bluuebunny/crossref_metadata_2025_split huggingface dataset:
Determinants of breastfeeding practice in Pujehun district, southern Sierra Leone: a mixed-method study
Authors: van Breevoort Dorothee , Tognon Francesca , Beguin Arne , Ngegbai Amara S. , Putoto Giovanni , van den Broek Ankie 
Published: May 2021

Abstract
Background
It is well established that exclusive breastfeeding can play a critical role in reducing child morbidity and mortality. Limited research has been done thus far on the practice and perceptions of breastfeeding in Sierra Leone, where more than 10 % of children die before the age of five. This study aimed to gain understanding into and explore both matters in order to develop recommendations for effective strategies to promote breastfeeding practice in Pujehun District, Southern Sierra Leone.

Methods
This exploratory mixed-method study included a cross-sectional survey of 194 mothers, semi-structured interviews and focus group discussions. Logistic regression analysis was used calculated odds ratios of factors associated with primarily breastfeeding practice, defined as ‘Children under six months of age who are fed with breast milk only and children older than six months of age that were exclusively breastfed up to six months’, based on recall from birth. Exclusive breastfeeding rate was based on breastfeeding practice 24 h prior to the survey. Qualitative data was analysed through a deductive approach, using a pre-determined framework on determinants of breastfeeding.

Results
This study revealed an exclusive breastfeeding rate of 62.8% (95% CI 53.9, 71.7); dropping from 74% in the 0–1-month age group to 33% in the 4–5 months group. Triangulation of qualitative and quantitative data revealed enabling factors for primarily breastfeeding practice included mothers receiving support during their first breastfeed, pregnant women being provided with information on the benefits of the practice, counselling by nurses, support from husbands, and women’s awareness of how their friends and family members fed their own babies. The main barriers were a lack of encouragement by husbands, women’s perception that their infants’ stools were abnormal or that they were not producing enough breast milk.

Conclusions
Although the exclusive breastfeeding may have risen over recent years, a gap remains compared to World Health Organization recommendations. According to the breastfeeding determinants identified in this study, promotion of counselling by a nurse, encouragement of husbands’ support, and improve knowledge of mothers on breastfeeding are recommended to be incorporated in the design of future health programs.
Utility of modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score in distinguishing necrotizing from non-necrotizing soft tissue infections
Authors: Wu Po-Han , Wu Kai-Hsiang , Hsiao Cheng-Ting , Wu Shu-Ruei , Chang Chia-Peng 
Published: May 2021

Abstract
Background
We conducted this study to promote a modified Laboratory Risk Indicator for Necrotizing Fasciitis (MLRINEC) score and evaluate the utility in distinguishing necrotizing fasciitis (NF) from other soft-tissue infections.

Method
A retrospective cohort study of hospitalized patients with NF diagnosed by surgical finding was conducted in two tertiary hospital in southern Taiwan between January 2015 and January 2020. Another group was matched by controls with non-necrotizing soft tissue infections based on time, demographics, and immune status. Data such as infectious location, comorbidities, and laboratory findings were recorded and compared. Logistics regression were used to determine the association with NF after adjustment for confounders and MLRINEC score was developed by then. Receiver operating curve (ROC) and the area under the curve (AUC) were used to evaluate its discriminating ability.

Result
A total of 303 patients were included; 101 in NF group and 202 in non-NF group. We added serum lactate and comorbid liver disease to the original LRINEC score and re-defined the cut-off values for 3 variables to develop the MLRINEC score. The cut-off value for MLRINEC score was 12 points with corresponding sensitivity of 91.8% and a specificity of 88.4%, and the area under ROC (AUC) was 0.893 (95% CI, 0.723 to 0.948; p < 0.01).

