset using a k-means clustering approach. The resulting model was tested on 100 field images, showing that the combination of synthetic and original field images to train the developed model could improve the mean average precision (mAP) metric from 0.751 to 0.829 compared to using collected field images alone. We also compared the performance of the developed model with the YOLOv3 and Tiny YOLO models. The developed model achieved a better trade-off between accuracy and speed. Specifically, the average precisions (APs@IoU0.5) of C. sepium and sugar beet were 0.761 and 0.897 respectively with 6.48 ms inference time per image (800 × 1200) on a NVIDIA Titan X GPU environment.

Conclusion
The developed model has the potential to be deployed on an embedded mobile platform like the Jetson TX for online weed detection and management due to its high-speed inference. It is recommendable to use synthetic images and empirical field images together in training stage to improve the performance of models.
The efficacy of Enhanced Recovery after Surgery (ERAS) for elderly patients with intertrochanteric fractures who received surgery: study protocol for a randomized, blinded, controlled trial
Authors: Yin Mengchen , Yan Yinjie , Fan Zhaoxiang , Fang Niankang , Wan Hongbo , Mo Wen , Wu Xuequn 
Published: March 2020

Abstract
Background
Intertrochanteric fracture (ITF) is increasing with the rapid increase in the aging population, often causes a high mortality rate in old patients and increases the economic burden of the family and society. ERAS (Enhanced Recovery after Surgery) is a powerful guarantee for patients to accelerate their recovery after surgery. TCM (traditional Chinese medicine) promotes repair of injured tissues and eliminates traumatic aseptic inflammation. Therefore, this prospective randomized controlled clinical trial aims to evaluate the clinical effect of the evidence-based ERAS pathway of integrating TCM with western medicine on perioperative outcomes in ITF patients undergoing intramedullary fixation and provide reliable evidence-based data for applying the program to clinical practice.

Methods/design
We will conduct a prospective randomized, blinded, controlled trial to compare the effectiveness of ERAS care pathway with traditional care pathway and to investigate whether the ERAS care pathway can improve the perioperative outcome in ITF patients undergoing intramedullary fixation. A total of 60 patients with ITF will be enrolled and treated with the two care pathway, respectively. Length of stay, economic indicators, Harris score, VAS score, time to get out of bed, 30-day readmission rates, postoperative transfusion rates, discharge to home, and mortality will be evaluated. Any signs of acute adverse reactions will be recorded at each visit during treatment.

Discussion
Although an evidence-based process using the best available literature and Delphi expert-opinion method has been used to establish an ERAS pathway of integrating TCM with western medicine, there is a lack of consensus about its effectiveness. This trial will provide convincing evidence about the effect of ERAS pathway.

Trial registration
Registered on 12 October 2019. Trial number is ChiCTR1900026487.
Methicillin resistant Staphylococcus aureus causing osteomyelitis in a tertiary hospital, Mwanza, Tanzania
Authors: Silago Vitus , Mushi Martha F. , Remi Boniface A. , Mwayi Alute , Swetala Stephen , Mtemisika Conjester I. , Mshana Stephen E. 
Published: March 2020

Abstract
Background
Culture results of fluid/pus from sinuses or open wound are not reliable in establishing the causative agent of osteomyelitis due to the high chances of contamination of superficial contaminants. Bone fragments obtained during surgery have been recommended as ideal sample to establish pathogens causing osteomyelitis. This study investigated pathogens causing osteomyelitis among patients undergoing orthopedic surgical treatment at Bugando Medical Centre.

Methods
A cross-sectional hospital-based study was conducted from December 2017 to July 2018 among 74 patients with osteomyelitis who underwent surgical treatments at Bugando Medical Centre, Mwanza, Tanzania. Bone fragments were collected using sterile 10 ml of in-house prepared brain heart infusion broth (Oxoid, UK) during surgery. Specimens were processed according to standard operating procedures within an hour of collection. Data were analyzed using STATA 13.0.

Results
The median age of study participants was 12 with inter quartile range of 8–20 years. The majority 45 (60.8%) of participants were male. All 74 non-repetitive bone fragment specimens had positive culture, of which 17 had dual growth of bacteria resulting to 91 bacterial isolates. Out of 91 isolates, 63 (85.1%) were Staphylococcus aureus (S. aureus) of which 18 (28.6%) were confirmed to be methicillin resistant Staphylococcus aureus strains. Fever was significantly associated with Staphylococcal osteomyelitis (100% vs. 79.6%, p = 0.029).