Conclusion
MLRINEC score shows a high sensitivity and specificity in distinguishing NF from non-necrotizing soft-tissue infections. Patients with a MLRINEC score > 12 points should be highly suspected of presence of necrotizing fasciitis.
Histological and ultrastructural degenerative findings in the gluteus medius tendon after hip arthroplasty
Authors: Ibrahim Mustafa , Hedlundh Urban , Sernert Ninni , Meknas Khaled , Haag Lars , Movin Tomas , Papadogiannakis Nikos , Kartus Jüri-Toomas 
Published: May 2021

Abstract
Background
Despite gluteus medius (GMED) tendinosis being relatively common, its presence in association with hip osteoarthritis (OA) or total hip arthroplasty (THA) is not well studied. It was hypothesized that more tendon degeneration would be found in patients with OA of the hip and in those that had undergone THA than that in a control group.

Methods
One hundred patients were included between 2016 and 2019 and were included into 4 groups; the patients were undergoing revision surgery in two groups and primary THA in the other two groups; 22 patients had previously undergone primary THA through a direct lateral approach (involving sectioning of the GMED tendon), 24 patients had previously undergone primary THA through a posterior approach (leaving the GMED tendon intact), 29 patients had primary hip OA, and 25 patients who suffered a femoral neck fracture served as controls. Biopsies from the GMED tendon were obtained at the time of the primary THA or the hip revision surgery. The tendon biopsies were examined ultrastructurally and histologically.

Results
Ultrastructurally, the direct lateral and posterior revision groups had statistically significantly more collagen fibrils with smaller diameters compared with the fracture and primary THA groups. Moreover, the direct lateral revision group had more collagen fibrils with smaller diameters compared with the posterior revision group.
Histologically, the direct lateral revision group had a higher total degeneration score (TDS) compared with the primary hip OA group.

Conclusions
The GMED tendon shows more ultrastructural degeneration in patients who undergo hip revision arthroplasty than in patients with primary OA of the hip and control patients, who had suffered a femoral neck fracture. Furthermore, patients who had previously undergone primary THA through a direct lateral approach revealed more histological GMED tendon degeneration than patients who suffer primary hip OA.
A systematic and meta-analysis review on the diagnostic accuracy of antibodies in the serological diagnosis of COVID-19
Authors: Vengesai Arthur , Midzi Herald , Kasambala Maritha , Mutandadzi Hamlet , Mduluza-Jokonya Tariro L. , Rusakaniko Simbarashe , Mutapi Francisca , Naicker Thajasvarie , Mduluza Takafira 
Published: May 2021

Abstract
Background
Serological testing based on different antibody types are an alternative method being used to diagnose SARS-CoV-2 and has the potential of having higher diagnostic accuracy compared to the current gold standard rRT-PCR. Therefore, the objective of this review was to evaluate the diagnostic accuracy of IgG and IgM based point-of-care (POC) lateral flow immunoassay (LFIA), chemiluminescence enzyme immunoassay (CLIA), fluorescence enzyme-linked immunoassay (FIA) and ELISA systems that detect SARS-CoV-2 antigens.

Method
A systematic literature search was carried out in PubMed, Medline complete and MedRxiv. Studies evaluating the diagnostic accuracy of serological assays for SARS-CoV-2 were eligible. Study selection and data-extraction were performed by two authors independently. QUADAS-2 checklist tool was used to assess the quality of the studies. The bivariate model and the hierarchical summary receiver operating characteristic curve model were performed to evaluate the diagnostic accuracy of the serological tests. Subgroup meta-analysis was performed to explore the heterogeneity.

Results
The pooled sensitivity for IgG (n = 17), IgM (n = 16) and IgG-IgM (n = 24) based LFIA tests were 0.5856, 0.4637 and 0.6886, respectively compared to rRT-PCR method. The pooled sensitivity for IgG (n = 9) and IgM (n = 10) based CLIA tests were 0.9311 and 0.8516, respectively compared to rRT-PCR. The pooled sensitivity the IgG (n = 10), IgM (n = 11) and IgG-IgM (n = 5) based ELISA tests were 0.8292, 0.8388 and 0.8531 respectively compared to rRT-PCR. All tests displayed high specificities ranging from 0.9693 to 0.9991. Amongst the evaluated tests, IgG based CLIA expressed the highest sensitivity signifying its accurate detection of the largest proportion of infections identified by rRT-PCR. ELISA and CLIA tests performed better in terms of sensitivity compared to LFIA. IgG based tests performed better compared to IgM except for the ELISA.

Conclusions
We report that IgG-IgM based ELISA tests have the best overall diagnostic test accuracy. Moreover, irrespective of the method, a combined IgG/IgM test seems to be a better choice in terms of sensitivity than measuring either antibody type independently. Given the poor performances of the current LFIA devices, there is a need for more research on the development of highly sensitivity and specific POC LFIA that are adequate for most individual patient applications and attractive for large sero-prevalence studies.

Systematic review registration
PROSPERO CRD42020179112
An accurate approach based on the orthonormal shifted discrete Legendre polynomials for variable-order fractional Sobolev equation
Authors: Heydari M. H. , Atangana A. 
Published: May 2021

AbstractThis paper applies the Heydari–Hosseininia nonsingular fractional derivative for defining a variable-order fractional version of the Sobolev equation. The orthonormal shifted discrete Legendre polynomials, as an appropriate family of basis functions, are employed to generate an operational matrix method for this equation. A new fractional operational matrix related to these polynomials is extracted and employed to construct the presented method. Using this approach, an algebraic system of equations is obtained instead of the original variable-order equation. The numerical solution of this system can be found easily. Some numerical examples are provided for verifying the accuracy of the generated approach.
Adapting a neuroscience-informed intervention to alter reward mechanisms of anorexia nervosa: a novel direction for future research
Authors: Haynos Ann F. , Anderson Lisa M. , Askew Autumn J. , Craske Michelle G. , Peterson Carol B. 
Published: May 2021

AbstractAccumulating psychobiological data implicate reward disturbances in the persistence of anorexia nervosa (AN). Evidence suggests that individuals with AN demonstrate decision-making deficits similar to those with mood and anxiety disorders that cause them to under-respond to many conventionally rewarding experiences (e.g., eating, interacting socially). In contrast, unlike individuals with other psychiatric disorders, individuals with AN simultaneously over-respond to rewards associated with eating-disorder behaviors (e.g., restrictive eating, exercising). This pattern of reward processing likely perpetuates eating-disorder symptoms, as the rewards derived from eating-disorder behaviors provide temporary relief from the anhedonia associated with limited responsivity to other rewards. Positive Affect Treatment (PAT) is a cognitive-behavioral intervention designed to target reward deficits that contribute to anhedonia in mood and anxiety disorders, including problems with reward anticipation, experiencing, and learning. PAT has been found to promote reward responsivity and clinical improvement in mood and anxiety disorders. This manuscript will: (1) present empirical evidence supporting the promise of PAT as an intervention for AN; (2) highlight nuances in the maintaining processes of AN that necessitate adaptations of PAT for this population; and (3) suggest future directions in research on PAT and other reward-based treatments that aim to enhance clinical outcomes for AN.
The landscape of bispecific T cell engager in cancer treatment
Authors: Zhou Shujie , Liu Mingguo , Ren Fei , Meng Xiangjiao , Yu Jinming 
Published: May 2021

AbstractT cell-based immunotherapies have revolutionized treatment paradigms in various cancers, however, limited response rates secondary to lack of significant T-cell infiltration in the tumor site remain a major problem. To address this limitation, strategies for redirecting T cells to treat cancer are being intensively investigated, while the bispecific T cell engager (BiTE) therapy constitutes one of the most promising therapeutic approaches. BiTE is a bispecific antibody construct with a unique function, simultaneously binding an antigen on tumor cells and a surface molecule on T cells to induce tumor lysis. BiTE therapy represented by blinatumomab has achieved impressive efficacy in the treatment of B cell malignancies. However, major mechanisms of resistance to BiTE therapy are associated with antigen loss and immunosuppressive factors such as the upregulation of immune checkpoints. Thus, modification of antibody constructs and searching for combination strategies designed to further enhance treatment efficacy as well as reduce toxicity has become an urgent issue, especially for solid tumors in which response to BiTE therapy is always poor. In particular, immunotherapies focusing on innate immunity have attracted increasing interest and have shown promising anti-tumor activity by engaging innate cells or innate-like cells, which can be used alone or complement current therapies. In this review, we depict the landscape of BiTE therapy, including clinical advances with potential response predictors, challenges of treatment toxicity and resistance, and developments of novel immune cell-based engager therapy.
Interspecific and intraspecific foraging differentiation of neighbouring tropical seabirds
Authors: Austin R. E. , De Pascalis F. , Votier S. C. , Haakonsson J. , Arnould J. P. Y. , Ebanks-Petrie G. , Newton J. , Harvey J. , Green J. A. 
Published: May 2021