Conclusion
About one third of cases of Staphylococcal osteomyelitis in the current study were caused by methicillin resistant Staphylococcus aureus. There is a need of tailoring antibiotic management of osteomyelitis based on culture and sensitivity results for the better treatment outcome of the patients.
Exploring mental health needs and services among affected population in a cyclone affected area in costal Bangladesh: a qualitative case study
Authors: Tasdik Hasan M. , Adhikary Gourab , Mahmood Sultan , Papri Nowshin , Shihab Hasan M. , Kasujja Rosco , Ahmed Helal Uddin , Azad Abul Kalam , Nasreen Mahbuba 
Published: March 2020

Abstract
Background
Bangladesh, one of the most densely populated countries in the world has been ranked 9th on the Climate Risk Index for 2017: the 10 most affected countries & 7th on the Long-Term Climate Risk Index: the 10 countries most affected from 1998 to 2017. Every year it is afflicted with various climatic disasters including floods, hurricanes and cyclones. Apart from the obvious devastation of lives and property, there is a huge increase in clinical diseases when these disasters occur. Mental health of affected persons after these disasters is a topic that is often neglected by local and national level.

Methods
A qualitative case study was conducted on perceived need on mental health support & availability of such services in a cyclone affected area in rural Bangladesh. Ten (10) key informant interviews (KIIs) with different stakeholders and ten (10) in-depth interviews (IDIs) with affected people were taken.

Findings
We found that cyclones had numerous psychosocial impacts on the population including acute stress disorder, sleep disorder, post-traumatic stress disorders (PTSDs), generalized anxiety disorders, suicidal ideation and depression. The survivors had specific needs for receiving support. Children, elderly and women were perceived to be more vulnerable. The government and NGOs had no specific action plans and initiatives to address these issues and support the mental health of affected population. There was a visible gap in finding effective ways to provide affected people with the required mental health & psycho-social services (MHPSS).

Conclusion
Resilient, responsive and self-sustaining health systems for this vulnerable population are required. Implementation of effective mental health programs and strong mental health policies remain a challenge in Bangladesh where there is a cultural fatalistic acceptance of mental health issues.
From single gene analysis to single cell profiling: a new era for precision medicine
Authors: Di Martino Maria Teresa , Meschini Stefania , Scotlandi Katia , Riganti Chiara , De Smaele Enrico , Zazzeroni Francesca , Donadelli Massimo , Leonetti Carlo , Caraglia Michele 
Published: March 2020

AbstractMolecular profiling of DNA and RNA has provided valuable new insights into the genetic basis of non-malignant and malignant disorders, as well as an increased understanding of basic mechanisms that regulate human disease. Recent technological advances have enabled the analyses of alterations in gene-based structure or function in a comprehensive, high-throughput fashion showing that each tumor type typically exhibits distinct constellations of genetic alterations targeting one or more key cellular pathways that regulate cell growth and proliferation, evasion of the immune system, and other aspects of cancer behavior. These advances have important implications for future research and clinical practice in areas as molecular diagnostics, the implementation of gene or pathway-directed targeted therapy, and the use of such information to drive drug discovery. The 1st international and 32nd Annual Conference of Italian Association of Cell Cultures (AICC) conference wanted to offer the opportunity to match technological solutions and clinical needs in the era of precision medicine.
Elevated central venous pressure is associated with increased mortality and acute kidney injury in critically ill patients: a meta-analysis
Authors: Chen Chuan-Yu , Zhou Yan , Wang Peng , Qi En-Yao , Gu Wan-Jie 
Published: March 2020

Abstract
Background
The association of central venous pressure (CVP) and mortality and acute kidney injury (AKI) in critically ill adult patients remains unclear. We performed a meta-analysis to determine whether elevated CVP is associated with increased mortality and AKI in critically ill adult patients.

Methods
We searched PubMed and Embase through June 2019 to identify studies that investigated the association between CVP and mortality and/or AKI in critically ill adult patients admitted into the intensive care unit. We calculated the summary odds ratio (OR) and 95% CI using a random-effects model.

Results
Fifteen cohort studies with a broad spectrum of critically ill patients (mainly sepsis) were included. On a dichotomous scale, elevated CVP was associated with an increased risk of mortality (3 studies; 969 participants; OR, 1.65; 95% CI, 1.19–2.29) and AKI (2 studies; 689 participants; OR, 2.09; 95% CI, 1.39–3.14). On a continuous scale, higher CVP was associated with greater risk of mortality (5 studies; 7837 participants; OR, 1.10; 95% CI, 1.03–1.17) and AKI (6 studies; 5446 participants; OR, 1.14; 95% CI, 1.06–1.23). Furthermore, per 1 mmHg increase in CVP increased the odds of AKI by 6% (4 studies; 5150 participants; OR, 1.06; 95% CI, 1.01–1.12). Further analyses restricted to patients with sepsis showed consistent results.