AbstractBackgroundSocial interactions, reproductive demands and intrinsic constraints all influence foraging decisions in animals. Understanding the relative importance of these factors in shaping the way that coexisting species within communities use and partition resources is central to knowledge of ecological and evolutionary processes. However, in marine environments, our understanding of the mechanisms that lead to and allow coexistence is limited, particularly in the tropics.MethodsUsing simultaneous data from a suite of animal-borne data loggers (GPS, depth recorders, immersion and video), dietary samples and stable isotopes, we investigated interspecific and intraspecific differences in foraging of two closely-related seabird species (the red-footed booby and brown booby) from neighbouring colonies on the Cayman Islands in the Caribbean.ResultsThe two species employed notably different foraging strategies, with marked spatial segregation, but limited evidence of interspecific dietary partitioning. The larger-bodied brown booby foraged within neritic waters, with the smaller-bodied red-footed booby travelling further offshore. Almost no sex differences were detected in foraging behaviour of red-footed boobies, while male and female brown boobies differed in their habitat use, foraging characteristics and dietary contributions. We suggest that these behavioural differences may relate to size dimorphism and competition: In the small brown booby population (n < 200 individuals), larger females showed a higher propensity to remain in coastal waters where they experienced kleptoparasitic attacks from magnificent frigatebirds, while smaller males that were never kleptoparasitised travelled further offshore, presumably into habitats with lower kleptoparasitic pressure. In weakly dimorphic red-footed boobies, these differences are less pronounced. Instead, density-dependent pressures on their large population (n > 2000 individuals) and avoidance of kleptoparasitism may be more prevalent in driving movements for both sexes.ConclusionsOur results reveal how, in an environment where opportunities for prey diversification are limited, neighbouring seabird species segregate at-sea, while exhibiting differing degrees of sexual differentiation. While the mechanisms underlying observed patterns remain unclear, our data are consistent with the idea that multiple factors involving both conspecifics and heterospecifics, as well as reproductive pressures, may combine to influence foraging differences in these neighbouring tropical species.
Artificial intelligence paradigm for ligand-based virtual screening on the drug discovery of type 2 diabetes mellitus
Authors: Bustamam Alhadi , Hamzah Haris , Husna Nadya A. , Syarofina Sarah , Dwimantara Nalendra , Yanuar Arry , Sarwinda Devvi 
Published: May 2021

Abstract
Background
New dipeptidyl peptidase-4 (DPP-4) inhibitors need to be developed to be used as agents with low adverse effects for the treatment of type 2 diabetes mellitus. This study aims to build quantitative structure-activity relationship (QSAR) models using the artificial intelligence paradigm. Rotation Forest and Deep Neural Network (DNN) are used to predict QSAR models. We compared principal component analysis (PCA) with sparse PCA (SPCA) as methods for transforming Rotation Forest. K-modes clustering with Levenshtein distance was used for the selection method of molecules, and CatBoost was used for the feature selection method.

Results
The amount of the DPP-4 inhibitor molecules resulting from the selection process of molecules using K-Modes clustering algorithm is 1020 with logP range value of -1.6693 to 4.99044. Several fingerprint methods such as extended connectivity fingerprint and functional class fingerprint with diameters of 4 and 6 were used to construct four fingerprint datasets, ECFP_4, ECFP_6, FCFP_4, and FCFP_6. There are 1024 features from the four fingerprint datasets that are then selected using the CatBoost method. CatBoost can represent QSAR models with good performance for machine learning and deep learning methods respectively with evaluation metrics, such as Sensitivity, Specificity, Accuracy, and Matthew’s correlation coefficient, all valued above 70% with a feature importance level of 60%, 70%, 80%, and 90%.

Conclusion
The K-modes clustering algorithm can produce a representative subset of DPP-4 inhibitor molecules. Feature selection in the fingerprint dataset using CatBoost is best used before making QSAR Classification and QSAR Regression models. QSAR Classification using Machine Learning and QSAR Classification using Deep Learning, each of which has an accuracy of above 70%. The QSAR RFC-PCA and QSAR RFR-PCA models performed better than QSAR RFC-SPCA and QSAR RFR-SPCA models because QSAR RFC-PCA and QSAR RFR-PCA models have more effective time than the QSAR RFC-SPCA and QSAR RFR-SPCA models.
The pedagogy of experience complexity for smart learning: considerations for designing urban digital citizen learning activities
Authors: Lister Pen 
Published: May 2021

AbstractThe Pedagogy of Experience Complexity for Smart Learning (PECSL) is a four-tier model of considerations for the design and development of learning activities situated in real world hyperlocal locations, mediated by smart enough technologies. Learner experience is placed at the centre of learning design, focusing on the complex interrelated experiences that may be possible. A wider awareness of types of learning may enhance potential for gaining value for learners and offer more flexibility for instructors or others. Learning is considered as any potential object of vital interest for the learner, and may include making connections with others, dialogic space expansion between learners and wider relevance of topic or location as much as any intended learning outcome.Taking inspiration from digital artefact user centred design, the PECSL adopts a position of flexible layers of considerations that impact stages of design for complex smart learning activities. Each tier being interrelated to the others, these iteratively adapting as a result of decisions being made throughout the design and development process. Categories of learner experience variation derived from a phenomenographic study of smart learning journeys inform the foundation of the PECSL, providing concepts of experience relevance structures leading to related pedagogies, further pedagogical relevance considerations and deeper epistemological reflections. Acknowledging significance of the context, process and content of learning in these activities, considerations expand to enable pragmatic support for much of value towards effective learning. This paper seeks to provide a means for learners to learn from each other as much as any specified learning goals or assessment.
Successful surgical rescue of delayed onset diaphragmatic hernia following radiofrequency ablation using a thoracoscopic approach for hepatocellular carcinoma: a case report
Authors: Morito Atsushi , Nakagawa Shigeki , Imai Katsunori , Uemura Norio , Okabe Hirohisa , Hayashi Hiromitsu , Yamashita Yo-ichi , Chikamoto Akira , Baba Hideo 
Published: May 2021

Abstract
Background
Radiofrequency ablation (RFA) is widely used as a minimally invasive treatment for hepatocellular carcinoma (HCC). RFA has a low risk of complications, especially compared with liver resection. Nevertheless, various complications have been reported after RFA for HCC; however, diaphragmatic hernia (DH) is extremely rare.

Case presentation
A 78-year-old man underwent thoracoscopic RFA for HCC located at the medial segment adjacent to the diaphragm approximately 7 years before being transported to the emergency department due complaints of nausea and abdominal pain. Computed tomography revealed a prolapsed small intestine through a defect in the right diaphragm, and emergency surgery was performed. The cause of diaphragmatic hernia was the scar of RFA. We confirmed that the small intestine had prolapsed into the right diaphragm, and we resected the necrotic small intestine and repaired the right diaphragm. Herein, we report a case of ileal strangulation due to diaphragmatic hernia after thoracoscopic RFA.

Conclusions
Care should be taken when performing thoracoscopic RFA, especially for tumors located on the liver surface adjacent to the diaphragm. Patients should be carefully followed up for possible DH, even after a long postoperative interval.