Conclusions
Elevated CVP is associated with an increased risk of mortality and AKI in critically ill adult patients admitted into the intensive care unit.

Trial registration
PROSPERO, CRD42019126381
WhatsGNU: a tool for identifying proteomic novelty
Authors: Moustafa Ahmed M. , Planet Paul J. 
Published: March 2020

AbstractTo understand diversity in enormous collections of genome sequences, we need computationally scalable tools that can quickly contextualize individual genomes based on their similarities and identify features of each genome that make them unique. We present WhatsGNU, a tool based on exact match proteomic compression that, in seconds, classifies any new genome and provides a detailed report of protein alleles that may have novel functional differences. We use this technique to characterize the total allelic diversity (panallelome) of Salmonella enterica, Mycobacterium tuberculosis, Pseudomonas aeruginosa, and Staphylococcus aureus. It could be extended to others. WhatsGNU is available from https://github.com/ahmedmagds/WhatsGNU.
Multiplexed capture of spatial configuration and temporal dynamics of locus-specific 3D chromatin by biotinylated dCas9
Authors: Liu Xin , Chen Yong , Zhang Yuannyu , Liu Yuxuan , Liu Nan , Botten Giovanni A. , Cao Hui , Orkin Stuart H. , Zhang Michael Q. , Xu Jian 
Published: March 2020

AbstractThe spatiotemporal control of 3D genome is fundamental for gene regulation, yet it remains challenging to profile high-resolution chromatin structure at cis-regulatory elements (CREs). Using C-terminally biotinylated dCas9, endogenous biotin ligases, and pooled sgRNAs, we describe the dCas9-based CAPTURE method for multiplexed analysis of locus-specific chromatin interactions. The redesigned system allows for quantitative analysis of the spatial configuration of a few to hundreds of enhancers or promoters in a single experiment, enabling comparisons across CREs within and between gene clusters. Multiplexed analyses of the spatiotemporal configuration of erythroid super-enhancers and promoter-centric interactions reveal organizational principles of genome structure and function.
Recruitment of low-income pregnant women into a dietary and dental care intervention: lessons from a feasibility trial
Authors: Rodrigues Amorim Adegboye Amanda , Cocate Paula G. , Benaim Camila , da Veiga Soares Carvalho Maria Claudia , Schlüssel Michael M. , de Castro Maria Beatriz T. , Kac Gilberto , Heitmann Berit L. 
Published: March 2020

AbstractBackgroundThere are difficulties in carrying out research in low-income urban communities, but the methodological challenges and suggestions on how to deal with them are often undocumented. The aims of this study are to describe the challenges of recruiting and enrolling low-income pregnant women with periodontitis to a clinical trial on vitamin D/calcium milk fortification and periodontal therapy and also to describe the patient-, study protocol- and setting-related factors related to women’s ineligibility and refusal to participate in the study.MethodsA mixed-method sequential exploratory design was applied. Qualitative and quantitative data on recruitment to a 2 × 2 factorial feasibility clinical trial were used. Eighteen women attending the health centre in a low-income area in Duque de Caxias (Rio de Janeiro, Brazil) took part in focus group discussions, and the data were thematically analysed. Quantitative data were analysed using appropriate descriptive statistics, including absolute and relative frequencies.ResultsOf all referrals (767), 548 (78.5%) did not meet the initial eligibility criteria. The main reason for exclusion (58%) was advanced gestational age (> 20 weeks) at first prenatal appointment. In the periodontal examination (dental screen), the main reason for exclusion was the presence of extensive caries (64 out of 127 exclusions). Non-participation of those eligible after the periodontal examination was approximately 24% (22 out 92 eligible women) and predominantly associated with patient-related barriers (e.g. transportation barriers, family obligations, patients being unresponsive to phone calls and disconnected telephones). The study recruited 70 women with periodontitis in 53 weeks and did not reach the benchmark of 120 women in 36 weeks (58.3% of the original target). Recruitment was severely hindered by health centre closures due to general strikes. The recruitment yields were 9.1% (70/767) of all women contacted at first prenatal visit and 76.1% (70/92) of those screened eligible and enrolled in the trial. Women did not report concerns regarding random allocation and considered fortified milk as a healthful and safe food for pregnant women. Some women reported that financial constraints (e.g. transportation costs) could hinder participation in the study.ConclusionEngagement between the research team and health centre staff (e.g. nurses) facilitated referral and recruitment, yet some pregnant women failed to participate in the study largely due to significant patient-related sociodemographic barriers and setting-related factors. Our data illustrate the complexity of overcoming recruitment and enrolment challenges for clinical trials in resource-limited settings.Trial registrationClinicalTrials.gov,NCT03148483. Registered on 11 May 2017.